TY - JOUR
T1 - Alcohol Outlet Clusters and Population Disparities
AU - Trangenstein, Pamela J.
AU - Gray, Claire
AU - Rossheim, Matthew E.
AU - Sadler, Richard
AU - Jernigan, David H.
N1 - Funding Information:
The project described was supported by Award Numbers T32AA007240, Graduate Research Training in Alcohol Problems: Alcohol-related Disparities and P50AA005595, Epidemiology of Alcohol Problems: Alcohol-Related Disparities from the National Institute on Alcohol Abuse and Alcoholism. The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institute on Alcohol Abuse and Alcoholism or the National Institutes of Health.
Funding Information:
The project described was supported by Award Numbers T32AA007240, Graduate Research Training in Alcohol Problems: Alcohol-related Disparities and P50AA005595, Epidemiology of Alcohol Problems: Alcohol-Related Disparities from the National Institute on Alcohol Abuse and Alcoholism. The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institute on Alcohol Abuse and Alcoholism or the National Institutes of Health.
Publisher Copyright:
© 2019, The New York Academy of Medicine.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Alcohol outlet clusters are an important social determinant of health in cities, but little is known about the populations exposed to them. If outlets cluster in neighborhoods comprised of specific racial/ethnic or economic groups, then they may function as a root cause of urban health disparities. This study used 2016 liquor license data (n = 1204) from Baltimore City, Maryland, and demographic data from the American Community Survey. We defined alcohol outlet clusters by combining SaTScan moving window methods and distances between outlets. We used multiple logistic regression to compare census block groups (CBGs) (n = 537) inside and outside of four types of outlet clusters: total, on-premise, off-premise, and LBD-7 (combined on-/off-premise). The most robust predictor of alcohol outlet cluster membership was a history of redlining, i.e., racially discriminatory lending policies. CBGs that were redlined had 7.32 times the odds of being in an off-premise cluster, 8.07 times the odds of being in an on-premise cluster, and 8.60 times the odds of being in a LBD-7 cluster. In addition, level of economic investment (marked by vacant properties) appears to be a key characteristic that separates CBGs in on- and off-premise outlet clusters. CBGs with racial/ethnic or socioeconomic advantage had higher odds of being in on-premise clusters and CBGs marked by disinvestment had higher odds of being in off-premise clusters. Off-premise clusters deserve closer examination from a policy perspective, to mitigate their potential role in creating and perpetuating social and health disparities. In addition to addressing redlining and disinvestment, the current negative effects of alcohol outlet clusters that have grown up in redlined and disinvested areas must be addressed if inequities in these neighborhoods are to be reversed.
AB - Alcohol outlet clusters are an important social determinant of health in cities, but little is known about the populations exposed to them. If outlets cluster in neighborhoods comprised of specific racial/ethnic or economic groups, then they may function as a root cause of urban health disparities. This study used 2016 liquor license data (n = 1204) from Baltimore City, Maryland, and demographic data from the American Community Survey. We defined alcohol outlet clusters by combining SaTScan moving window methods and distances between outlets. We used multiple logistic regression to compare census block groups (CBGs) (n = 537) inside and outside of four types of outlet clusters: total, on-premise, off-premise, and LBD-7 (combined on-/off-premise). The most robust predictor of alcohol outlet cluster membership was a history of redlining, i.e., racially discriminatory lending policies. CBGs that were redlined had 7.32 times the odds of being in an off-premise cluster, 8.07 times the odds of being in an on-premise cluster, and 8.60 times the odds of being in a LBD-7 cluster. In addition, level of economic investment (marked by vacant properties) appears to be a key characteristic that separates CBGs in on- and off-premise outlet clusters. CBGs with racial/ethnic or socioeconomic advantage had higher odds of being in on-premise clusters and CBGs marked by disinvestment had higher odds of being in off-premise clusters. Off-premise clusters deserve closer examination from a policy perspective, to mitigate their potential role in creating and perpetuating social and health disparities. In addition to addressing redlining and disinvestment, the current negative effects of alcohol outlet clusters that have grown up in redlined and disinvested areas must be addressed if inequities in these neighborhoods are to be reversed.
KW - Alcohol outlets
KW - Alcohol policy
KW - Clustering
KW - Health disparities
KW - Violence
UR - http://www.scopus.com/inward/record.url?scp=85069459761&partnerID=8YFLogxK
U2 - 10.1007/s11524-019-00372-2
DO - 10.1007/s11524-019-00372-2
M3 - Article
C2 - 31264024
AN - SCOPUS:85069459761
SN - 1099-3460
VL - 97
SP - 123
EP - 136
JO - Journal of Urban Health
JF - Journal of Urban Health
IS - 1
ER -