Alcohol availability and intimate partner violence among US couples

Abstract

Objectives: We examined the relation between alcohol outlet density (the number of alcohol outlets per capita by zip code) and male-to-female partner violence (MFPV) or female-to-male partner violence (FMPV). We also investigated whether binge drinking or the presence of alcohol-related problems altered the relationship between alcohol outlet density and MFPV or FMPV.

Methods: We linked individual and couple sociodemographic and behavioral data from a 1995 national population-based sample of 1,597 couples to alcohol outlet data and 1990 US Census sociodemographic information. We used logistic regression for survey data to estimate unadjusted and adjusted odds ratios between alcohol outlet density and MFPV or FMPV along with 95% confidence intervals (CIs) and p-values. We used a design-based Wald test to derive a p-value for multiplicative interaction to assess the role of binge drinking and alcohol-related problems.

Results: In adjusted analysis, an increase of one alcohol outlet per 10,000 persons was associated with a 1.03-fold increased risk of MFPV (p-value for linear trend = 0.01) and a 1.011-fold increased risk of FMPV (p-value for linear trend = 0.48). An increase of 10 alcohol outlets per 10,000 persons was associated with 34% and 12% increased risk of MFPV and FMPV respectively, though the CI for the association with FMPV was compatible with no increased risk. The relationship between alcohol outlet density and MFPV was stronger among couples reporting alcohol-related problems than those reporting no problems (p-value for multiplicative interaction = 0.01).

Conclusions: We found that as alcohol outlet density increases so does the risk of MFPV and that this relationship may differ for couples who do and do not report alcohol-related problems. Given that MFPV accounts for the majority of injuries related to intimate partner violence, policy makers may wish to carefully consider the potential benefit of limiting alcohol outlet density to reduce MFPV and its adverse consequences.

Fig. 1

Adjusted odds ratios and 95% confidence intervals of associations between total alcohol outlet density and male-to-female partner violence and female-to-male partner violence. (Odds ratios for MFPV were adjusted for male and female age, education level, employment status, and illicit drug use; couple level ethnicity, income, and marital status; and zip code level percent living in poverty and percent living in owner occupied homes. Odds ratios for FMPV were adjusted for the same factors as MFPV and also adjusted for zip code level percent with a high school degree and percent with a college degree.)

Fig. 2

Adjusted odds ratios and 95% confidence intervals of associations between alcohol outlet density and male-to-female partner violence among couples who did and did not report having alcohol-related problems across select levels of alcohol outlet density. (Odds ratios were adjusted for male and female age, education level, employment status, and illicit drug use; couple level ethnicity, income, and marital status; and zip code level percent living in poverty and percent living in owner occupied homes.)