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Int. J. Environ. Res. Public Health 2019, 16(8), 1346; https://doi.org/10.3390/ijerph16081346

Using Rural–Urban Continuum Codes (RUCCS) to Examine Alcohol-Related Motor Vehicle Crash Injury and Enforcement in New York State

1
Departments of Epidemiology and Health Policy and Management and Center for Injury Epidemiology and Prevention at Columbia, Columbia University, New York, NY 10032, USA
2
Bureau of Occupational Health and Injury Prevention, New York State Department of Health, Albany, NY 12237, USA
3
Department of Epidemiology, Columbia University, New York, NY 10032, USA
4
Department of Biostatistics, Columbia University, New York, NY 10032, USA
*
Author to whom correspondence should be addressed.
Received: 5 March 2019 / Revised: 8 April 2019 / Accepted: 10 April 2019 / Published: 15 April 2019
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Abstract

Rural areas of New York State (NYS) have higher rates of alcohol-related motor vehicle (MV) crash injury than metropolitan areas. While alcohol-related injury has declined across the three geographic regions of NYS, disparities persist with rural areas having smaller declines. Our study aim was to examine factors associated with alcohol-related MV crashes in Upstate and Long Island using multi-sourced county-level data that included the Crash Outcome Data Evaluation System (CODES) with emergency department visits and hospitalizations, traffic citations, demographic, economic, transportation, alcohol outlets, and Rural–Urban Continuum Codes (RUCCS). A cross-sectional study design employed zero-truncated negative binominal regression models to assess relative risks (RR) with 95% confidence interval (CI). Counties (n = 57, 56,000 alcohol-related crashes over the 3 year study timeframe) were categorized by mean annual alcohol-related MV injuries per 100,000 population: low (24.7 ± 3.9), medium (33.9 ± 1.7) and high (46.1 ± 8.0) (p < 0.0001). In multivariable analyses, alcohol-related MV injury was elevated for non-adjacent, non-metropolitan counties (RR 2.5, 95% CI: 1.6–3.9) with higher citations for impaired driving showing a small, but significant protective effect. Less metropolitan areas had higher alcohol-related MV injury with inconsistent alcohol-related enforcement measures. In summary, higher alcohol-related MV injury rates in non-metropolitan counties demonstrated a dose–response relationship with proximity to a metropolitan area. These findings suggest areas where intervention efforts might be targeted to lower alcohol-related MV injury. View Full-Text
Keywords: rural health; motor vehicle crash; injury; alcohol; traffic citations and enforcement rural health; motor vehicle crash; injury; alcohol; traffic citations and enforcement
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Pressley, J.C.; Hines, L.M.; Bauer, M.J.; Oh, S.A.; Kuhl, J.R.; Liu, C.; Cheng, B.; Garnett, M.F. Using Rural–Urban Continuum Codes (RUCCS) to Examine Alcohol-Related Motor Vehicle Crash Injury and Enforcement in New York State. Int. J. Environ. Res. Public Health 2019, 16, 1346.

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