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Social disadvantage and exposure to lower priced alcohol in off-premise outlets.

ABSTRACT: Greater concentrations of off-premise alcohol outlets are found in areas of social disadvantage, exposing disadvantaged populations to excess risk for problems such as assault, child abuse and intimate partner violence. This study examines whether the outlets to which they are exposed also sell cheaper alcohol, potentially further contributing to income-related health disparities.We conducted unobtrusive observations in 295 off-premise outlets in Melbourne, Australia, randomly selected using a spatial sample frame. In semi-logged linear regression models, we related the minimum purchase price for a 750?mL bottle of wine to a national index of socioeconomic advantage for the census areas in which the outlets were located. Other independent variables characterised outlet features (e.g. volume, chain management) and conditions of the local alcohol market (adjacent outlet characteristics, neighbourhood characteristics).A one decile increase in socioeconomic advantage was related to a 1.3% increase in logged price. Larger outlets, chains, outlets adjacent to chains, outlets in greater proximity to the nearest neighbouring outlet and those located in areas with more students also had cheaper alcohol.Not only are disadvantaged populations exposed to more outlets, the outlets to which they are exposed sell cheaper alcohol. This finding appears to be consistent with the spatial dynamics of typical retail markets.

SUBMITTER: Morrison C

PROVIDER: S-EPMC4501384 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Social disadvantage and exposure to lower priced alcohol in off-premise outlets.

Morrison Christopher C Ponicki William R WR Smith Karen K

Drug and alcohol review 20150325 4

<h4>Introduction and aims</h4>Greater concentrations of off-premise alcohol outlets are found in areas of social disadvantage, exposing disadvantaged populations to excess risk for problems such as assault, child abuse and intimate partner violence. This study examines whether the outlets to which they are exposed also sell cheaper alcohol, potentially further contributing to income-related health disparities.<h4>Design and methods</h4>We conducted unobtrusive observations in 295 off-premise out ...[more]

PMID: 25808717

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Project description:To assess spatial accessibility measures to on-premise alcohol outlets at census block, census tract, county, and state levels for the United States.Using network analysis in a geographic information system, we computed distance-based measures (Euclidean distance, driving distance, and driving time) to on-premise alcohol outlets for the entire U.S. at the census block level. We then calculated spatial access-based measures, specifically a population-weighted spatial accessibility index and population-weighted distances (Euclidean distance, driving distance, and driving time) to alcohol outlets at the census tract, county, and state levels. A multilevel model-based sensitivity analysis was conducted to evaluate the associations between different on-premise alcohol outlet accessibility measures and excessive drinking outcomes.The national average population-weighted driving time to the nearest 7 on-premise alcohol outlets was 5.89 min, and the average population-weighted driving distance was 2.63 miles. At the state level, population-weighted driving times ranged from 1.67 min (DC) to 15.29 min (Arizona). Population-weighted driving distances ranged from 0.67 miles (DC) to 7.91 miles (Arkansas). At the county level, population-weighted driving times and distances exhibited significant geographic variations, and averages for both measures increased by the degree of county rurality. The population-weighted spatial accessibility indexes were highly correlated to respective population-weighted distance measures. Sensitivity analysis demonstrated that population weighted accessibility measures were more sensitive to excessive drinking outcomes than were population weighted distance measures.These results can be used to assess the relationship between geographic access to on-premise alcohol outlets and health outcomes. This study demonstrates a flexible and robust method that can be applied or modified to quantify spatial accessibility to public resources such as healthy food stores, medical care providers, and parks and greenspaces, as well as, quantify spatial exposure to local adverse environments such as tobacco stores and fast food restaurants.

Project description:BackgroundAlcohol outlets have been associated with various forms of injury and may contribute to neighborhood disparities in drug overdose. Few studies have examined the associations between alcohol outlets and drug overdose. This study investigated whether alcohol outlets were associated with the neighborhood drug overdose rate and whether the sale of drug paraphernalia contributes to this association.MethodsA cross-sectional ecological spatial analysis was conducted within census block groups in Baltimore City (n = 653). Outcomes were counts of EMS calls for any drug overdose in 2015 (n = 3,856). Exposures of interest were counts of alcohol outlets licensed for off-premise and on-premise consumption and the proportion of off-premise outlets selling drug paraphernalia (e.g., blunt wrappers, baggies, pipes). Negative binomial regression was used to assess the relationship between outlet count and overdose rate, and if paraphernalia sales altered this relationship, controlling for other neighborhood factors. Spatial autocorrelation was assessed and regression inference adjusted accordingly.ResultsEach additional off-premise alcohol outlet was associated with a 16.6% increase in the neighborhood overdose rate (IRR=1.17, 95%CI=(1.11, 1.23)), adjusted for other neighborhood variables. On-premise alcohol outlets were not significantly associated with overdose rate when adjusting for off-premise alcohol outlets (IRR=1.01, 95% CI=(0.97, 1.06)). The proportion of off-premise outlets that sold drug paraphernalia was negatively associated with overdose rate (IRR=0.55, 95% CI=(0.41, 0.74)) and did not alter the relationship between off-premise outlets and overdose.ConclusionThis study provides preliminary public health evidence for informing policy decisions about alcohol outlet licensing and zoning. Alcohol outlets could be potential community partners for harm reduction strategies such as health communication in identifying overdose symptoms or Good Samaritan Laws.

Dataset Information

Social disadvantage and exposure to lower priced alcohol in off-premise outlets.

Publications

Social disadvantage and exposure to lower priced alcohol in off-premise outlets.

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