Alcohol Sale Status and Suicide in Kentucky, 2005-2012

Background: The current study aims to determine whether suicide decedents who are residents of wet counties have higher odds of alcohol involvement than suicide decedents who are residents of moist/dry counties; and determine whether the association between alcohol sale status and alcohol-related suicide exists only in counties with a high population size. Methods: Multilevel logistic regression analysis was used to analyze decedents who died violently and were therefore included in the Kentucky Violent Death Reporting System, 2005-2012. Stratification by population size was done to study its possible interaction with alcohol sale status of the decedent’s residence. Results: Approximately 36% of suicide decedents who lived in wet counties had an alcohol-related suicide, compared to 33% among those in moist/ dry counties. After adjusting for potential confounders, residence in a wet county was associated with a 22% increase in the odds of alcohol-related suicide (aOR=1.22, 95%CI= 1.00-1.51). Population size was not an effect modifier. Conclusion: Suicide decedents who resided in wet counties had increased odds of alcohol-related suicides in comparison to residents of moist/dry counties, after adjusting for potential confounders and population size. A multifaceted approach that aims to reducing gun accessibility, providing health care for the mentally ill and the elderly, improving the economic status of the community by increasing accessibility to education and providing job opportunities is needed.