Alcohol-related injury death and alcohol availability in remote Alaska

JAMA. 1997 Dec 3;278(21):1755-8.


Context: Injury is a major public health problem in Alaska, and alcohol consumption and injury death are associated.

Objective: To determine the association between injury death, particularly alcohol-related injury death, and alcohol availability in remote Alaska.

Design, setting, and participants: Survey using death certificate data and medical examiner records to compare mortality rates for total injury and alcohol-related injury during 1990 through 1993 among Alaskans aged 15 years and older who had resided in remote villages of fewer than 1000 persons.

Main outcome measures: Rate ratios of injury death among residents of wet villages (ie, those without a restrictive alcohol law) as compared with injury death among residents of dry villages (ie, those with laws that prohibited the sale and importation of alcohol).

Results: Of 302 injury deaths, blood alcohol concentrations (BACs) were available for 200 deaths (66.2%). Of these, 130 (65.0%) had a BAC greater than or equal to 17 mmol/L (> or =80 mg/dL) and were, therefore, classified as alcohol related. The total injury mortality rate was greater among Alaska Natives from wet villages (rate ratio [RR],1.6; 95% confidence interval [CI], 1.3-2.1), whereas this difference was not present for nonnatives (RR, 1.1; 95% CI, 0.3-3.8). For Alaska Natives, the alcohol-related injury mortality rate was greater among residents of wet villages (RR, 2.7; 95% CI, 1.9-3.8) than among residents of dry villages. The strength of this association was greatest for deaths due to motor vehicle injury, homicide, and hypothermia.

Conclusions: Although insufficient data existed to adjust for the effects of all potential confounders, residence in a wet village was associated with alcohol-related injury death among Alaska Native residents of remote Alaska villages. These findings indicate that measures limiting access to alcoholic beverages in this region may decrease alcohol-related injury deaths.

Publication types

  • Comparative Study

MeSH terms

  • Accidents / mortality
  • Accidents / statistics & numerical data
  • Adolescent
  • Adult
  • Alaska / epidemiology
  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / blood
  • Alcohol Drinking / epidemiology*
  • Alcoholic Beverages / statistics & numerical data
  • Alcoholic Beverages / supply & distribution*
  • Alcoholic Intoxication / epidemiology
  • Commerce
  • Drug and Narcotic Control*
  • Ethanol / blood
  • Female
  • Humans
  • Inuits / statistics & numerical data*
  • Male
  • Mortality / trends*
  • Wounds and Injuries / blood
  • Wounds and Injuries / etiology*
  • Wounds and Injuries / mortality


  • Ethanol