|
|
Since the topic of alcohol abuse and its attendant social harms are a
continuing part of the public conversation in Alaska, this article will
look at the various secondary data sources that can be used in examining
effectiveness of alcohol control policies. A number of agencies retain
data relevant to the impact of public policies involving alcohol, but
not all the data collections are solid—reliable and valid—for
research purposes. Considered below are the data collections assembled
by the police, public health agencies, and other entities such as the
state child protection and transportation departments. In addition to
describing each data source, this article discusses each in terms of whether
it provides statewide coverage, the extent to which it is complete, and
the level of geographic and temporal specificity it provides.
Data collections for examining alcohol control
efforts would ideally have the following characteristics: they would be
complete; they would measure associated harms at the community level;
they would be available for many years; and they would allow for measurement
of those harms on a weekly or monthly basis in order to capture the time
series effects of changes in policy. In Alaska, four different sources
meet these requirements to a useful extent: the Alaska Trauma Registry,
death certificate records from the Bureau of Vital Statistics, reports
of harm from the Office of Children’s Services, and traffic accident
records from the Department of Transportation. Data maintained by law
enforcement agencies are, in general, less useful when considered as a
means for understanding the impact of public alcohol policies.
Before examining the useful data sources,
this article will first consider the flaws in available police statistics.
Police Data Sources
There are two possible sources of police
statistics relevant to understanding the harm that results from the use
of alcohol in Alaska—the Uniform Crime Reports (UCR) and calls-for-service
records kept by individual police agencies. These sources share one major
shortcoming: although each is useful for understanding the harms that
occur in some jurisdictions in Alaska, neither is particularly useful
for making inter-community comparison measurements on a statewide basis.
Uniform Crime Reports
The Uniform Crime Reports are a standardized
record of offenses known to the police. For agencies in Alaska, these
records are available from the Inter-university Consortium for Political
and Social Research (ICPSR) for the years 1975 through 2001. The UCR provided
by the ICPSR are available on a month-by-month basis in 27 annual data
sets. The UCR includes measures of the so-called Part I offenses—the
serious criminal offenses of murder (and non-negligent manslaughter),
aggravated assault, forcible rape, robbery, burglary, motor vehicle theft,
and larceny theft. Also included are records of the number of simple assaults
recorded per police agency per month. For all of these Part I offenses
and simple assaults, the UCR record the number of offenses that have come
to the attention of the police and are considered to have actually occurred—that
is, the reports are not “unfounded.” The Part I offenses are
recorded whether or not an arrest is made for the offense.
For less serious offenses—generally
referred to as the Part II crimes—the UCR only provide records of
police arrests. These Part II crimes include many offenses often associated
with the use and abuse of alcoholic beverages: driving under the influence,
violations of liquor laws, public drunkenness, disorderly conduct, and
vagrancy. The ICPSR has available month-by-month UCR arrest records for
police agencies in Alaska only for the years 1998 through 2001. For earlier
indicators of arrests for Part II offenses by Alaskan police agencies
it is necessary to refer to the annual Crime in Alaska reports
issued by the Alaska Criminal Justice Planning Agency for the years 1976
through 1987 or to the annual Crime Reported in Alaska reports
issued by the Alaska Department of Public Safety for the years 1988 through
2002. The arrest statistics presented in these two reports are given by
individual agency. Available in hard copy through 2001 and online for
2002, the volumes can be obtained at University of Alaska libraries in
Anchorage or Fairbanks.
While many of the Part I offenses reported
in the UCR may be associated with alcohol use, in general the information
recorded does not permit a determination of the extent to which alcohol
use is actually involved in crimes occurring in a given jurisdiction.
The one exception to this rule is the Supplementary Homicide Reports (SHR)
assembled by the FBI. Also available through the ICPSR for the years 1975
through 2001, the SHR provide incident-based information on all criminal
homicides known to the police. Included in the SHR are the date of the
offense, victim and offender demographics, information on the victim-offender
relationship, weapons used, and, for the purposes of understanding the
role of alcohol in criminal violence, information on whether the circumstances
of the homicide involved a brawl due to the influence of alcohol.
