Alcohol and fatal injury: The use of routinely collected fatality data in community prevention evaluation

Background: This study analyzed patterns of alcohol involvement among coron ers' cases (which typically include blood alcohol content information) to d evelop a method for weighting death-certificate cases (which typically do n ot include blood alcohol content information) for likelihood of alcohol inv olvement for purposes of alcohol-involved injury intervention evaluation. Methods: The coroners' data analyzed here were collected from four Californ ia communities and correspond to all injury coroner cases between 1987 and 1996 in those communities. The death-certificate data were provided by the State of California, Department of Health Services, and correspond to all i njury deaths occurring in that state between 1980 and 1996. Each injury fat ality in the death-certificate data was assigned a probability of alcohol i nvolvement based upon the coroners' data. These were then summed to provide an estimate of, or "surrogate measure" for, the total number of alcohol-in volved fatal injuries per 10,000 California residents aggregated across the state of California by month for the period from January 1980 to 1996. As a test of this estimate, we examined its responsiveness to an intervention designed to reduce alcohol-involved injuries which was implemented in Calif ornia in 1990 using a time series analysis technique (ARIMA) that corrects for serial autocorrelation typically found in time ordered data. Results: This analysis found an effect during the postintervention period ( p = 0.046). An alternative model testing for intervention effects on all in jury fatalities did not find an effect. Conclusions: This surrogate measure seems responsive to intervention effect s and may provide a useful tool for interventions designed to reduce alcoho l-involved injuries.