- freely available
2010, 7(4), 1855-1871; https://doi.org/10.3390/ijerph7041855
2. Behind the Neglect of Alcohol’s Harm to Others
3. Conceptualizing Alcohol’s Harm to Others
4. Relevant Comprehensive Approaches to Measuring Harms from Drinking
4.1. Survey Research Traditions
4.2. The Cost of Alcohol Tradition
5. Approaches to Studying Alcohol’s Harm to Others
- The fact of an occurrence, for instance, a death or a traffic crash, can be viewed as an indicator of harm for the person affected. Thus a count of deaths, or of years of life lost (YLLs) short of a full life, is one kind of metric of harm to the individual.
- Particularly in population survey data, the respondent’s report of an adverse occurrence—for example, something being broken or damaged that mattered to the respondent—is often used as an indication of harm to the respondent.
- The frequency and intensity of such harms can also be indicated by the respondent, for instance by asking how often it happened, and whether the adverse effect was a lot or a little.
- Another measure used of the degree of harm to the respondent can be in terms of the respondent’s report on items indicating a degree of wellbeing or of health disability (e.g., impact on health related quality of life, HRQoL), which can then be compared with the reports of others similarly situated.
- For harms where it is possible, a monetary measure of the amount of harm can be calculated. This can be measured in various frames of reference, depending on the harm: e.g., in terms of the wages which could have been earned in time which was lost, in terms of the loss of monetary value of something broken or damaged, in terms of the conventional monetary value assigned by econometric studies to an increment of health disability.
- In data drawn from population surveys, alcohol’s causal involvement in the harm is commonly measured directly by the attribution of the person affected. Thus a question like “How many times in the last 12 months were you physically hurt by them because of their drinking?” has built into the question an attribution (in a “yes” response) of the occurrence to the other’s drinking.
- For some harms, the alcohol attribution is commonly made by the personnel of the health or social response system—for instance, a child protection worker coding that the parent’s drinking is involved in a child endangerment case. Sometimes the attribution is built into the system’s categorization of the case—for instance, a Foetal Alcohol Syndrome diagnosis, or a “drunk and disorderly” arrest.
- For harms measured by the health system without any routine coding of alcohol involvement, meta-analyses of special studies have often relied on to measure an “alcohol attributable fraction” (AAF). AAFs are usually concerned with the drinking of the person with the illness, but it is possible to develop analogous fractions concerning the drinking of another, for instance, in estimating the proportion of child traffic deaths where another’s drinking played a causal role.
- In studying the effects of others’ drinking on personal wellbeing and health disability, the alcohol attribution can be imputed from differences in wellbeing or disability scores between those similarly situated who are affected by heavy drinkers and those who are not.
6. Getting the Right Focus in a Binocular View
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