Other than for homicide, most criminologists
are reluctant to use UCR data as a measure of how much crime there is.
They see the UCR data as lacking measurement validity (because the statistics
only measure a fraction of the crime that occurs in society) as well as
reliability (because the amount of crime that actually occurs that is
eventually measured by the UCR varies from jurisdiction to jurisdiction).
In addition to these usual misgivings, there are other reasons why the
UCR statistics lack utility when attempting to understand inter-community
variations in behaviors often associated with alcohol in Alaska. First
of all, the UCR are limited by a lack of geographic specificity in Alaska.
Secondly, the Alaska UCR data are somewhat incomplete because many police
agencies, especially those from the less urbanized areas of the state,
provide information to the FBI on a sporadic basis.
The lack of geographic specificity results
from the fact that the reports are made at the level of the individual
police agency rather than for specific geopolitical areas. For instance,
the UCR contains those crimes known to the North Slope Borough Police
Department—a broad level of aggregation. It is impossible to determine
which offenses occurred in Barrow, the borough seat, and which offenses
occurred in the seven other communities scattered across the approximately
90,000 square mile jurisdiction. This problem is even more conspicuous
for those communities policed by the Alaska State Troopers (AST)—about
a third (32%) of the state’s population, as shown in Figure 1. Although
these crimes are recorded in the UCR as offenses known to the Troopers,
most have been reported to the Troopers from one of roughly 90 second-class
cities or a similar number of unincorporated villages. Aggregation of
these police statistics at a level above that of individual cities and
villages masks theoretically important inter-community differences in
the amount of harm associated with alcohol.

The other problem with the use of Alaska
UCR data is that the data are incomplete on a time series basis. Many
agencies, particularly those serving jurisdictions with smaller numbers
of residents, report to the FBI only on a sporadic basis. The proportion
of the Alaska population covered by police agencies that reported UCR
statistics for a complete 12-month-year for the years 1975 through 2001
is shown in Figure 2. Overall, UCR crime statistics were reported to the
FBI for a complete 12 months for most of the Alaska population (annual
mean = 94%) during that time period. However, when the proportion of the
population for which UCR offenses were reported to the FBI is considered
for all police agencies except for the state’s two largest departments
(i.e., the AST and the Anchorage Police Department), the extent to which
the data are incomplete on a time series basis becomes apparent. Excluding
the population served by the Troopers or the Anchorage Police Department,
between 1975 and 2001, UCR crime statistics were reported to the FBI on
a complete 12-month basis by agencies serving roughly four-fifths (annual
mean = 78.5%) of the population. Particularly after 1994, these police
agencies were even less likely to report.

Illustrating the problem of incomplete
UCR data in the ICPSR holdings, the North Slope Borough Police Department
(NSBPD) did not report for any months during the three years 1996 through
1998. This gap is particularly unfortunate for those wishing to understand
the effects of local alcohol control policies. Residents of the North
Slope hub community of Barrow voted to allow alcohol possession in October
1995, then voted to ban possession in February 1996, only to allow possession
again in November 1997. A valid examination of the effect these changes
had upon alcohol-related violence across the North Slope Borough would
have provided compelling evidence regarding the effectiveness (or ineffectiveness)
of local prohibition.
Other police agencies serving hub communities
in northern and western Alaska are also infrequent in reporting UCR records
to the FBI. For example, the Unalaska Department of Public Safety, an
agency serving a primary fishing port and the hub for the Aleutian Islands,
went 17 years without reporting. The Nome and Kotzebue Police Departments
also have not reported UCR statistics for many years. For understanding
the effects of alcohol control policies, it is unfortunate that the police
agencies in these two communities have not reported recently because they
otherwise present potentially interesting comparisons. With similar population
sizes and traditional indigenous heritages, one primary difference between
the two communities is that Nome allows the local sale of alcohol and
has a number of bars while Kotzebue forbids the sale of alcohol within
city limits. Without complete UCR data, it is less possible to determine
if the differences in alcohol control policies in the two communities
translate into differences in rates of violent crimes associated with
alcohol use.
