Alcohol and Alcoholism, 2018, 53(5) 578–585

doi: 10.1093/alcalc/agy034
Advance Access Publication Date: 26 May 2018
Article

Article

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A Need for Tailored Programs and Policies to
Reduce Rates of Alcohol-related Crimes for
Vulnerable Communities and Young People:
An Analysis of Routinely Collected Police Data
Mieke Snijder1,*, Bianca Calabria1,2, Timothy Dobbins1, Alice Knight1,3,
and Anthony Shakeshaft1
1
National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052,
Australia, 2National Centre for Epidemiology and Population Health, Research School of Population Health,
Australian National University, 62 Mills Road, Acton, ACT 2601, Australia, and 3Department of Family and
Community Services, FACS Analysis and Research, 3/4-6 Cavill Avenue, Ashfield, NSW 2131, Australia

*Corresponding author: National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney,
NSW 2052, Australia. E-mail: m.snijder@unsw.edu.au
Received 15 October 2017; Revised 26 April 2018; Editorial Decision 27 April 2018; Accepted 18 May 2018

Abstract
Background and aims: Given ongoing community concern about high rates of alcohol-related
crimes (ARCs) experienced by disadvantaged populations, a more specific and nuanced
understanding of factors associated with ARCs would help inform the development of more
sophisticated programs and policies aimed at reducing ARCs. This study estimates rates of
ARCs across all communities in New South Wales (NSW), Australia, using routinely collected
police data; investigates whether there are differences between communities; and identifies
individual and community characteristics that are significantly associated with higher rates of
ARCs.
Short summary: This study analysed routinely collected police data in New South Wales,
Australia, to identify individual and community characteristics associated with alcohol-related
crimes. Young people, Aboriginal Australians, socio-economically disadvantaged communities,
remote and regional communities and communities with higher per capita rate of on-venue liquor
licenses are at risk of alcohol-related crimes.
Methods: Age standardized rates of ARCs were calculated. A multi-level Poisson regression ana-
lysis was conducted to investigate the individual and community factors that were statistically sig-
nificantly associated with higher rates of ARC, separately for Aboriginal and non-Aboriginal
Australians.
Results: Rates of ARCs were statistically significantly higher for Aboriginal Australians, young
people (aged 13–37 years) and on weekends. ARCs varied significantly across communities, and
were significantly higher in remote or regional communities, in communities with a higher per
capita rate of on-venue licences, and for socio-economically disadvantaged communities for non-
Aboriginal Australians, but not for Aboriginal females.
Conclusion: This analysis shows that the impact of national-level and jurisdictional-level legisla-
tion and policies is uneven across communities and defined populations, leaving young people,
socio-economically disadvantaged communities and Aboriginal Australians at increased risk of
ARCs. To more equitably reduce the exposure of all Australians to ARC, mechanisms that

