Alcohol Outlet Density and Area-Level Heavy Drinking Are Independent Risk Factors for Higher Alcohol-Related Complaints
Alcohol outlet density has well-documented associations with social and health indicators such as crime and injury. However, significantly less is known about the relationships among alcohol-related complaints. Bayesian hierarchical Poisson regression with spatial autocorrelation was used to model the association between on- and off-premises alcohol outlet density and area-level prevalence of current drinkers and heavy drinking, and graffiti density—an indicator of physical disorder—in association with calls from civilians reporting illegal use, alcohol sales, and other alcohol-related activities (hereafter alcohol-related complaints). Complaints were separated into two groups based on whether they occurred at (a) clubs/bars/restaurants or (b) elsewhere. Alcohol-related complaints and graffiti were collected from NYC Open Data. Alcohol density data are from ESRI Business Analyst and information on the prevalence of drinking from the New York City Community Health Survey. The unit of analysis consisted of ZIP codes in New York City (n = 167), and the design was a cross-sectional analysis of aggregated data between 2009 and 2015. In multivariable models, a one-unit increase in off-premises alcohol outlet density was associated with a 47% higher risk of alcohol-related complaints at clubs, bars, and restaurants [rate ratio (RR = 1.46, 95% CI = 1.21, 1.77)]. Area-level prevalence of heavy drinking was associated with a 59% higher risk of alcohol-related complaints at the club, bars, and restaurants (RR = 1.59, 95% CI = 1.34, 1.86) and a 40% higher risk of complaints elsewhere (RR = 1.40, 95% CI = 1.20, 1.63). In New York City, area-level heavy drinking prevalence is a strong independent mechanism that links alcohol outlet density to alcohol-related complaints. Area-level heavy drinking should be investigated as a predictor of other public health problems such as drug overdose mortality.
KeywordsAlcohol availability Alcohol-related complaints New York City Heavy drinking
We thank Bureau of Epidemiology Services in the New York City Department of Health and Mental Hygiene for providing access to the ZIP-code level CHS data.
We thank Jeffery Blossom and Giovanni Zambotti in the Center for Geographic Analyses, Harvard University for geographic information systems related support and acquiring data from Business Analyst in ArcGIS.
Y. Ransome received funding from the Alonzo Smythe Yerby Postdoctoral Fellowship at Harvard T.H. Chan School of Public Health, and the National Institute of Mental Health K01MH111374. Support for data collection and analysis came from pilot funding from the Robert Wood Johnson Foundation Health and Society Scholars Program at Harvard University. D. Duncan was supported by grants from the National Institutes of Health and the Center for Disease Control and Prevention, including R01MH112406, U01PS005122, R21MH110190, and R03DA039748.
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