Calls-for-Service Records / Incident Reports
Calls-for-service records and incident
reports generated in the day-to-day operations of individual departments
provide a potential alternative to using the Uniform Crime Reports statistics.
As might be expected, the availability of these records varies considerably
along the lines of agency size and departmental resources. There are also
substantial differences in the validity and reliability of these calls-for-service
records.
The availability of calls-for-service records
from the agencies (not including police departments responsible for airports
and universities) recognized by the Alaska Police Standards Council (APSC)
in the latter part of 2003 is mixed. Although no systematic assessment
of these agencies’ record-keeping and dissemination capabilities
has been performed, it is probably safe to assume that, given the broad
range of population sizes they serve, some departments are more able than
others to be able to provide data for the purposes of studying violence
and other offenses associated with alcohol use. The larger departments
in the state, particularly those in Anchorage and Fairbanks, employ computer-assisted
dispatch technologies that allow for the production of geographically
and temporally specific data records amenable to a broad range of analytical
techniques. Use of these records in research is limited mostly by the
willingness of the agencies to share the information and by the ability
of record-keepers to manipulate proprietary software programs to produce
case-based data sets.
The incident reports produced by the Alaska
State Troopers are one good example of the records that could be useful
in alcohol research. Their records are available for the time period since
1990 from their headquarters in Anchorage, with each record listing the
location, date, and offense (if any) for every call for service received
by the Troopers. One important benefit of the Troopers’ incident
reports is that they allow for an examination of violent behavior and
liquor law violations in all areas of the state not covered by municipal
police departments. This coverage would include most, but not all, of
the Alaska Native villages located in the more isolated areas of the state.
The availability of case-based calls-for-service
records from smaller police departments is probably much more limited.
An analysis of information drawn from the Census of State and Local Law
Enforcement Agencies (CSLLEA) conducted by the Bureau of Justice Statistics
in 2000 shows that many small departments in Alaska probably lack the
resources to provide calls-for-service information in a format that would
be useful for research purposes. For instance, 6 of the 42 APSC member
departments responding to the CSLLEA had no full or part-time civilian
employees, while 7 departments had only 1 full or part-time civilian employee.
Typically in the more isolated areas of the state that are thought to
be especially troubled by the harms associated with alcohol use, these
departments are rather small, with an average of four sworn officers per
department responsible to a mean population of 1195 residents.
Even the calls-for-service records for the
larger police agencies more likely to be available for use in alcohol
research are potentially beset by problems of measurement validity and
reliability. One problem is that these records, as with most police crime
statistics, are social artifacts that are often more of an indication
of factors such as police presence and variations in the public’s
willingness to report offenses than a realistic measure of an underlying
amount of criminal behavior.
Public Health Data Sources
An alternative to Alaska police statistics
in considering the effects of alcohol control policies are the data available
from the state’s public health authorities. The two main data sources
are the records of traumatic injuries recorded in the Alaska Trauma Registry
and the death certificate records compiled by the Alaska Bureau of Vital
Statistics. The primary advantage of the public health data sources is
that their records are not subject to the biases of incomplete data and
differential reporting associated with the statistics produced by the
police.
Alaska Trauma Registry
Maintained within the Alaska Division
of Public Health, the Alaska Trauma Registry is a standardized, statewide
record of all injuries resulting in a hospital admission or declaration
of death in an emergency room. The data in the Alaska Trauma Registry
have been gathered since the beginning of 1991 for all 24 acute care hospitals
in the state. Information from the Alaska Trauma Registry is currently
available in electronic format at the level of the individual trauma case
for the years 1991 through 2000. Aggregation of individual trauma cases
information in the Alaska Trauma Registry provides for city/village level
indicators of harms associated with alcohol use, such as assault, suicide,
and unintentional injuries, which are available across multiple time frames.