© The Author(s) 2018. Medical Council on Alcohol and Oxford University Press. All rights reserved. 578
Alcohol and Alcoholism, 2018, Vol. 53, No. 5
effectively engage vulnerable communities and defined populations, need to be developed in con-
sultation with them, implemented and evaluated.
INTRODUCTION
Internationally, a strong relationship exists between single occasion
risky drinking and crime (Rehm et al., 2009). This relationship
imposes an avoidable economic burden, as it costs the criminal just-
ice system ~25 billion USD per year in the United States, 2.4 billion
USD per year in Australia and 7 billion USD per year in the United
Kingdom (Manning et al., 2013; Sacks et al., 2010; Lister et al.,
2008).
Individual characteristics significantly associated with higher
rates of alcohol-related crime (ARC) include being young, male,
unmarried, and unemployed (Teece and Williams, 2000; Williams,
2001; Palk et al., 2007; Collins, 2016). Community characteristics
significantly associated with higher rates of ARC include socio-
economic disadvantage, income inequality, increased density of alco-
hol outlets, and increased remoteness (Breen et al., 2011; Collins,
2016; Gmel et al., 2016). While these characteristics have been iden-
tified using data from a select number of communities, there has
been no published analysis of whether those characteristics differ
between all communities in whole jurisdictions, or between specific
populations, such as comparing Indigenous and non-Indigenous
Peoples. Indigenous Peoples are known to experience disproportion-
ately higher rates of ARCs than non-Indigenous People, despite
efforts to address this (Wundersitz, 2010; Perry, 2004; d’Abbs,
2015). A better understanding of the generalizability of individual
and community characteristics that are significantly associated with
higher rates of ARC can contribute to more effective efforts aimed
at reducing ARCs as they can target the specific characteristics of
different communities and defined populations.
In order to improve the generalizability of existing data this
study has three aims. Firstly, to estimate and specify rates of ARCs
by individual, community, and offence characteristics for all com-
munities in New South Wales (NSW), Australia, separately for
Aboriginal and non-Aboriginal Australians. Secondly, to investigate
whether differences in rates of ARCs between Aboriginal and non-
Aboriginal Australians vary across geographical communities.
Thirdly, to identify individual and community characteristics signifi-
cantly associated with rates of ARCs for all communities in NSW
separately for Aboriginal and non-Aboriginal Australians.
METHODS
Ethics
The NSW Aboriginal Health and Medical Research Council Ethics
Committee (approval no. 987/13) and the NSW Population &
Health Services Research Ethics Committee (approval no. 2014/02/
516) approved this study.
Study design and setting
This observational study used NSW Police data. NSW is the most
populous state of Australia. It has an estimated population of 7 mil-
lion, of whom an estimated 2.4% identify as Aboriginal (the term
Aboriginal is used in this paper following recommendations from
the Aboriginal Health and Medical Research Council for New
South Wales (2013)). The majority (72%) of the NSW population
579
resides in major cities, which are defined as having a high accessibil-
ity to services and 250,000 or more inhabitants (Australian Bureau
of Statistics, 2011).
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Data sources and definitions
Police recorded criminal incidents
The NSW Bureau of Crime Statistics and Research (BOCSAR) col-
lects data on all NSW Police recorded criminal incidents. BOCSAR
defines a criminal incident as ‘an activity detected by or reported to
police which involved the same offender(s) and the same victim(s),
occurred at the one location, during one uninterrupted period of
time, falls into one offence category (e.g. assault, offensive conduct,
and theft) and falls into one incident type (e.g. actual, attempted,
conspiracy)’ (NSW BOCSAR, 2016, p. 49).
For this study, BOCSAR provided de-identified, unit-level crim-
inal incident data and person of interest (POI) data. A POI is a sus-
pected offender recorded by police in connection with a criminal
incident. The POI is not necessarily legally proceeded against. The
POI dataset is not composed solely of unique offenders; the same
POI can be linked to more than one criminal incident, and one crim-
inal incident can involve multiple POIs. Data comprised all criminal
incidents in NSW that occurred from 1 January 2005 to 31
December 2014 and involved POIs aged 13 years and older (NSW
BOCSAR, 2015).
Criminal incident data included incident number, date and time
of incident, postcode of incident location, offence category and sub-
category, and whether a criminal incident was flagged by the police
as alcohol-related. POI data included incident number, age, gender,
postcode of POI, offence category and subcategory, and whether the
POI is recorded as non-Aboriginal, Aboriginal and/or Torres Strait
Islander, or unknown. Aboriginal status is based on whether the
POI has been identified as Aboriginal and/or Torres Strait Islander
in any previous contact with the police, either as POI or as victim.
POIs with an unknown Aboriginal status were excluded from the
analyses (n = 5,725,974; 58%). Criminal incident and POI datasets
were combined by the researchers using incident numbers. All inci-
dents had associated POI data.
The extent to which NSW Police accurately identify criminal
incidents as alcohol-related is unclear, but it is likely that the
reported numbers underestimate the true incidence (Wiggers et al.,
2016). The intra-rater reliability (the consistency with which a police
officer identifies different incidents as alcohol-related) and the inter-
rater reliability (the consistency with which different police officers
identify incidents as alcohol-related) is also unknown. Given this
uncertainty, this study used a proxy measure to identify ARCs
(Matthews et al., 2002). Although proxy measures are problematic
for quantifying valid estimates of the incidence of ARCs, they are
more reliable than police judgements for comparing rates of ARCs
between jurisdictions, between communities, or over time
(Matthews et al., 2002; Breen et al., 2011). The Australian-derived
proxy measure used in this study comprises two components: inci-
dent types and time of occurrence (Matthews et al., 2002; Breen
et al., 2011). Incident types included are those that have been shown
to correlate strongly with alcohol use, specifically: assault (domestic,
580
non-domestic and police assaults), sexual assault (sexual and indecent
assaults), disorderly conduct (offensive language and conduct), and
malicious damage to property. Times of occurrence are the time peri-
