Alcohol outlets are associated with fatal drowning events in England: a nationwide geospatial study

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OBJECTIVE: Drowning is a leading cause of unintentional and intentional death among children and young adults. Alcohol consumption increases drowning risk. We examined the association between alcohol outlet availability and fatal drowning events stratified by suspected outcome (accidents [unintentional] and suicide [intentional]), age group and sex. METHODS: We combined alcohol outlet location data and validated United Kingdom (UK) fatal drowning events (2012-2019). We examined the association between alcohol outlets and fatal events within 125m (n= 3276), 250m (n = 3304), and 500m (n= 3314) radii of event locations in England. Bayesian multinomial hierarchical modelling tested associations and Deviance Information Criterion (DIC) assessed model fit. RESULTS: The strongest associations were observed within 500m of the drowning event location. Stratified by age group and sex, Log Odds Ratios (OR) and Credible intervals (CI) indicated increased likelihood of drowning due to alcohol intoxication, relative to drowning by natural causes, in males aged 13 to 18 (LOR 0.67; CI 0.20-1.03) and 19 to 35 years (LOR 0.39; 0.24-0.57). CONCLUSION: Alcohol outlets were associated with adverse drowning outcomes, especially for males, within 500m of water. We utilised an innovative population-level, data-driven approach and support the World Health Organisation's call to limit alcohol availability near water.

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