Both interpersonal violence (including homicide) and self-directed violence (including suicide) are the end result of a """"""""causative web"""""""" of contributing factors that includes alcohol, firearms, and risky neighborhoods. Nevertheless, injury reduction measures that focus on firearms can sometimes be protracted strategies that must contend with ambivalent political support and uncertain consequences. Because individuals may place themselves at risk simply by entering a neighborhood where alcohol is present, regardless of their consumption, alcohol may function as a strong, although sometimes indirect, contributor to violence committed with firearms. Moreover, the management of certain alcohol-related factors that contribute to violence are often politically easier to accomplish than the management of many firearms-related factors. One reasonable approach to the control of violent deaths due to firearms may be to focus on alcohol outlets. However, the ecological evidence that alcohol outlets produce violence remains conflicted. Localities interested in rezoning alcohol outlets for health reasons are similarly conflicted when deciding how best to proceed. Using Philadelphia County as a study site, a population-based case-control study will be conducted to better delineate the causal relationship between alcohol outlets and firearm violence. Cases of firearm injury will be compared with age, race, and gender-matched controls identified with random-digit dialing. This study will specifically aim to answer the following questions: (1) Does geographic proximity to alcohol outlets increase the risk of being injured with a firearm when compared to the genographic proximity of alcohol outlets?; and (3) Does geographic proximity to other non-residential land-uses, such as firearms dealers, fast food restaurants, or mini-markets, pose a differential risk of being injured with a firearm when compared to alcohol outlets? The proposed study will fill several gaps in knowledge that continue to limit the understanding of alcohol outlets and violence: (1) A comparison of individual and environmental risk factors for alcohol-related violence; (2) Determination of the influence of alcohol outlets on firearm violence; (3) Analysis of the influence of alcohol outlets on self-directed violence; (4) Analysis of the influence of alcohol outlets on violence using other non-residential land-uses for comparison; and (5) Analysis of the influence of alcohol outlets on violence using a case-control (and not ecological) study design. In this way, health policies to change the numbers and locations of alcohol outlets can become more certain, more effective, and more politically admissible.
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| Branas, Charles C; Culhane, Dennis; Richmond, Therese S et al. (2008) Novel Linkage of Individual and Geographic Data to Study Firearm Violence. Homicide Stud 12:298-320 |