ods in which a disproportionately high number of ARCs occur
(Sunday 10 p.m.–Monday 6 a.m., Monday 10 p.m.–Tuesday 2 a.m.,
Wednesday 10 p.m.–Thursday 2 a.m., Friday 10 p.m.–Saturday 6 a.
m., and Saturday 6 p.m.–Sunday 6 a.m.). Incidents satisfying both
components were coded as ARCs.
Individual characteristics
The individual characteristics included in the analyses were the
Aboriginal status, gender, and age of the POI, as identified in the
dataset. Aboriginal status was categorized as Aboriginal or non-
Aboriginal. Gender was categorized as male or female. Age was
categorized in 5-year categories. The youngest age category started
at 13 years, because this was the youngest age available in the data
provided by BOCSAR.
Community characteristics
Community characteristics were obtained for each Postcode Area
(POA) in which a criminal incident occurred. Although a variety of
geographical units can be used to identify a ‘community’ in
Australia, POA was used because postcodes were included in the
criminal incident dataset and the community characteristics of inter-
est, obtained from various resources as specified below, were more
readily available by POA, compared to other geographical units.
Ten postcodes in the criminal incident dataset (n = 53 ARCs) were
excluded because no data on community characteristics were avail-
able for those postcodes. Community characteristics were selected
based on a previous study, investigating community characteristics
associated with ARCs in the general population of NSW: Socio-
economic status (SES), remoteness, per capita rate of liquor licences,
and population characteristics (Breen et al., 2011).
SES. Each community’s SES was determined using the Index of
Relative Socio-economic Disadvantage from the Socio-Economic
Indexes for Areas. This index assesses variables that reflect the rela-
tive disadvantage of an area compared to the rest of the state (Pink,
2011). Quintile scores were obtained from the Australian Bureau of
Statistics using 2011 POA census data: A higher quintile equals
more disadvantage (Australian Bureau of Statistics, 2013a).
Remoteness. Remoteness of each community was determined using
the Australian Standard Geographical Classification remoteness struc-
ture, which defines remoteness based on road distance to service cen-
tres. Researchers grouped all NSW communities into three categories:
major city, regional and remote (Australian Bureau of Statistics, 2007).
Liquor licences. Data on the per capita rate of liquor licences per
1000 population in communities were provided by Liquor and
Gaming NSW (2015). Given that different types of liquor licences are
related to different types of ARCs (Gmel et al., 2016), distinct licences
were grouped into three categories: on-venue licences (e.g. bars, clubs
and restaurants), packaged licences (e.g. liquor stores), and hotel
licences (which can have both on-venue and packaged licences).
Population characteristics. For each community, the proportion of
the population that identified as Aboriginal and the proportion of
young (20–29 years old) male residents were obtained from the
Australian Bureau of Statistics using 2011 POA Census data
(Australian Bureau of Statistics, 2011). The age range for young
Alcohol and Alcoholism, 2018, Vol. 53, No. 5
males was based on the minimum drinking age (18 years), however,
as POA Census data were only available in 5- or 10-year age cat-
egories, the minimum age was set at 20 rather than 18 years.
Additionally, findings from previous research indicate that young
males’ involvement in ARCs declines after 30 years of age (Teece
and Williams, 2000; Palk et al., 2007).
Offence characteristics
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The offence categories were limited to those included in the proxy def-
inition: assaults, sexual assaults, disorderly conduct and malicious dam-
age to property. Time of occurrence of the criminal incident identified
whether the incident took place during the week or weekend.
Statistical analyses
Rates of ARCs for Aboriginal and non-Aboriginal Australians in NSW
were standardized using the Standard Population for Use in Age-
Standardization Table provided by the Australian Bureau of Statistics,
which uses 2001 Census data as the most recent standard population
available in Australia (2013b). Age-Standardized Rates (ASRs) were
estimated separately for males and females for the total number of
ARCs and separately for all individual characteristics (Aboriginal iden-
tity, gender and age), for the categorical community characteristics
(SES, remoteness), and for the offence characteristics (offence category
and time of occurrence). A preliminary analysis was conducted using a
single-level Poisson model with ARCs as outcome variable that was
composed of age, gender, Aboriginal status, and an interaction term of
gender and Aboriginal status. This preliminary analysis identified that
the effect of Aboriginal status on the rates of ARCs was modified by
gender (RR 0.42 (99% CI 0.40; 0.43) P ≤ 0.05). Therefore, all models
in this study were stratified by gender. The statistical significance of dif-
ferences in ASRs for Aboriginal and non-Aboriginal POIs were esti-
mated by calculating rate ratios using single-level Poisson models for
individual characteristics (each age category) and categorical commu-
nity characteristics (SES and remoteness) with ARC as the outcome.
To investigate whether differences in the ASRs of ARCs between
Aboriginal and non-Aboriginal Australians were statistically signifi-
cantly different across communities, a random intercept for POA
was added to all Poisson models.
To identify individual and community characteristics that are
significantly associated with the rates of ARCs, separate multi-level
Poisson models with rates of ARCs as outcome variable for
Aboriginal and non-Aboriginal Australians were estimated. These
models comprised individual characteristics (age), community char-
acteristics (SES, remoteness, per capita rate of liquor licences, pro-
portion of young males, and proportion of Aboriginal Australians),
and the random intercept for POA.
All analyses were conducted using Stata 14 (StataCorp, 2015).
Confidence intervals were calculated at the 99% level.
RESULTS
Rates of ARCs
A total of 330,063 ARCs were identified between 2005 and 2014
involving POIs aged 13 and over in NSW (43,590 [13%] involving
Aboriginal POIs and 286,473 [87%] involving non-Aboriginal POIs).
For individual characteristics, Table 1 shows that the ASRs of ARCs
per 1000 were 48.7 (CI 47.8–49.5) for Aboriginal males and 21.9 (CI
20.5–23.2) for Aboriginal females, compared to 10.0 (CI 10.0–10.1)
for non-Aboriginal males and 1.8 (CI 1.7–1.8) for non-Aboriginal
females. ASRs were highest for 18–22-year olds and second highest
Alcohol and Alcoholism, 2018, Vol. 53, No. 5 581

