Gender differences in the relationship between alcohol and violent injury: An analysis of cross-national emergency department data

Objective: The objectives of the present study were two-fold: (1) to determine whether gender differences exist in the roles of drinking in the event (i.e., self-reported drinking before the injury and estimated blood alcohol concentration [BAC] captured after injury) and drinking pattern (i.e., heavy episodic drinking) in explaining violent versus nonviolent injuries and (2) to assess whether these gender differences vary by country. Method: Emergency department data were analyzed from 30 hospitals in 15 countries, as part of the Emergency Room Collaborative Alcohol Analysis Project and the World Health Organization Collaborative Study of Alcohol and Injuries. Interaction effects between gender and alcohol were tested in the prediction of violent versus nonviolent injury for each country. Results: The bivariate analyses revealed significantly larger effects of drinking-in-the-event variables for men than for women in three countries (i.e., 6 hours before the injury in Argentina and having a positive BAC in Belarus and Spain). In the multivariate analyses, restricted to countries with sufficient sample sizes (i.e., Mexico, South Africa, and the United States), no significant gender differences were found between the drinking-in-the-event variables and violent injury. In the bivariate and multivariate analyses, a significant interaction effect between gender and heavy episodic drinking was found in the United States, indicating that heavy episodic drinking predicted violent injury for women but not for men. Conclusions: Although the results are preliminary, treatment and prevention programs may need to target both genders equally or perhaps even focus more on heavy-drinking women, particularly in the United States.