May 5, 2008 While previous studies have confirmed a relationship between alcohol-outlet density and violence, few have looked at what happens within a suburb as outlet density changes. An Australian study examined this relationship over time ... finding that increasing the density of all kinds of alcohol outlets in a suburb leads to increasing rates of violence in that suburb.
"The literature shows that suburbs with more alcohol outlets experience more violence, but only a handful of papers have explored what happens within a suburb as outlet density changes," explained Michael Livingston, a research fellow at the Turning Point Alcohol and Drug Centre and the study's sole author. "In addition, the study examined whether different types of outlets -- hotel pubs, bars and restaurants, packaged-liquor outlets -- had different effects in specific types of suburbs -- inner-city, outer-suburbs, etc. -- which is a question that few studies in this area have examined."
"A longitudinal study like this provides much stronger evidence about the causal nature of any relationships found," added Robin Room, director of the Alcohol Education and Rehabilitation Centre for Alcohol Policy Research and professor in the school of population health at the University of Melbourne.
Livingston gathered and analyzed nine years of information, from the years 1996 to 2005, for three groupings of data: three types of alcohol outlets -- general (hotel), on-premise (nightclubs, restaurants and bars), and packaged -- using liquor-licensing records; alcohol-related violence, using police-recorded night-time assault numbers; and 186 postcodes (the equivalent of zip codes) in the metropolitan area of Melbourne, corresponding to roughly 85 percent of the population. The postcodes were further grouped into five clusters, based on socio-demographics.
"The study found that, across Melbourne, the three types of outlets examined -- hotel pubs, bars, and packaged liquor outlets -- all had positive relationships to assault rates," said Livingston. "In other words, increasing the density of these outlets in a suburb leads to increasing rates of violence in that suburb. When these relationships were explored for specific types of suburbs, it was found that hotels and bars were the biggest drivers of violence in inner-city areas and packaged liquor outlets were more important in suburban areas."
Livingston explained that, for inner-city areas, each additional hotel pub or on-premise license was related to two extra night-time assaults per year -- the strongest link found in the study. Bars and restaurants were strongly related to violence in inner-suburban areas, with each extra premise responsible for, on average, an extra 0.5 night-time assaults per year. Packaged liquor outlets were the strongest influence on violence rates in outer-suburban areas, he added.
"The results of this study don't really point to particular communities being more at risk than others," Livingston said, "instead they suggest that different types of outlets are problematic in different areas."
"These differences likely reflect how different types of outlets function in different parts of the metropolitan area," added Room. "Many of the purchases from downtown package stores may be by commuters, with the alcohol consumed elsewhere, while package stores in the suburbs may be more problematic, for instance, in attracting under-age drinkers. Generally, it seems that on-premise outlets may be more problematic downtown, while packaged liquor outlets are more problematic in the suburbs."
Both Livingston and Room recommend that greater attention be paid to outlet density when issuing liquor licenses.
"The strong longitudinal relationship between outlet density and violence greatly strengthens the evidence base that density of alcohol outlets in a suburb is a driver of violence, making liquor licensing and planning regulations legitimate areas for public-health interventions," said Livingston.
"Alcohol controls," noted Room, "that is, limits on the number of licenses, on opening hours, etc., definitely matter, even if we often take them for granted as part of the social scenery. Rates of harms due to drinking can be influenced by these kinds of not-very-visible controls. Specifically, the density of alcohol outlets is an important dimension to consider in alcohol policymaking."
Livingston recommended that residents pay attention to the number and kind of alcohol outlets in their neighborhoods. "The strongest implication of these findings for the average reader is that changes to the local environment, through additional outlets, can lead to increasing local problems, such as violence. We're advocating a much more localised approach to liquor licensing, where local governments have a greater say in how their areas are developed."
The study "A Longitudinal Analysis of Alcohol Outlet Density and Assault" will be published in the June issue of Alcoholism: Clinical & Experimental Research and are currently available at OnlineEarly.
The study was funded by the Alcohol Education and Rehabilitation Foundation.
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