Table 1. Age-standardized rates of ARCs in NSW between 2005 and 2014, by Aboriginal status and gender

ARCs Aboriginal Non-Aboriginal

Male Female Male Female

a a a
N ASR (99% CI) N ASR (99% CI) N ASR (99% CI) N ASRa (99% CI)

Total ARCs 32,032 48.7 (47.8–49.5) 11,558 21.9 (20.5–23.2) 244,738 10.0 (10.0–10.1) 41,735 1.8 (1.7–1.8)
Individual characteristics
Age of POI

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13–17 6464 62.9 (60.9–65.0) 2523 29.7 (29.3–31.3) 32,323 15.7 (15.5–15.9) 7694 4.1 (3.9–4.2)
18–22 8846 107.6 (104.7–110.6) 2920 45.7 (43.5–47.9) 74,930 36.7 (36.4–37.1) 11,031 5.7 (5.6–59)
23–27 5424 69.7 (66.8–72.6) 1822 37.7 (35.5–40.0) 44,875 21.8 (21.5–22.0) 6369 3.1 (3.0–3.2)
28–32 3853 24.7 (22.8–26.6) 1316 34.6 (32.2–37.1) 29,055 13.6 (13.4–13.8) 4502 2.1 (2.0–2.2)
33–37 3023 72.9 (69.6–76.4) 1174 31.1 (28.9–33.5) 22,034 10.4 (10.2–10.6) 4189 2.0 (1.9–2.1)
38–42 2122 46.0 (43.5–48.7) 902 21.4 (19.6–23.3) 16,616 7.4 (7.2–7.5) 3436 1.5 (1.4–1.6)
43–47 1230 31.7 (29.5–34.2) 558 15.4 (13.8–17.2) 11,151 5.3 (5.2–5.4) 2254 1.1 (1.1–1.2)
48–52 639 23.8 (21.4–26.2) 225 9.9 (8.3–11.8) 6602 3.0 (2.9–3.1) 1209 0.6 (0.6–0.7)
53–57 274 15.7 (13.3–18.3) 81 8.2 (6.0–10.8) 3651 1.9 (1.8–2.0) 560 0.4 (0.3–0.4)
58–62 104 10.9 (8.3–14.0) 22 6.3 (3.4–10.7) 1821 1.1 (1.1–1.2) 268 0.3 (0.2–0.3)
63–67 40 10.5 (6.7–15.6) 11 6.0 (2.4–12.5) 887 0.7 (0.6–0.8) 116 0.3 (0.2–0.4)
68+ 13 4.2 (1.8–8.3) 4 7.3 (1.2–22.9) 793 0.3 (0.3–0.3) 107 0.1 (0.0–0.1)
Community characteristics
SES quintile
1 (least disadvantaged) 835 26.0 (22.3–29.8) 243 15.0 (12.0–18.1) 36,947 6.4 (6.3–6.5) 5269 1.0 (0.9–1.0)
2 2330 33.0 (27.1–38.8) 857 18.3 (16.0–20.6) 45,305 8.5 (5.4–8.6) 7093 1.4 (1.4–1.5)
3 8222 44.8 (43.2–46.4) 2776 18.6 (17.0–20.3) 74,542 13.4 (12.9–13.2) 12,330 2.3 (2.2–2.3)
4 8735 53.1 (46.5–59.7) 3219 23.7 (17.2–30.2) 48,842 13.6 (13.4–13.7) 9186 2.6 (2.5–.27)
5 (most disadvantaged) 11,910 62.4 (60.8–64.0) 4463 25.7 (24.6–26.8) 39,102 10.4 (10.3–10.6) 7857 2.2 (2.1–2.3)
Remoteness
Major city 7213 30.6 (29.2–32.0) 2541 13.5 (12.6–14.4) 143,798 8.2 (8.1–8.3) 23,967 1.4 (1.4–1.5)
Regional 18,871 51.5 (50.4–52.7) 6667 22.5 (21.1–24.0) 96,181 15.0 (14.9–15.1) 16,800 2.7 (2.7–2.8)
Remote 5948 119.9 (116.1–123.7) 2350 44.4 (42.0–46.8) 4755 24.4 (23.5–25.3) 968 5.8 (5.2–6.4)
Offence characteristics
Offence categories
Assaults 17,435 32.4 (31.4–33.4) 6718 14.9 (13.5–16.3) 114,632 4.8 (4.7–4.8) 26,348 1.2 (1.2–1.2)
Sexual assaults 1096 6.0 (5.2–6.8) 28 2.4 (0.6–4.3) 14,794 0.7 (0.7–0.7) 433 0.2 (0.2–0.2)
Disorderly conduct 5903 15.0 (13.5–16.5) 2809 10.4 (8.0–12.8) 58,664 2.7 (2.7–2.7) 6630 0.5 (0.5–0.5)
Malicious damage 7598 14.3 (13.5–15.2) 2003 7.3 (4.8–9.7) 56,648 2.4 (2.4–2.4) 8324 0.5 (0.5–0.5)
Time of occurrence
Weekend 22,237 36.2 (35.2–37.2) 8164 17.0 (15.8–18.3) 176,379 7.3 (7.3–7.4) 29,630 1.3 (1.3–1.4)
Week day 9795 19.1 (18.3–19.8) 3394 11.4 (0.5–17.9) 68,359 2.9 (2.9–2.9) 12,105 0.6 (0.6–0.6)

