Developing a Framework to Assess the Aggregate Alcohol Policy Environment in U.S. States

Background: Alcohol is a leading preventable cause of death in the U.S. While alcohol policies can reduce alcohol-related outcomes, most policies are studied individually. However, most policies are affected by the concurrent presence and adequacy of other policies. There has been no previous effort to characterize the aggregate alcohol policy environment in U.S. states. Methods: Policy selection, comparative policy effectiveness ratings for youth and adult outcomes, and within-policy implementation indices for 29 U.S. alcohol policies were developed with assistance from 10 alcohol policy experts using a modified Delphi process. Policy data from 1999-2011 were obtained from the Alcohol Policy Information System, the National Highway Traffic Safety Administration, the Tax Foundation, and other sources. By state and year, policies were weighted and aggregated based on their presence, theoretical effectiveness, and degree to which they were actually implemented. Results: This presentation will summarize the policy nomination and selection process, the comparative policy rating exercise, the development of within-policy implementation indices, and methods used to aggregate policies in the U.S. in order to characterize the policy environment by state and year in each of four domains: youth drinking, youth drinking and driving, adult binge drinking, and adult impaired driving. The descriptive epidemiology of state-specific policy scores in 2011 will be presented for the four aggregate policy domains. Conclusions: It is feasible to develop policy variables to characterize the aggregate alcohol policy environment in the U.S. Future analyses relating the policy environment to alcohol-related outcomes will be crucial for policy development and prevention efforts.