Towards a direct definition of an alcohol‐related death: an analysis in Aboriginal adults

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Abstract
This paper addresses the conceptual and methodological difficulties in obtaining reliable information on alcohol‐related mortality in Aboriginal communities. A working definition is proposed; this requires an alcohol‐positive history together with a consistent mode of death, and is applied retrospectively to a series of 29 adult deaths in a large Aboriginal community. An informant history of alcohol abuse was found to be the most sensitive indicator of an alcohol‐positive history and correlated well with autopsy findings and medical records. Alcohol‐positive histories were found for 17 of 29 deaths by informant history, for 9 of 29 by autopsy findings, and for 12 of 29 by medical record review. These indicators were combined with a mode of death categorisation to arrive at an estimate of 5 of 29 definite, 5 of 29 probable, and 1 of 29 possible alcohol‐related deaths. We conclude by examining the process by which such a definition might be further developed and the context in which resulting information might then be used.