Development of the International Alcohol Policy and Injury Index

OBJECTIVE: To develop a new index to measure the effectiveness of alcohol control policies on selected indicators of alcohol-related injuries. METHODS: We used the World Health Organization Global Information System on Alcohol and Health (GISAH) for cross-sectional data from 156 countries for this analysis. Five policy domains were selected: physical availability, drinking context, pricing, advertising, and vehicular. Injury mortality and alcohol-attributable fractions (AAFs) for vehicular deaths were also used for the same countries. We created a new composite indicator, the International Alcohol Policy Injury Index (IAPII), in order to assess the association between policy and deaths due to alcohol-related injury. RESULTS: After we controlled for per-capita alcohol consumption, we found that injury deaths and AAF deaths were inversely associated with four of the five policy domains. The domains were weighted according to effectiveness and used to construct the IAPII, which produced acceptable sensitivity and specificity. Regression results, controlling for consumption, demonstrated that the IAPII was significantly associated with AAF vehicular injury death for males, AAF vehicular injury death for females, and overall injury death at p < 0.01. CONCLUSIONS: Our findings support the IAPII as a reliable indicator of the relationship between alcohol policies and injury deaths: the stronger the policy, the less the likelihood of both overall and vehicular injury death. Future work should test the effectiveness of the IAPII in reducing alcohol-related injury morbidity, which accounts for a larger share of the global burden of disease than alcohol-related injury mortality does.