CI = confidence interval; POI = person of interest; SES = socio-economic status.

a
Age standardized rates per 1000 population.

for 23–27 year olds among both Aboriginal and non-Aboriginal
groups. ARCs progressively reduced as age categories increased. The
only exception to these patterns was for non-Aboriginal females,
where the second highest ASRs were for 13–17-year olds.
For community characteristics, ASRs of ARC generally increased
as communities became more disadvantaged, regardless of
Aboriginal status or gender, although they were lower in the most
disadvantaged areas (5) than to the second most disadvantaged
areas (4) for non-Aboriginal POIs. Furthermore, ASRs increased as
communities became more remote.
For offence characteristics, assaults were the most commonly
recorded ARCs, regardless of Aboriginal status or gender, followed
by disorderly conduct and malicious damage, with a relatively small
number of sexual assaults. ASRs of ARCs were at least twice as high
on weekends than on weekdays, Aboriginal status and gender
notwithstanding.
Despite similar patterns in the ASRs of ARCs among Aboriginal
and non-Aboriginal POIs, and for males and females, the rate ratios
presented in Table 2 indicate that ARCs were statistically signifi-
cantly higher for Aboriginal than for non-Aboriginal POIs.
Community variation in the differences between
Aboriginal and non-Aboriginal Australians in rates
of ARCs
Single-level Poisson models identified that rates of ARCs for Aboriginal
POIs were 6.75 (CI 6.67–6.83) and 14.58 (CI 14.29–14.89) times high-
er than rates for non-Aboriginal POIs, for males and females, respect-
ively. However, these estimates reduced to 4.65 (CI 4.59–4.71) times
higher for Aboriginal males and 8.42 (CI 8.22–8.63) times higher for
Aboriginal females after adjusting for community variation in the rate
ratios of ARCs of Aboriginal and non-Aboriginal POIs. This change in
rate ratio provides evidence that differences in rates of ARCs between
Aboriginal and non-Aboriginal POIs significantly varied among com-
munities for both males (P ≤ 0.05) and females (P ≤ 0.05).
582 Alcohol and Alcoholism, 2018, Vol. 53, No. 5

Table 2. Rate ratios of ARCs for Aboriginal compared to non-Aboriginal POIs, stratified by gender resulting from single-level Poisson
models

Male Female
a
Rate ratio (99% CI) Rate ratioa (99% CI)

Individual characteristics
Age of POI
13–17 2.78 (2.67–2.89) 4.63 (4.33–4.95)

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18–22 1.97 (1.91–2.04) 4.40 (4.14–4.68)
23–27 2.95 (2.83–3.07) 6.66 (6.15–7.22)
28–32 3.82 (3.64–4.01) 9.18 (8.32–10.12)
33–37 4.33 (4.10–4.58) 8.42 (7.61–9.33)
38–42 3.84 (3.59–4.09) 9.27 (8.27–10.39)
43–47 4.10 (3.76–4.46) 9.77 (8.47–11.26)
48–52 5.90 (5.25–6.63) 14.46 (11.63–17.98)
53–57 6.78 (5.67–8.11) 22.62 (16.20–31.59)
58–62 7.65 (5.69–10.29) 22.77 (12.86–40.32)
63–67 14.22 (8.97–22.91) 21.59 (9.58–48.65)
68+ 12.81 (5.66–28.96) 85.28 (22.97–316.60)
Community characteristics
SES quintile
1 (least disadvantaged) 5.37 (4.90–5.88) 16.89 (14.18–20.12)
2 4.48 (4.24–4.73) 13.74 (12.48–15.12)
3 4.90 (4.75–5.06) 9.66 (9.11–10.24)
4 4.97 (4.81–5.12) 8.21 (7.75–8.70)
5 (most disadvantaged) 5.38 (5.22–5.55) 7.67 (7.22–8.14)
Remoteness
Major city 4.11 (3.98–4.25) 9.14 (8.64–9.67)
Regional 5.30 (5.19–5.41) 9.20 (8.83–9.59)
Remote 6.83 (6.47–7.22) 7.32 (6.53–8.19)

CI = confidence interval; POI = person of interest; SES = socio-economic status.

a
All presented rate ratios are statistically significant (P ≤ 0.01).

