RT Journal Article
SR Electronic
T1 Global systematic review of Indigenous community-led legal interventions to control alcohol
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e013932
DO 10.1136/bmjopen-2016-013932
VO 7
IS 3
A1 Janani Muhunthan
A1 Blake Angell
A1 Maree L Hackett
A1 Andrew Wilson
A1 Jane Latimer
A1 Anne-Marie Eades
A1 Stephen Jan
YR 2017
UL http://bmjopen.bmj.com/content/7/3/e013932.abstract
AB Objectives The national and subnational governments of most developed nations have adopted cost-effective regulatory and legislative controls over alcohol supply and consumption with great success. However, there has been a lack of scrutiny of the effectiveness and appropriateness of these laws in shaping the health-related behaviours of Indigenous communities, who disproportionately experience alcohol-related harm. Further, such controls imposed unilaterally without Indigenous consultation have often been discriminatory and harmful in practice.Setting, participants and outcome measures In this systematic review of quantitative evaluations of Indigenous-led alcohol controls, we aim to investigate how regulatory responses have been developed and implemented by Indigenous communities worldwide, and evaluate their effectiveness in improving health and social outcomes. We included articles from electronic databases MEDLINE, EMBASE, CINAHL, PsycINFO and Web of Science from inception to December 2015.Results Our search yielded 1489 articles from which 18 met the inclusion criteria. Controls were implemented in rural and remote populations of high-income nations. Communities employed a range of regulatory options including alcohol rationing, prohibition of sale, importation or possession, restrictions on liquor sold, times of sale or mode of sale, Indigenous-controlled liquor licensing, sin tax and traditional forms of control. 11 studies reported interventions that were effective in reducing crime, injury deaths, injury, hospitalisations or lowering per capita consumption. In six studies interventions were found to be ineffective or harmful. The results were inconclusive in one.Conclusions Indigenous-led policies that are developed or implemented by communities can be effective in improving health and social outcomes.