The cases in the Alaska Trauma Registry could be used to consider the
effects of a broad range of alcohol control policies and efforts directed
toward the reduction of alcohol-related harm. For instance, a city could
examine the impact of its programs aimed at reducing underage drinking
by following trends in injuries to residents under the age of 21 years.
A broad range of information concerning
each individual trauma case is recorded in the Alaska Trauma Registry.
This includes information on treatment provided at the injury scene, by
those transporting the patient, and by emergency room physicians. It also
includes data on case outcomes such as the extent of disability resulting
from the injury and whether the case ended in death. For the purposes
of studying the effects of efforts to deal with alcohol-related problems,
the most important information in the Alaska Trauma Registry involves
(1) patient demographics, (2) injury specifics, and (3) alcohol and other
drug screening. The demographics in the Alaska Trauma Registry include
specifics on each patient’s age, sex, race/ethnicity, and home address.
Injury details include the cause-of-injury E-code, measures of injury
severity, and records on the date, time, city/village, and place (e.g.,
home, work, or public building) of injury. Records of the results of blood
alcohol content as measured by blood test or breathalyzer are also available
for a selected sample of cases.
A great deal of care has been taken to insure
that the Alaska Trauma Registry provides a valid representation of traumatic
injury in the state. Validation studies have been conducted on three different
occasions to determine the extent to which cases of traumatic injury actually
were recorded in the registry. Ninety-one percent of potential cases in
11 hospitals in 1994, 87 percent of potential cases in 6 hospitals in
1998, and 90 percent of potential cases in 11 hospitals in 1999 were eventually
recorded in the Alaska Trauma Registry database; hence, although there
are some gaps, the information that is recorded in the database is generally
complete.
Bureau of Vital Statistics Death Certificate Records
Death certificate records compiled by
the state Bureau of Vital Statistics (BVS) form another public health
data source that can be used to examine the effects of alcohol control
policies in Alaska. These records have value as a single data set in examining
the impact of control policies and also can be combined with the records
of the Alaska Trauma Registry for a complete data set to capture all cases
of injury, whether or not they resulted in emergency medical care. Included
in the BVS death certificate records are indicators of the dates of death
and injury, city/village of injury, city/village of residence, decedent’s
age, sex, and race, and the cause-of-injury E-code. They are available
on a case-by-case basis with records going back as far as 1980.
These death certificate records have been used in a number of studies
on the effectiveness of alcohol policies in Alaska. Matthew Berman, a
professor with the UAA Institute of Social and Economic Research, used
death certificate records to examine the effects of local alcohol prohibition
in isolated Alaska Native villages. A similar study, using cases from
both the death certificate records and the Alaska Trauma Registry, was
conducted by the author of this article to consider the impact of police
presence upon traumatic injury in Alaska Native villages where alcohol
is prohibited.
There are, however, some limitations to
the BVS death certificate records as measures of alcohol-related harms.
First, unlike the Alaska Trauma Registry, the death certificate records
do not include records for non-Alaska residents. Another problem is that,
except for those cases with specific alcohol-related cause-of-death E-codes,
the BVS death certificate records do not record whether the death was
alcohol or drug-related. It is necessary to examine individual death certificates
to obtain this information. The one other shortcoming of the BVS death
certificate records is that they are incomplete on a number of measures.
For deaths by traumatic injury, the death certificate records are missing
the place of injury in a tenth (9.9%) of cases and the date of injury
for roughly one of seven cases (14.1%). Otherwise, the records of violent
deaths are very comprehensive.
