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Alcohol Outlet Clusters and Population Disparities.

Pamela J Trangenstein^1,2, Claire Gray³, Matthew E Rossheim⁴

¹Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA, 94608, USA. ptrangenstein@arg.org.

Journal of Urban Health : Bulletin of the New York Academy of Medicine

|July 3, 2019

Summary

Historical redlining significantly predicts alcohol outlet clusters in urban neighborhoods. Redlined areas show higher odds of being in off-premise alcohol clusters, contributing to health disparities.

Keywords:

Alcohol outlets Alcohol policy Clustering Health disparities Violence

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Area of Science:

Urban Health Disparities
Social Determinants of Health
Spatial Epidemiology

Background:

Alcohol outlet density is a recognized social determinant of urban health.
Limited understanding exists regarding the demographic composition of populations exposed to alcohol outlet clusters.
Clustering in specific racial/ethnic or economic groups may indicate a root cause of health inequities.

Purpose of the Study:

To investigate the relationship between neighborhood characteristics and the presence of alcohol outlet clusters.
To identify demographic and socioeconomic factors associated with alcohol outlet cluster membership.
To inform policy interventions aimed at reducing health disparities linked to alcohol outlets.

Main Methods:

Utilized 2016 Baltimore City liquor license data (n=1204) and American Community Survey demographic data.
Defined alcohol outlet clusters using SaTScan moving window methods and inter-outlet distances.
Employed multiple logistic regression to compare census block groups (CBGs) (n=537) inside and outside of four cluster types (total, on-premise, off-premise, LBD-7).

Main Results:

A history of redlining was the strongest predictor of alcohol outlet cluster membership.
Redlined CBGs had significantly higher odds of being in off-premise (7.32x), on-premise (8.07x), and LBD-7 (8.60x) clusters.
Economic disinvestment (vacant properties) differentiated on- and off-premise clusters, with disinvested areas favoring off-premise clusters.

Conclusions:

Historical redlining and disinvestment are key factors shaping the spatial distribution of alcohol outlets.
Off-premise alcohol outlet clusters in disinvested, redlined areas warrant specific policy attention to address health disparities.
Reversing neighborhood inequities requires addressing historical policies and mitigating the impact of existing alcohol outlet clusters.