Evidence of a structural effect for alcohol outlet density: a multilevel analysis

Area of Science:

• Public Health
• Sociology
• Environmental Health

Background:

• Ecological studies link high alcohol outlet density to adverse alcohol-related outcomes.
• Previous research design limits distinguishing individual vs. neighborhood-level effects.
• Alcohol outlet density may affect individuals directly or through neighborhood structural factors.

Purpose of the Study:

• To differentiate between individual and neighborhood-level influences of alcohol outlet density on alcohol-related outcomes.
• To investigate the role of proximity to alcohol outlets at both individual and census tract levels.
• To analyze the relationship between alcohol outlet density and drinking norms/consumption.

Main Methods:

• A multilevel study design was employed.
• Individual distance to the nearest alcohol outlet and mean distance within census tracts were measured.
• Telephone surveys from 2604 households across 24 census tracts were analyzed, controlling for individual and neighborhood covariates.

Main Results:

• Census tract level accounted for 16.2% of variance in drinking norms and 11.5% in alcohol consumption.
• Individual distance to alcohol outlets showed no significant relationship with drinking norms or consumption.
• Mean distance to alcohol outlets at the neighborhood level was negatively associated with drinking norms and alcohol consumption.

Conclusions:

• The impact of alcohol outlet density on alcohol-related outcomes operates at the neighborhood level.
• Problem drinkers appear to aggregate in neighborhoods, a pattern predicted by alcohol outlet density.
• Findings highlight the importance of neighborhood context in understanding alcohol consumption patterns.