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Epidemiol Health > Accepted Articles
Epidemiology and Health 2019;e2019041.
DOI: https://doi.org/10.4178/epih.e2019041    [Accepted] Published online Oct 8, 2019.
Alcohol-related emergency department visits and income inequality in New York City, United States: an ecological study
Kathleen Heather Reilly  , Katherine Bartley, Denise Paone, Ellenie Tuazon
New York City Department of Health and Mental Hygiene, Long Island City, United States
Correspondence  Kathleen Heather Reilly ,Tel: 1-347-396-7755, Email: kreilly3@health.nyc.gov
Received: Jul 27, 2019  Accepted after revision: Oct 8, 2019
Abstract
Purpose:
Previous research has found that greater income inequality across a variety of geographical areas is related to problematic alcohol use in the U.S. and NYC; these studies used self-reported data to assess alcohol use. This study examined the relationship between within-neighborhood income inequality and alcohol-related emergency department (ED) visits.
Method:
The study outcome was alcohol-related ED visit rate per 10,000 persons during 2010-2014 from the New York Statewide Planning and Research Cooperative System. The main predictor of interest was income inequality measured using the Gini coefficient from the American Community Survey (2010-2014) at the Public Use Microdata Area (PUMA)-level (n=55) in NYC. Variables associated with alcohol-related ED visits in bivariate analyses were considered for inclusion in a multivariable model.
Results:
There were 420,568 alcohol-related ED visits with a valid NYC address between 2010-2014. The overall annualized NYC alcohol-related ED visit rate was 100.7 per 10,000 persons. The median alcohol ED visit rate for NYC PUMAs was 88.0 per 10,000 persons (IQR: 64.5, 133.5) and the median Gini coefficient was 0.48 (IQR: 0.45, 0.51). In the multivariable model, neighborhood higher Gini coefficient, lower median age, and lower percentage male residents were independently associated with alcohol-related ED visits.
Conclusions:
This study found that higher neighborhood income inequality was associated with higher neighborhood alcohol visit rates. The precise mechanism for this relationship is not understood and further investigation is warranted to determine temporality and if results are generalizable to other locales.
Keywords: socioeconomic factors; alcohol drinking; urban health
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