Abstract
BACKGROUND: More than 40% of urban traffic fatalities are alcohol related and the rate of such fatalities varies more than 10-fold across U.S. cities. These variations might be explained by differences in local alcohol control policies and practices. METHODS: We conducted a cross-sectional survey of state Alcohol Beverage Control agencies and local city police departments in 107 cities that participate in the National Highway and Traffic Safety Administration's Fatality Analysis Reporting System. We examined the association of alcohol control practices in 1997 and alcohol-related traffic fatalities per daily vehicle miles traveled, 1995-1997. RESULTS: Ninety-seven (91%) cities participated. Regulations related to alcohol accessibility, licensure of alcohol outlets, disciplinary procedures of alcohol outlets, and enforcement of blood alcohol concentration laws were associated with lower rates of fatalities. Cities with 9 or fewer of the 20 regulations had 1.46-fold greater alcohol-related traffic fatality rates than cities with 15 or more of these regulations, representing 392 excess deaths annually. Beer consumption was found to be a potential mediator of the effect of regulations on traffic fatalities. CONCLUSIONS: Alcohol beverage regulations are associated with alcohol-related traffic fatalities. Localities should consider greater restrictions on alcohol accessibility, stricter disciplinary measures for violations, and stricter licensure requirements as a potential means to reduce alcohol-related traffic fatalities. Copyright 2002 American Health Foundation and Elsevier Science (USA).