Less Useful Public Health Data Sources
Apart from the Alaska Trauma Registry
and the BVS death certificate records, the other statewide data sources
that could possibly be used for the study of alcohol-related harmful behaviors
are largely incomplete or limited to certain subsets of the population.
Among these less useful sources are Emergency Medical Services (EMS) records
and hospitalization records. The state only began to catalog EMS records
in 2001, and these records are not yet available for analysis. Once available,
however, they might be preferable over Alaska Trauma Registry records
because they would record those injuries that result in medical care but
do not require an overnight admission to the hospital (as is the case
with the trauma registry data). There is no statewide set of records for
hospitalizations for all Alaskans of all races/ethnicities. Such records
would have to be obtained on a hospital-by-hospital basis. However, hospitalization
and medical system records for Alaska Natives, roughly 18 percent of the
state population, are recorded in a centralized data system—the
Resource and Patient Management System (RPMS) kept by the Indian Health
Service. The extent to which these records are available for research
is unknown. Accessing them would require the approval of the IHS, the
Alaska Native Tribal Health Consortium, and other entities.
Other Data Sources
A couple of other data sources providing
statewide coverage also allow for inter-community comparisons of problems
associated with alcohol abuse. These include records of harm to children
from the state Office of Children’s Services (formerly Department
of Family and Youth Services) and records of traffic accidents from the
state Department of Transportation.
Reports of Harm to Children
The Alaska Office of Children’s Services
(OCS) records contain information on reported incidents of harm to children
and of substantiated cases of harm to children. These reports and cases
are recorded in a statewide, standardized, centralized data system in
the OCS office in Juneau. It is possible to obtain village/city level
records of reported incidents of harm and of substantiated cases of harm
through the OCS data system.
The OCS database contains cases going back
to 1990, but according to OCS’s data manager, these reports are
reliable only from 1994 forward. Records of cases of neglect, physical
abuse, mental injury, abandonment, and sexual abuse are available. The
temporal and geographic detail of the OCS reports available for research
is limited mainly by concerns over confidentiality and the willingness
of the state to make the data available. While it is possible for OCS
to produce a case-based data set that would permit the examination of
any preferred time at the village/city level, concerns over confidentiality
make it more likely that aggregated village/city level reports on a monthly
basis for each of the five different types of child mistreatment could
be obtained.
Three possible outcome measures for each
of the five types of harm to children can be obtained to examine the impact
upon child welfare of efforts to deal with alcohol-related problems. The
first of these, the reports of harm, include each report of an incident
of harm, substantiated or not, that comes to the attention of the OCS.
They are reports of incidents and, especially in the larger offices, may
include duplicate reports of a single incident. For instance, if a school
nurse and a neighbor both reported the same incident of physical abuse
for the same child, staff in the larger local OCS offices might not recognize
that the reports are based on a single incident, thus inflating the number
of incidents. A second outcome measure available from OCS is the substantiated
case—those reported incidents of child harm found to be true. The
records of substantiated cases are less likely to have duplications and
hence are a more valid indicator of actual cases of harm to children.
However, as with the records of reports of harm, the records of substantiated
cases can include multiple referrals on individual children. For example,
there would be two substantiated cases for a child that was harmed in
August and then in, say, October. Likewise, there would be two substantiated
cases of harm for a child that was both neglected and physically abused.
The third outcome measure available from the Alaska OCS—the number
of children harmed—gives us less of an idea of how much harm is
occurring in a given jurisdiction but does help to avoid the problems
of duplicate reports and multiple referrals.
A preliminary analysis of the OCS records
of harm to children seems to indicate that the records are reasonably
complete. For example, for the reports-of-harm measure the village/city-of-referral
variable was missing in only 19 out of nearly 175,000 reports of harm
in the 11 year period 1990-2001. During that same period the village/city
of referral variable for the substantiated case measure was missing in
about 2 percent (1.87%) of 53,586 substantiated cases. Given that the
OCS records are systematically gathered by a single state agency, it is
sensible to expect similarly high levels of completeness on other variables
in the database.
