%0 Journal Article %T Using Rural⁻Urban Continuum Codes (RUCCS) to examine alcohol-related motor vehicle crash injury and enforcement in New York State %J International journal of environmental research and public health %D 2019 %A Pressley, Joyce C. %A Hines, Leah M. %A Bauer, Michael J. %A Oh, Shin Ah %A Kuhl, Joshua R. %A Liu, Chang %A Cheng, Bin %A Garnett, Matthew F. %V 16 %N 8 %P e16081346-e16081346 %X Rural areas of New York State (NYS) have higher rates of alcohol-related motor vehicle (MV) crash injury than metropolitan areas. While alcohol-related injury has declined across the three geographic regions of NYS, disparities persist with rural areas having smaller declines. Our study aim was to examine factors associated with alcohol-related MV crashes in Upstate and Long Island using multi-sourced county-level data that included the Crash Outcome Data Evaluation System (CODES) with emergency department visits and hospitalizations, traffic citations, demographic, economic, transportation, alcohol outlets, and Rural-Urban Continuum Codes (RUCCS). A cross-sectional study design employed zero-truncated negative binominal regression models to assess relative risks (RR) with 95% confidence interval (CI). Counties (n = 57, 56,000 alcohol-related crashes over the 3 year study timeframe) were categorized by mean annual alcohol-related MV injuries per 100,000 population: low (24.7 ± 3.9), medium (33.9 ± 1.7) and high (46.1 ± 8.0) (p < 0.0001). In multivariable analyses, alcohol-related MV injury was elevated for non-adjacent, non-metropolitan counties (RR 2.5, 95% CI: 1.6-3.9) with higher citations for impaired driving showing a small, but significant protective effect. Less metropolitan areas had higher alcohol-related MV injury with inconsistent alcohol-related enforcement measures. In summary, higher alcohol-related MV injury rates in non-metropolitan counties demonstrated a dose-response relationship with proximity to a metropolitan area. These findings suggest areas where intervention efforts might be targeted to lower alcohol-related MV injury.

Language: en

%G en %I MDPI: Multidisciplinary Digital Publishing Institute %@ 1661-7827 %U http://dx.doi.org/10.3390/ijerph16081346