Perhaps the greatest challenge to studies of the impacts of alcohol outlets on neighborhood health is the assessment of the degree to which alcohol sales through outlets affect individual and social problems. Almost universally, studies of outlets and problems focus upon the physical availability of alcohol, the number and densities of outlets in neighborhoods; in general, these are associated with problems like interpersonal violence and impaired driving. However, since comprehensive measures of alcohol sales through outlets are almost universally unavailable, all we can say from these studies is that there is some “outlet-related effect”. Whether that effect is related to patronizing an outlet (e.g., going to a bar) vs drinking at an outlet (i.e., drinking at that bar) is unknown.
The research literature convincingly demonstrates that some problems are related to the numbers and densities of outlets in neighborhood areas. Thus, regulating the numbers and densities of outlets to reduce problems appears to be a sensible policy strategy that can be implemented by communities in the US. However, problems related to outlets may be due to human activities in and around those outlets otherwise unrelated to the use of alcohol (e.g., routine social activities that lead to crowding or greater foot traffic through and around outlets) or to alcohol sales per se; we simply cannot tell the difference without adequate measures of sales. Thus, effective regulations on sales through outlets which may be achieved through the manipulation of beverage prices, limitations on hours and days of sale, specific conditions on products that can be sold, etc., will be uninformed to the extent we know little about effects related to sales vs outlets per se.
This project relies upon alcohol outlet and sales data collected and compiled in the Western Australia Alcohol Indicators Database (WAAID) over 30 years to assess differential effects of alcohol outlet numbers and densities vs sales of alcohol through those outlets upon a suite of critical neighborhood problems such as crime and hospital admissions related to interpersonal violence and impaired driving. We will establish the degree to which such outcomes are related to greater or lesser concentrations of outlets independent of sales through those outlets and build causal analysis models that bring us several steps closer to convincing causal arguments about outlet effects.