Individual and community characteristics associated
with ARCs
In terms of individual characteristics, the same pattern of results was
observed for Aboriginal and non-Aboriginal POIs: rates of ARCs
were statistically significantly higher in age categories younger than
the reference group (38–42-year olds) and statistically significantly
lower in age categories older than the reference group (Table 3).
In terms of community characteristics, more socio-economic dis-
advantage in the community was associated with higher rates of
ARCs for non-Aboriginal POIs and Aboriginal males, but not for
Aboriginal females. For both Aboriginal and non-Aboriginal POIs,
rates of ARCs were higher in remote and regional communities than
in major cities.
A higher per capita rate of on-venue licences within a community
was significantly associated with higher rates of ARCs, regardless of
Aboriginal status. For non-Aboriginal females and Aboriginal males,
a higher per capita rate of hotel licences in the community was also
associated with higher rates of ARCs.
For non-Aboriginal females, a higher proportion of young males
in the community was significantly associated with lower rates of
ARCs. For Aboriginal females a higher proportion of young males
was associated with higher rates of ARCs. A small, but statistically
significant, association was found between a higher proportion of
residents in a community identifying as Aboriginal and a higher rate
of ARCs, regardless of the Aboriginal status of the POI, except
among non-Aboriginal males, where this was not statistically signifi-
cant. Nevertheless, the marginal nature of this association (e.g. a
1% increase in Aboriginal Australians in a community lead to a 3%
increase in ARCs for Aboriginal males), suggests its statistical sig-
nificance is a consequence of the large sample size, rather than a
practically meaningful association.
DISCUSSION
This study found that age standardized rates of ARCs were statistically
significantly higher for Aboriginal POIs, young people (aged 13–37
years) and on weekends. Differences in the rates of ARCs for
Aboriginal and non-Aboriginal POIs varied significantly across com-
munities. ARC rates were significantly higher in remote or regional
communities, in communities with a higher per capita rate of on-venue
licences, and for more socio-economically disadvantaged communities.
For national- or jurisdictional-level policy frameworks, these find-
ings highlight the need to ensure legislation continues to target young
people, such as the enforcement of minimum legal drinking age and
potentially further consideration of increasing the legal minimum
drinking age, especially considering those aged 18–22 had the highest
rates of ARCs (Cobiac et al., 2009). Minimum Unit Pricing (MUP)
policies are an additional policy strategy that has shown to reduce
alcohol consumption and related assaults in countries such as
Canada, United Kingdom and Australia (Boniface et al., 2017).
However, more evidence is required for the evidence of MUP for sub-
groups, such as Indigenous Peoples and young people (Seaman et al.,
2013). Similarly, the importance of continuing to target alcohol con-
sumption on weekends is also highlighted by these findings.
Alcohol and Alcoholism, 2018, Vol. 53, No. 5 583

Table 3. Adjusted rate ratios of ARCs among Aboriginal and non-Aboriginal POIs in NSW, resulting from the multi-level Poisson regres-
sion model

Aboriginal (N = 43,590) Non-Aboriginal (N = 286,473)

Males Females Males Females

a a a
RR 99% CI RR 99% CI RR 99% CI RRa 99% CI

Individual characteristics (age POI)

13–17 1.63** (1.53–1.74) 1.63** (1.47–1.80) 2.20** (2.15–2.26) 2.74** (2.59–2.89)

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18–22 2.97** (2.79–3.17) 2.47** (2.24–2.73) 5.12** (5.01–5.24) 3.79** (3.60–4.00)
23–27 2.46** (2.39–2.63) 1.81** (1.62–2.02) 2.78** (2.71–2.85) 1.91** (1.80–2.02)
28–32 2.04** (1.90–2.19) 1.56** (1.39–1.75) 1.68** (1.64–1.73) 1.30** (1.22–1.38)
33–37 1.73** (1.60–1.86) 1.48** (1.39–1.75) 1.37** (1.34–1.41) 1.30** (1.23–1.39)
38–42 (ref) 1.00 1.00 1.00 1.00
43–47 0.69** (0.62–0.75) 0.68** (0.59–0.78) 0.72** (0.69–0.74) 0.73** (0.68–0.78)
48–52 0.44** (0.39–0.50) 0.40** (0.33–0.48) 0.40** (0.39–0.42) 0.39** (0.36–0.43)
53–57 0.26** (0.22–0.31) 0.30** (0.22–0.41) 0.24** (0.23–0.25) 0.22** (0.20–0.25)
58–62 0.19** (0.14–0.24) 0.25** (0.14–0.44) 0.14** (0.13–0.15) 0.15** (0.12–0.17)
63–67 0.16** (0.11–0.25) 0.21** (0.10–0.46) 0.08** (0.07–0.09) 0.15** (0.12–0.19)
68+ 0.05** (0.03–0.11) 0.28* (0.08–1.02) 0.03** (0.03–0.04) 0.05** (0.04–0.06)
Community characteristics
SES quintile
1 (least disadvantaged) (ref) 1.00 1.00 1.00 1.00
2 1.10 (0.79–1.54) 0.83 (0.54–1.26) 1.13 (0.91–1.39) 1.23* (0.98–1.53)
3 1.40* (1.01–1.95) 0.83 (0.55–1.24) 1.53** (1.25–1.88) 1.66** (1.34–2.07)
4 1.33* (0.94–1.88) 1.05 (0.69–1.61) 1.88** (1.51–2.34) 2.09** (1.66–2.64)
5 (most disadvantaged) 1.32* (0.93–1.88) 0.91 (0.59–1.39) 1.81** (1.45–2.26) 2.08** (1.65–2.63)
Remoteness
Major City (ref) 1.00 1.00 1.00
Regional 1.38* (1.05–1.82) 1.51* (1.10–2.06) 1.39** (1.16–1.67) 1.40** (1.14–1.68)
Remote 2.41** (1.41–4.11) 2.10* (1.20–3.67) 1.47* (1.00–2.16) 1.39* (0.91–2.11)
Liquor licences
Hotels 0.79** (0.67–0.93) 0.97 (0.78–1.21) 1.04 (0.95–1.45) 1.30** (1.15–1.46)
On-venue 1.18** (1.11–1.25) 1.14* (1.06–1.23) 1.17** (1.13–1.21) 1.12** (1.07–1.17)
Packaged 0.91 (0.81–1.03) 0.92 (0.79–1.07) 0.99 (0.93–1.07) 1.01 (0.93–1.10)
Population characteristicsb
Young males 1.03 (0.99–1.08) 1.06* (1.01–1.12) 0.98 (0.95–1.01) 0.97* (0.94–1.00)
Aboriginal 1.03** (1.01–1.05) 1.02* (1.00–1.04) 1.01 (1.00–1.02) 1.03** (1.01–1.04)

