Twenty-five-year changes in alcohol environment in US metropolitan areas: Examining patterns by area level...

Limiting the availability of alcohol is one of the most effective approaches for reducing alcohol misuse and its health consequences. However, few studies have examined the changing trajectories of alcohol environment characterized jointly by on- and off-premises outlets and their sociodemographic disparities. We aimed to (1) explore 25-year profiles of changes in the alcohol environment in urban areas in the U.S.; and 2) examine sociodemographic disparities in these changes. We used parallel-process latent class growth analyses to identify profiles of changes in the alcohol environment, based on the availability of both on-premises and off-premises outlets. We employed conditional multinomial models to examine associations between profiles of change in the alcohol environment and sociodemographic characteristics at census tract level. We identified 6 distinct profiles that outlined variations in availability of on- and off-premises alcohol outlets and change trajectories, and found variability in these trajectories across racial/ethnic and socioeconomic groups. Tracts with a higher percentage of Blacks and other minoritized populations had higher odds of being in alcohol environment classes featuring high/medium density of alcohol outlets and increasing trends of on-premises outlets. Additionally, tracts with lower income and lower percentage of residents with college degree had higher odds of having medium and high density of alcohol outlets and increasing in on-premises outlets over time. Differences by area level income and education were greater for Blacks and other minority racial/ethnic groups. Since alcohol outlets often require licensing to open, our results suggest that policy-level interventions are needed to reduce racial/ethnic and socioeconomic disparities.