Impact of Alcohol Outlet Density on Reported Cases of Child Maltreatment in Japan: Fixed Effects Analysis

Abstract

Background: Parental drinking habits or binge drinking are a known risk factor of child maltreatment. Though drinking habits are affected by alcohol outlet density, the direct association between alcohol outlet density and child maltreatment is still controversial. Purpose: This study aimed to examine the impact of off-premises alcohol outlet density on child maltreatment cases reported to Child Guidance Centers in Japan. Methods: A fixed effects model was used to investigate the association between a change in off-premises alcohol outlet density and a change in child maltreatment cases in each unit. Time-series of cross-sectional ecological data collected from across Japan over 16 years (2000 to 2015) was used, and maltreatment cases were further sub-grouped by type of maltreatment (physical, sexual, psychological abuse and neglect) and by perpetrators (father, stepfather, mother, and stepmother). Results: The association between alcohol outlet density and total cases of child maltreatment was not observed (coefficient = 0.98, 95% confidence interval: −6.30, 8.25). However, alcohol outlet density was shown to be positively associated with neglect (coefficient = 3.08, 95% confidence interval: 0.54, 5.62), which indicates that 1 alcohol outlet per 1,000 adults increase would lead to 3 more neglect cases per 10,000 children. Also, a negative association was observed between a change in the incidence of total child maltreatment by father and a change in alcohol outlet density (coefficient = −3.03, 95% confidence interval: −5.78, −0.28). Conclusion: The findings suggest that off-premises alcohol outlet density may have a causal effect on the increasing cases of neglect and decrease in maltreatment by father in Japan.