title: Global systematic review of Indigenous community-led legal interventions to control alcohol.
abstract: The national and subnational governments of most developed nations have adopted cost-effective regulatory and legislative controls over alcohol supply and consumption with great success. However, there has been a lack of scrutiny of the effectiveness and appropriateness of these laws in shaping the health-related behaviours of Indigenous communities, who disproportionately experience alcohol-related harm. Further, such controls imposed unilaterally without Indigenous consultation have often been discriminatory and harmful in practice.
  
  
  
  In this systematic review of quantitative evaluations of Indigenous-led alcohol controls, we aim to investigate how regulatory responses have been developed and implemented by Indigenous communities worldwide, and evaluate their effectiveness in improving health and social outcomes. We included articles from electronic databases MEDLINE, EMBASE, CINAHL, PsycINFO and Web of Science from inception to December 2015.
  
  
  
  Our search yielded 1489 articles from which 18 met the inclusion criteria. Controls were implemented in rural and remote populations of high-income nations. Communities employed a range of regulatory options including alcohol rationing, prohibition of sale, importation or possession, restrictions on liquor sold, times of sale or mode of sale, Indigenous-controlled liquor licensing, sin tax and traditional forms of control. 11 studies reported interventions that were effective in reducing crime, injury deaths, injury, hospitalisations or lowering per capita consumption. In six studies interventions were found to be ineffective or harmful. The results were inconclusive in one.
  
  
  
  Indigenous-led policies that are developed or implemented by communities can be effective in improving health and social outcomes.
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|The Australian Prevention Partnership Centre, Australia.
authors.forename: Janani
authors.initials: J
authors.lastname: Muhunthan
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|The Poche Centre for Indigenous Health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Blake
authors.initials: B
authors.lastname: Angell
authors.affiliation: The George Institute for Global Health, Sydney, Australia.
authors.forename: Maree L
authors.initials: ML
authors.lastname: Hackett
authors.affiliation: The Australian Prevention Partnership Centre, Australia.|Menzies Centre for Health Policy, University of Sydney, Sydney, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wilson
authors.affiliation: The George Institute for Global Health, Sydney, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Latimer
authors.affiliation: The George Institute for Global Health, Sydney, Australia.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Eades
authors.affiliation: The George Institute for Global Health, Sydney, Australia.|Sydney Medical School, University of Sydney, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000517:prevention & control*; D014943:Global Health; D033161:Government Regulation; D040261:Harm Reduction; D006291:Health Policy; D006293:Health Promotion; D006303:Health Services, Indigenous / Q000458:organization & administration; D054624:Health Status Disparities; D006801:Humans; D011050:Policy Making; D044382:Population Groups / Q000706:statistics & numerical data; D012424:Rural Population
keywords: Alcohol control; Indigenous health; Public health law