Neighborhood Access to Alcohol and the Risk of Suicide

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Neighborhood Access to Alcohol and the Risk of Suicide     

Jim Windell

             Is there an association between alcohol use and suicide?

            According to some research, there is such a link. That is, studies have found that both acute drinking and alcohol use disorder are associated with increased suicide risk – possibly because of behavioral inhibition, depressed mood or aggression.

           However, the relationship between alcohol use and suicide is complex, and, thus, is difficult to unravel. For instance, while the link between heavy drinking and suicidal behavior likely reflects genetic and environmental influences, what about the proximity of alcohol outlets?

           This question has been previously explored, but research has been inconclusive. But a new study, published recently in Alcohol: Clinical & Experimental Research, draws on the experiences of hundreds of thousands of individuals in Sweden. The intent of the study was to further explore the association between neighborhood alcohol outlets and suicide attempts and fatalities.

           Attempting to refine their study methods in several ways, the researchers examined individual risk rather than risk across the population. Also, in the study, they included both fatal and non-fatal outcomes, tested the effects of multiple types of alcohol outlet, and analyzed the data by sex. Furthermore, working with Swedish national databases relating to population, health, and the distribution of bars, nightclubs, and government alcohol stores (similar to state-run liquor outlets in the U.S.), they analyzed data on adults aged 18 to 25.

           Information on suicide attempts during two-year windows relating to four periods in the early 2000s was available for 347,900 to 420,000 women and 371,000 to 448,000 men (depending on the timeframe). The investigators also considered demographic factors (biological sex at birth, age, parent education, and neighborhood deprivation) and individuals’ aggregate genetic risk of suicidal behavior. They used statistical analysis to explore associations between neighborhood alcohol access, suicide attempts and other factors.

           What the scientists in this found were that a young adult living in a neighborhood with bars or government alcohol outlets had a slightly higher risk of suicidal behavior in the subsequent two years than those living further from alcohol retailers. Young adults with higher genetic liabilities for suicide attempts were slightly more susceptible to these exposures.

           Overall, government alcohol outlets were associated with an increased risk of suicide and suicide attempts (though not for all separate observation periods), especially among men. This tallies with previous studies showing that the effects of alcohol on suicide risk were limited to or driven by men. These study findings suggest that policies affecting a range of alcohol outlet types may help reduce suicidal behavior, especially among men and people with a genetic risk for suicide attempts. The authors recommend further study into the complex relationships between alcohol use, suicidal behavior, and other relevant factors.

           Yet, the findings remain somewhat perplexing. Across the four observation periods and the full sample of young adults, proximity to bars was linked to a higher risk of non-fatal suicide attempts and a lower risk of dying by suicide. These seemingly paradoxical results suggest that alcohol accessibility may differentially influence the risk for the two outcomes as such things as hours of operation, clientele age, and other factors need to be considered.

           To read the original article, find it with this reference:

Edwards, A. C., Ohlsson, H., Lannoy, S., Stephenson, M., Crump, C., Sundquist, J., ... & Sundquist, K. (2023). Exposure to alcohol outlets and risk of suicidal behavior in a Swedish cohort of young adults. Alcoholism: Clinical and Experimental Research.


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