title: Alcohol-related injury death and alcohol availability in remote Alaska.
abstract: BACKGROUND
  Injury is a major public health problem in Alaska, and alcohol consumption and injury death are associated.
  
  
  OBJECTIVE
  To determine the association between injury death, particularly alcohol-related injury death, and alcohol availability in remote Alaska.
  
  
  METHODS
  Survey using death certificate data and medical examiner records to compare mortality rates for total injury and alcohol-related injury during 1990 through 1993 among Alaskans aged 15 years and older who had resided in remote villages of fewer than 1000 persons.
  
  
  METHODS
  Rate ratios of injury death among residents of wet villages (ie, those without a restrictive alcohol law) as compared with injury death among residents of dry villages (ie, those with laws that prohibited the sale and importation of alcohol).
  
  
  RESULTS
  Of 302 injury deaths, blood alcohol concentrations (BACs) were available for 200 deaths (66.2%). Of these, 130 (65.0%) had a BAC greater than or equal to 17 mmol/L (> or =80 mg/dL) and were, therefore, classified as alcohol related. The total injury mortality rate was greater among Alaska Natives from wet villages (rate ratio [RR],1.6; 95% confidence interval [CI], 1.3-2.1), whereas this difference was not present for nonnatives (RR, 1.1; 95% CI, 0.3-3.8). For Alaska Natives, the alcohol-related injury mortality rate was greater among residents of wet villages (RR, 2.7; 95% CI, 1.9-3.8) than among residents of dry villages. The strength of this association was greatest for deaths due to motor vehicle injury, homicide, and hypothermia.
  
  
  CONCLUSIONS
  Although insufficient data existed to adjust for the effects of all potential confounders, residence in a wet village was associated with alcohol-related injury death among Alaska Native residents of remote Alaska villages. These findings indicate that measures limiting access to alcoholic beverages in this region may decrease alcohol-related injury deaths.
authors.affiliation: Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Ga, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Landen
authors.forename: M
authors.initials: M
authors.lastname: Beller
authors.forename: E
authors.initials: E
authors.lastname: Funk
authors.forename: M
authors.initials: M
authors.lastname: Propst
authors.forename: J
authors.initials: J
authors.lastname: Middaugh
authors.forename: R L
authors.initials: RL
authors.lastname: Moolenaar
mesh_terms: D000059:Accidents / Q000401:mortality / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000413:Alaska / Q000453:epidemiology; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000097:blood / Q000453:epidemiology*; D000434:Alcoholic Beverages / Q000706:statistics & numerical data / Q000600:supply & distribution*; D000435:Alcoholic Intoxication / Q000453:epidemiology; D003132:Commerce; D004335:Drug and Narcotic Control; D000431:Ethanol / Q000097:blood; D005260:Female; D006801:Humans; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D009026:Mortality / Q000639:trends*; D014947:Wounds and Injuries / Q000097:blood / Q000209:etiology* / Q000401:mortality
chemical_list: D000431:Ethanol