Evidence map›Paper›PMID 38051148›Full record

ArticleAlcohol, clinical & experimental research2023

Health claims denial for alcohol intoxication: State laws and structural stigma.

Sunday Azagba, Todd Ebling, Mark Hall

Abstract read
In one paragraph

Article in Alcohol, clinical & experimental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Sunday AzagbaCollege of Nursing, Pennsylvania State University, University Park, Pennsylvania, USA.ORCID https://orcid.org/0000-0001-5810-2841
Todd EblingCollege of Nursing, Pennsylvania State University, University Park, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-7199-4108
Mark HallHealth Law and Policy Program, Wake Forest School of Law, Winston-Salem, North Carolina, USA.

Funding

Assessing the Effects of State Alcohol Exclusion Laws on Alcohol-Related Behaviors and OutcomesR01AA026666 · NIAAA · UNIVERSITY OF UTAH · PI AZAGBA, SUNDAY · 2018 to 2021
$1.5M
NIAAA NIH HHS R01 AA026666
6 · The paper itself

Abstract

backgroundSome alcohol exclusion laws (AELs) allow health insurers to deny coverage to individuals injured due to being intoxicated. Evidence has shown that such AELs disincentivize health-care providers to screen for alcohol while they deter treatment utilization by people with an alcohol use disorder (AUD). Certain states have changed AELs to enhance the health of people with an AUD, but these changes are not well documented in the extant literature. This study examined the current status and historical trends in AELs across US states.

methodsWe conducted a systematic legal analysis in 2023 to examine how state alcohol exclusion laws vary across the United States. These laws allow or prohibit insurers from denying coverage for injuries or deaths related to alcohol use. We classified the states into three categories: (1) States that explicitly permit alcohol exclusions, (2) States that explicitly ban alcohol exclusions, and (3) States that have no clear policy on alcohol exclusions.

resultsWe found that 18 states still have alcohol exclusion laws, down from 37 in 2004. Meanwhile, the number of states that have explicitly banned AELs and prohibited insurers from applying alcohol exclusions (AEs) to their policies has increased from 3 to 15 in the same period. The remaining 17 states have no clear laws on AEs. We also noted that five states that repealed their AELs did not adopt any specific prohibition on AEs, and four states limited their prohibition to policies that cover hospital, medical, or surgical expenses.

conclusionsOur systematic mapping reveals that some states have prohibited AELs in response to their detrimental effects. However, some states maintain these policies, and none has effectively outlawed AEs in the last 10 years, despite their possible role in reinforcing stigma.

Indexed as

alcohol exclusion lawsalcohol use disordersdiscriminationstructural stigmauniform accident and sickness policy provision law

Identifiers

PMID38051148
PMCPMC10699208

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.