Traffic Accident Records
The other statewide, standardized data
source that would be amenable to an analysis of the effects of alcohol
policies is the traffic accident records maintained by the Alaska Department
of Transportation (DOT). This data source contains records of all reported
motor vehicle traffic accidents occurring on any public road in the state.
Traffic accident records from as far back as 1977 are recorded by the
DOT. Included in the DOT’s Highway Analysis System (HAS) are records
on each accident for location (including city/village and mile marker
for outside of inhabited areas), date, time, alcohol relatedness, severity
(i.e., property damage only, minor injury, major injury, or fatality),
pedestrian involvement, and vehicle type (i.e., auto, truck, ATV, snowmachine).
The information recorded in the HAS database is provided to the DOT by
the state Department of Motor Vehicles (DMV).
The DOT’s traffic accident records
would be useful for examining the effects of a number of alcohol policies.
Obviously, they would be required for any consideration of policies aimed
at reducing drunk driving. They could also be used, for instance, to examine
the effects of local regulations of drinking establishment closing times.
The completeness and coverage of the HAS
record of motor vehicle accidents is limited by a couple of factors. First,
accidents that go unreported to the police and those for which the police
fail to notify the DMV are not included in the data. Secondly, the accident
database only includes incidents that happen on public roads, so many
of the snowmachine and ATV accidents occurring in roadless areas of the
state are not included.
Without data in hand to analyze, it is difficult
to determine exactly how well the more isolated areas of the state are
covered in the accident data. There are, however, a few reasons to believe
that motor vehicle accident records receive less than full statewide coverage
in the HAS database. One problem is that while many Alaska Native villages
have roads used by the general public, not all of these roads are recognized
in the state’s records. For instance, only two of the eight villages
in the North Slope Borough (Barrow and Point Hope) are represented in
the route lists generated by the HAS database. Another indication that
there might be less than complete coverage of the isolated areas of the
state is that very few traffic accidents are recorded in the HAS database
as occurring in isolated places off the main road system or Alaska Marine
Highway. According to the latest report on traffic accidents in Alaska,
in 2001 only 240 out of 15,273 traffic accidents (1.6%) were reported
as happening in non-connected, isolated census areas. It is possible,
however, that these small numbers reflect the fact that residents of isolated
Alaska Native villages just use motor vehicles much less and therefore
have fewer accidents.
Conclusion
To summarize—relatively few statewide,
standardized data sources in the state of Alaska are solid and extensive
enough to ground a fruitful and valid consideration of the effects of
variations in local alcohol policies. Statistics generated by local and
state police, where they do exist, are generally inadequate for this purpose.
The four data sources that appear to offer potential for the study of
the harmful effects of alcohol use in Alaska are the collection maintained
by the Alaska Trauma Registry, the Bureau of Vital Statistics death certificate
records, the client and incident database at the Office of Children’s
Services, and motor vehicle accident records from the Department of Transportation.
Each of these databases is centralized, complete, geographically specific
to the village/city level, and allows for the measurement of alcohol-related
harms in time frames as narrow as the single date. Use of any one of these
data sets could facilitate obtaining a clearer understanding of what impact,
if any, specific alcohol control policies have upon the harm that often
results from alcohol use in Alaska.
The research conducted for this paper
was made possible by a Graduate Research Training on Alcohol Problems
Fellowship, sponsored by the National Institute on Alcohol Abuse and Alcoholism
grant number T32AA0724026. This research was also supported by National
Institute of Alcohol Abuse and Alcoholism Center grant number AA06282
to the Prevention Research Center, Pacific Institute for Research and
Evaluation, Berkeley, California.
Darryl Wood is an associate professor with
the Justice Center. He is currently on a sabbatical appointment as a research
scientist at the Prevention Research Center, Pacific Institute for Research
and Evaluation, Berkeley, California. |