Browsing by Author "Kerr, William C."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Quantifying risk of injury from usual alcohol consumption: An instrumental variable analysis
    (Wiley, 2021) Ye, Yu; Cherpitel, Cheryl J.; Terza, Joseph V.; Kerr, William C.; Economics, School of Liberal Arts
    Background: There have been numerous studies of roadside accidents among emergency room patients showing elevated risk of injury from acute alcohol consumption, i.e. recent drinking prior to the injury event, with large effect size and a dose-response relationship observed. In contrast, studies quantifying the association between injury risk and chronic consumption such as past year average volume show that relative risk estimates are low compared to those from acute consumption. Methods: Using the US National Alcohol Surveys (NAS) combining four waves for years 2000–2015 (N=29,571, 53% overall cooperation rate), risk of any past-year injury was first estimated by past-year volume using logistic regression. An instrumental variable (IV) analysis utilizing the two-stage residual inclusion (2SRI) approach was then conducted to estimate injury risk from volume, further adjusting for unobserved confounders, using state beer and spirits tax rates, zip code-level outlet and bar density, and control state status as instruments. Results: Based on the combined US population surveys and controlling for socio-demographics, odds ratios of injury from average volume of 1, 2 and 5 drinks per day were 1.12 [95% confidence interval: 1.02, 1.24], 1.10 [1.00, 1.22], and 1.04 [0.88, 1.22], respectively, using conventional logistic regression, compared to 1.67 [1.00, 2.78], 2.38 [0.87, 6.54] and 6.98 [0.57, 85.89] using the IV method. The proportion of injury attributed to alcohol also increased in magnitude, from 6.2% [0.3%, 11.9%] using the conventional approach to 17.9% [8.2%, 27.7%] using the IV method. Conclusions: Findings suggest that the association between injury and chronic alcohol consumption may be confounded by unobserved factors, with the risk estimate possibly biased downward.
  • Thumbnail Image
    Item
    U.S. Alcohol Affordability and Real Tax Rates, 1950–2011
    (Elsevier, 2013) Kerr, William C.; Paterson, Deidre; Greenfield, Thomas K.; Jones, Alison Snow; McGeary, Kerry Anne; Terza, Joseph V.; Ruhm, Christopher J.; Economics, School of Liberal Arts
    Background: The affordability of alcoholic beverages, determined by the relationship of prices to incomes, may be an important factor in relation to heavy drinking, but little is known about how affordability has changed over time. Purpose: To calculate real prices and affordability measures for alcoholic beverages in the U.S. over the period from 1950 to 2011. Methods: Affordability is calculated as the percentage of mean disposable income required to purchase 1 drink per day of the cheapest spirits, as well as popular brands of spirits, beer, and wine. Alternative income and price measures also are considered. Analyses were conducted in 2012. Results: One drink per day of the cheapest brand of spirits required 0.29% of U.S. mean per capita disposable income in 2011 as compared to 1.02% in 1980, 2.24% in 1970, 3.61% in 1960, and 4.46% in 1950. One drink per day of a popular beer required 0.96% of income in 2010 compared to 4.87% in 1950, whereas a low-priced wine in 2011 required 0.36% of income compared to 1.05% in 1978. Reduced real federal and state tax rates were an important source of the declines in real prices. Conclusions: Alcoholic beverages sold for off-premises consumption are more affordable today than at any time in the past 60 years; dramatic increases in affordability occurred particularly in the 1960s and 1970s. Declines in real prices are a major component of this change. Increases in alcoholic beverage tax rates and/or implementing minimum prices, together with indexing these to inflation could be used to mitigate further declines in real prices.