Alcohol-related injury and young males

Malinda Steenkamp
James Harrison
Research Centre for Injury Studies (RCIS)

and

Steve Allsop
Next Step Specialist Drug and Alcohol Services

2002
Australian Institute of Health and Welfare
Canberra
AIHW cat. no. INJCAT 42

Injury Technical Paper Series Number 1

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Abstract

This report aims to describe what is known about the occurrence of alcohol related injury (ARI) in young males; to outline current knowledge about reducing ARI in young males; to highlight important gaps in the data; and to indicate ways forward.

Most knowledge about alcohol and injury in young males comes from the transport arena and, to a lesser extent, from research on violence. Transport, self-harm, falls, and violence are notable contributors to ARI deaths and hospitalisations. Leisure and recreation, violence, and ‘other’ household activities seem to make up a large proportion of ARI not resulting in death or hospitalisation. Research indicates that ARI peaks in young males aged 20 - 24 years and there seems to be a specific subgroup of young males that display a cluster of risk behaviour.

Few interventions specifically address ARI in young males. Current evidence comes mainly from the traffic arena where drink-driving has been addressed. Evidence shows a decline in alcohol-related motor vehicle crashes overall. A comprehensive strategy, which employed legislation, RBT, and ongoing reinforcement through the media, was the key. Other promising approaches to reduce alcohol-related road crashes in young males include low blood alcohol level laws, focusing on a sub-group of high-risk drivers, administrative per se laws, and installing ignition interlock devices.

Evidence about other approaches to reduce alcohol-related harm is increasing. Some strategies are to reduce alcohol availability by decreasing liquor outlet density and banning alcohol in some communities. Responsible beverage service practices and environmental strategies are useful, but seem most effective when combined with other approaches. Evidence from community trials aimed at reducing ARI is not unequivocal, but multi-pronged strategies seem most effective. Brief interventions are useful too.

The risk of injury is often associated with other health risks, which in turn are linked with alcohol use. Young people often engage in risk behaviour and involvement in one risk behaviour increases involvement in others. Interventions should address risk behaviour as a complex of health compromising behaviours. A combination of school-based programs, community wide cessation campaigns for adults, and a strong media component seem most successful.

ARI in young Aboriginal males deserve specific attention. These young males seem to be at increased risk for experiencing alcohol-related problems. A number of approaches have been employed to reduce ARI in Aboriginal people, but the impact on young males is unknown.

There is no simple solution to reduce ARI in young males. Community level interventions that incorporate a number of different effective approaches seem to offer most promise. Another useful avenue may be to focus on a syndrome of risk behaviour, rather than just on alcohol use.