CI = confidence interval; POI = person of interest; SES = socio-economic status.

a
Adjusted incidence rate ratios.
b
Percentage of young males (20–29) and Aboriginal Australians per POA.
*P ≤ 0.05; **P ≤ 0.01.

Currently, policies restricting night time alcohol sales in central enter-
tainment districts have been successfully implemented in cities in
Norway, California and Australia (Kypri, 2015). Evaluation of these
liquor licensing restrictions in Australia and Norway has shown sig-
nificant reductions in weekend night time assaults (Menéndez et al.,
2017; Rossow and Norström, 2012).
Even though all communities included in this study are subject
to the same jurisdictional-level framework, there are unique commu-
nity characteristics that contributed to higher rates of ARCs. First,
rates of ARCs were higher in communities with a higher per capita
rate of on-venue licences and hotel licenses for Aboriginal males and
non-Aboriginal females. Currently, there is no official threshold for
the number of liquor licenses allowed in any one community in
NSW. Applications for new licenses have to provide a community
impact statement and local council feedback, which covers the num-
ber of licenses in their community. While these factors are con-
sidered in the decision-making process by the NSW government
office of Liquor and Gaming, implementing a jurisdiction-wide
threshold to cap the density of alcohol licences in any one commu-
nity may help reduce the variability in rates of ARCs across different
communities.
Second, rates of ARC were significantly higher in remote and
regional communities and in lower SES communities, both of which
have been previously associated with higher rates of alcohol harms
(Australian Institute for Health and Welfare, 2015; Collins, 2016).
Given the impracticality of legislative approaches for communities
based on their geographical location or SES, this finding highlights
the need to develop a mechanism that effectively engages with vul-
nerable communities to assist them to effectively reduce their rates
of ARC. Previous research has identified multi-component
approaches that can effectively help regional communities reduce
ARCs, such as increasing licensees’ awareness and police activity
(Shakeshaft et al., 2014). In addition to benefiting these high-risk
communities, such a process would have jurisdictional-level benefits
given the resources expended in responding to ARC, such as
policing and the provision of emergency and health care services
584
following serious assaults, are met at the jurisdictional-level rather
than by local councils.
Despite the finding that the risk factors for ARC were mostly the
same for Aboriginal and non-Aboriginal Australians, this study found
rates of ARCs were significantly higher for Aboriginal Australians.
Two possible explanations for this are: Aboriginal status is being
confounded with other factors, and/or there are characteristics not
measured in this study that are specific to Aboriginal Australians that
increase their risk of experiencing ARC. The findings of this analysis
are consistent with the possibility of confounding by remoteness,
because both the proportion of Aboriginal Australians and rates of
ARCs increase with greater remoteness (Australian Bureau of
Statistics and Australian Institute of Health and Welfare, 2008; Gmel
et al., 2016). They are also consistent with the possibility of con-
founding by socio-economic status: although rates of ARC were
significantly higher for more socio-economically disadvantaged com-
munities, this was not true for Aboriginal females and less pro-
nounced for Aboriginal males which most likely reflects the high level
of disadvantaged experienced by Aboriginal Australians, relative to
non-Aboriginal Australians (Australian Bureau of Statistics and
Australian Institute of Health and Welfare, 2008).
Given this study did not identify any characteristics uniquely asso-
ciated with ARCs for Aboriginal Australians, it is unlikely that the vari-
ables included in this study explain the differences in rates of ARC
between Aboriginal and non-Aboriginal Australians. Furthermore, a
study by Wundersitz (2010) identified similar factors associated with
(non-alcohol-related) violent offending by Aboriginal Australians as our
study identified for alcohol-related crimes for Aboriginal Australians,
including males, young people and remoteness of community.
Additionally she identified childhood abuse and alcohol abuse as pre-
dictors of violent offending, with the latter being the number one pre-
dictor. Given there are similar factors associated with violent offending
and ARCs and similar characteristics for Aboriginal and non-
Aboriginal Australians, it is likely that there are other, fundamental dri-
vers to violence among Aboriginal Australians, whether alcohol-related
or not. Previous studies have identified that issues regarding race, ethni-
city and history can influence rates of ARCs, such as experience of
racism or transgenerational trauma resulting from the history of colon-
