- Injuries are the leading cause of death among children ages one to 14 in the United States.
- A first-of-its-kind study shows that numerous off-premise alcohol outlets in neighborhoods can reduce overall guardianship of children's activities, leading to increased injuries.
Childhood injuries constitute a serious issue in the United States. In 2001, there were 12,249 deaths among children ages one to 14: injuries were the leading cause, accounting for 33.2 percent of all deaths for children ages one to four, and 39.4 percent of all deaths for children ages five to 14. A new study has found that numerous off-premise alcohol outlets in neighborhoods can reduce overall guardianship of children's activities, leading to increased injuries.
Results will be published in the November issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Neighborhood areas with high levels of social disorganization can make the children who live there more vulnerable to injury in a number of ways," explained Bridget Freisthler, assistant professor in the department of social welfare at the University of California, Los Angeles (UCLA) and affiliated research scientist at the Prevention Research Center, Pacific Institute for Research and Evaluation (PRC/PIRE). This research was a joint project between UCLA and PRC/PIRE.
"Impoverished and disorganized neighborhoods may present more physically dangerous environments," said Freisthler. "Limited social capital restricts their ability to respond to social problems that might endanger children's health and well being. Reduced levels of social control may facilitate risky behaviors, such as playing in dangerous streets or vacant buildings. And, areas that have fewer adults available to monitor and supervise children's activities may further exacerbate problem behaviors."
"One's neighborhood environment determines the number and type of risks a resident of a particular neighborhood will be exposed to," agreed Richard Scribner, D'Angelo Professor of Alcohol Research at the Louisiana State University School of Public Health. "This study supports the conceptual model that views the neighborhood environment as an essential component in contributing to population health."
Freisthler and her colleagues analyzed aggregate data collected for the year 2000 on populations and environments in 1,646 California zip code areas, examining connections with numbers of hospital discharges for childhood injuries from accidents and assaults, and injuries related to child abuse.
They found that neighborhoods with a higher density of off-premise alcohol outlets - such as liquor stores and grocery stores that sell alcohol - had more injuries among children.
"Those neighborhoods with an already weakened structure may have a limited ability to deal with the negative effects related to high densities of alcohol outlets in their community," explained Freisthler. "First, greater densities of off-premise alcohol outlets may increase the frequency of drinking among parents at home, undermining their ability to adequately supervise their children's activities. Second, greater densities may increase the number of people who travel in and out of the neighborhood to shop or dine at restaurants, making it more difficult for residents to know who lives in the area and who is just conducting business there. Thus, other adults in the area may be less likely to intervene when they see unsupervised children playing."
"The most surprising outcome was the association with percent [of African-American residents,]" added Scribner. "It is also the most difficult to interpret. There is increasing interest in the role of black residential segregation in terms of neighborhood risk because a white and a black neighborhood with similar measured socioeconomic conditions may be very different due to environmental risks."
"This study shows that the effects of high concentrations of alcohol outlets are more far reaching than previously thought," said Freisthler. "Specific findings indicate that costs associated with injuries among children could be reduced if outlet densities were more carefully controlled. It is important to emphasize that these injuries are only one measurable outcome of the kind of lack of supervision and support that seems to occur in these disordered neighborhoods with high alcohol-outlet densities."
"Given the difficulty in [implementing] policies to modify neighborhood environments in an effort to address population health, it is a sad fact that outcomes like child abuse and child assault are more likely to get the attention of policymakers," noted Scribner. "Children are perceived as innocent and therefore it is unjust for them to be exposed to greater risk. In this vein, the study may [encourage] policymakers to experiment with targeting the neighborhood environment to address problems like child abuse, accidents, and assault."
Freisthler certainly hopes her findings will lead in that direction. "Decisions about licensing and location of alcohol outlets have important ramifications," she said. "They affect the quality of life, the relationships among neighbors, levels of crime, and the safety of all of us. Obviously, we want policy makers to pay attention to these findings. But they are also important for average citizens to understand."
"This research clearly suggests it [really] does take a village to keep our children safe," added Scribner. "So, get involved in your neighborhood. Develop informal social ties with neighbors. Make sure [that businesses] like alcohol outlets are accountable to the residents. Keep your eyes on the street. Sit on the front porch or take walks and get to know your neighborhood."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "An Ecological Assessment of the Population and Environmental Correlates of Childhood Accident, Assault and Child Abuse Injuries," were: Paul J. Gruenewald and Elizabeth A. LaScala of the Prevention Research Center at the Pacific Institute for Research and Evaluation; and Lori Ring of the UCLA Department of Social Welfare. The study was funded by the National Institute on Alcohol Abuse and Alcoholism.