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      Association Between Socioeconomic and Demographic Characteristics and Non-fatal Alcohol-Related Injury in Maringá, Brazil

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          Background: Previous research has corroborated a high burden of alcohol-related injury in Brazil and the presence of socioeconomic disparities among the injured. Yet, individual-level data is scarce. To fill this gap, we examined the association between demographic and socioeconomic characteristics with non-fatal alcohol-related injury in Maringá, Brazil.

          Methods: We used household survey data collected during a 2015 cross-sectional study. We conducted univariate and multivariate analyses to evaluate associations of demographic (age, gender, race) and socioeconomic characteristics (employment, education, income) with non-fatal alcohol-related injury.

          Results: Of the 995 participants who reported injuries, 62 (6.26%) were alcohol-related. Fifty-three (85%) alcohol-related injuries were reported by males. Multivariate analysis indicated being male (OR = 5.98 95% CI = 3.02, 13.28), 15–29 years of age (OR = 3.62 95% CI = 1.72, 7.71), and identifying as Black (OR = 2.38 95% CI = 1.09, 4.95) were all significantly associated with increased likelihood of reporting an alcohol-related injury, whereas unemployment was significantly associated with decreased likelihood of reporting an alcohol-related injury (OR = 0.41 95% CI = 0.18, 0.88).

          Conclusion: Our findings suggest that in Maringá, being male, between the ages of 15 and 29, employed, or identifying as Black were characteristics associated with a higher risk for non-fatal alcohol-related injury. Individual level data, such as ours, should be considered in combination with area-level and country-level data when developing evidence-based public-health policies.

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          Most cited references 54

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          The validity of self-reports of alcohol consumption: state of the science and challenges for research.

          To review three topics pertaining to the validity of alcohol self-reports: factors that influence response accuracy; the relative merits of different self-report approaches; and the utility of using alternative measures to confirm verbal reports. Response behavior is influenced by the interaction of social context factors, respondent characteristics, and task attributes. Although research has advanced our knowledge about self-report methods, many questions remain unanswered. In particular, there is a need to investigate how task demands interact with different patterns of drinking behavior to affect response accuracy. There is also a continuing need to use multiple data sources to examine the extent of self-report response bias, and to determine whether it varies as a function of respondent characteristics or assessment timing. Self-report methods offer a reliable and valid approach to measuring alcohol consumption. The accuracy of such methods, however, can be improved by research directed at understanding the processes involved in response behavior.
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            Socioeconomic status and injury mortality: individual and neighbourhood determinants.

            This study examined both individual and neighbourhood correlates of injury mortality to better understand the contribution of socioeconomic status to cause specific injury mortality. Of particular interest was whether neighbourhood effects remained after adjusting for individual demographic characteristics and socioeconomic status. Census tract data (measuring small area socioeconomic status, racial concentration, residential stability, urbanisation, and family structure) was merged with the National Health Interview Survey (NHIS) and a file that links the respondents to subsequent follow up of vital status and cause of death data. Cox proportional hazards models were specified to determine individual and neighbourhood effects on homicide, suicide, motor vehicle deaths, and other external causes. Variances are adjusted for the clustered sample design of the NHIS. United States, 1987-1994, with follow up to the end of 1995. From a sample of 472 364 persons ages 18-64, there were 1195 injury related deaths over the follow up period. Individual level effects were generally robust to the inclusion of neighbourhood level variables in the models. Neighbourhood characteristics had independent effects on the outcome even after adjustment for individual variability. For example, there was approximately a twofold increased risk of homicide associated with living in a neighborhood characterised by low socioeconomic status, after adjusting for individual demographic and socioeconomic characteristics. Social inequalities in injury mortality exist for both persons and places. Policies or interventions aimed at preventing or controlling injuries should take into account not only the socioeconomic characteristics of people but also of the places in which they live.
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                Author and article information

                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                25 March 2020
                : 8
                1Duke Global Health Institute, Duke University , Durham, NC, United States
                2Division of Emergency Medicine, Duke University Medical Center , Durham, NC, United States
                3Department of Nursing, State University of Maringá , Maringá, Brazil
                4Department of Medicine, Ingá University Center , Maringá, Brazil
                Author notes

                Edited by: Ahmed Mohamed, University of Arizona, United States

                Reviewed by: Guoqing Hu, Central South University, China; Jasmina Burdzovic Andreas, Norwegian Institute of Public Health, Norway

                *Correspondence: Catherine Staton catherine.staton@

                This article was submitted to Epidemiology, a section of the journal Frontiers in Public Health

                Copyright © 2020 El-Gabri, Toomey, Gil, de Oliveira, Calvo, Tchuisseu, Williams, Andrade, Vissoci and Staton.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 63, Pages: 8, Words: 6086
                Funded by: Fogarty International Center 10.13039/100000061
                Public Health
                Original Research

                injury, socioeconomic, demographic, alcohol, brazil


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