ization and dispossession (Wundersitz, 2010; Cunningham and
Paradies, 2013; Osborne et al., 2013). This highlights the need to
develop specific strategies for Aboriginal communities that are
devised and implemented by the community themselves and evalu-
ated in partnership with researchers. Particularly strategies that sup-
port Aboriginal communities to empower themselves to address
ARCs can be promising to reduce ARCs (Tsey, 2008). More work is
needed in this space, as was highlighted in a systematic review of
Australian Aboriginal community-based studies (Snijder et al., 2015).
Only 31 evaluations were published between 1990 and 2015 (one
addressed substance use and related harms), with only a moderate
level of participation of Indigenous Peoples, especially in the design
and evaluation phases of these studies (Snijder et al., 2015).
Methodological considerations
There are several methodological limitations due to the use of police
data that are not collected for research purposes. First, the
Aboriginal status for 58% of POIs in the dataset was recorded as
unknown, these POIs were excluded from the analyses because it is
unclear whether Aboriginal people are more or less likely to be
recorded as unknown in police incident data (Thompson et al.,
2012). Second, while the proxy measure for ARCs has not been
Alcohol and Alcoholism, 2018, Vol. 53, No. 5
explicitly validated for use with Aboriginal Australians, the proxy
has been validated with the NSW population, which included
Aboriginal Australians (Breen et al., 2011). Currently, no published
research indicates that patterns of ARCs differ between Aboriginal
and non-Aboriginal Australians. The findings of this study suggest
that these patterns might be very similar and an additional analysis
of the times at which ARCs flagged by the police occur also indi-
cated that times are similar for Aboriginal and non-Aboriginal
Australians. Regardless, the validation of the proxy measure with
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Aboriginal populations would help improve future estimates for
Aboriginal Australians (Chikritzhs et al., 2004). Third, there are
potential biases that influence the police recorded data, such as insti-
tutional racism (Cunneen, 2006; Wundersitz, 2010). Previous stud-
ies identified that 40% of Aboriginal Australians reported to have
experienced racism within the legal system, possibly leading to an
artefactual overrepresentation of Aboriginal Australians in police
records (Cunneen, 2006; Cunningham and Paradies, 2013). Fourth,
the use of POA is not a complete measure of communities; ten POAs
in this study were not included in POA classification, either because
they covered two or more areas, or only partially covered one area
(Australian Bureau of Statistics, 2012). Despite its limitations, POA
was considered the most appropriate classification to use, because of
the availability of community characteristics data by POA and the
availability of postcodes in the datasets containing ARCs. Finally,
the possibility of reoffending makes it not possible to identify
whether characteristics of POIs contribute to a higher proportion of
these groups involved in ARCs, or whether the group has more
repeat offenders. The findings of this study can nevertheless identify
at risk groups that can benefit from targeted policies or programs.
CONCLUSION
In 2016, The Lancet published an Indigenous-led paper that called
for governments internationally to improve Indigenous health by
developing targeted strategies that are grounded in data collected in
national surveillance systems (Anderson et al., 2016). The current
study operationalized this by utilizing routinely collected police data
to identify that there is a need for programs that are tailored to vul-
nerable people and communities, specifically young people, socio-
economically disadvantaged and Aboriginal communities. Current
best-evidence suggests such programs are likely to be most effective
if they are led by communities themselves, and directly respond to
issues of transgenerational trauma, racism and social exclusion, in
addition to ARC (Gray and Wilkes, 2011). The lack of published
evaluations of such programs highlights the need to develop a prac-
tical framework on which partnerships between communities and
researchers can be developed (Snijder et al., 2015).
ACKNOWLEDGEMENTS
The authors thank the NSW Ministry of Health for funding the body of
research of which this study is one part. Mieke Snijder thanks the NDARC
Education Trustees for funding her doctoral research, which includes this
paper. The authors thank BOCSAR for providing the data.
FUNDING
This study was funded by the NSW Ministry of Health as part of the
‘Aboriginal Injury Prevention and Safety Promotion demonstration Grants
Program’. M.S. was funded by a postgraduate scholarship from the NDARC
Educationan Trustees.
Alcohol and Alcoholism, 2018, Vol. 53, No. 5
CONFLICT OF INTEREST STATEMENT
None declared.
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