Relationships of State Alcohol Policy Environments with Homicides and Suicides

James P Murphy; Rosanna Smart; Terry L Schell; Nancy Nicosia; Timothy S Naimi

doi:10.1016/j.amepre.2024.04.002

Relationships of State Alcohol Policy Environments with Homicides and Suicides

Am J Prev Med. 2024 Apr 9:S0749-3797(24)00114-4. doi: 10.1016/j.amepre.2024.04.002. Online ahead of print.

Authors

James P Murphy¹, Rosanna Smart², Terry L Schell², Nancy Nicosia³, Timothy S Naimi⁴

Affiliations

¹ RAND Corporation, Santa Monica, CA. Electronic address: jpmurphy@rand.org.
² RAND Corporation, Santa Monica, CA.
³ RAND Corporation, Boston, MA.
⁴ Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.

PMID: 38604458
DOI: 10.1016/j.amepre.2024.04.002

Abstract

Introduction: Alcohol use is involved in a large proportion of homicides and suicides each year in the United States, but there is limited evidence on how policies targeting alcohol influence violence in the U.S.

Context: Extant studies generally focus on individual policies in isolation of each other. This study examines of the effects of changes in states' alcohol policy restrictions on overall homicide and suicide rates and firearm-related homicide and suicide rates using a holistic measure of states' alcohol policy environments.

Methods: Using a composite measure of state-level alcohol policies (Alcohol Policy Scale) and data from the National Vital Statistics System from 2002 to 2018, this study applied a Bayesian time series model to estimate the effects of alcohol policy changes on overall and firearm-involved homicide and suicide rates. The analysis was performed in 2023 and 2024.

Results: A one standard deviation change in the Alcohol Policy Scale was associated with a 6 percent decline in homicide rates both overall (IRR=0.94; 95-percent credibility interval = [0.89, 1.00]) and for firearm homicides specifically (IRR=0.94, 95-percent CI=[0.88, 1.01]). There was no clear association of alcohol policy with suicides. The model predicts that a nationwide increase in alcohol restrictions equivalent to a shift from the 25^th to 75^th percentile of the scale's distribution would result in almost 1200 fewer homicides annually.

Conclusions: Increases in the restrictiveness of state-level alcohol policies are associated with reductions in homicides. More restrictive alcohol policy environments may offer an opportunity to reduce homicides.