Prior studies have not only demonstrated a clear connection between alcohol outlets and alcohol-related problems, they have also shown that certain types of outlets are associated with different types of problem outcomes. A new study shows that a particular group, underage youth and young adults, have specific problems -- injury accidents, traffic crashes, and assaults that are related to specific types of alcohol outlets -- off-premise outlets, bars and restaurants.
Results will be published in the March 2010 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Over the past four decades, public health researchers have come to recognize that although most drinkers safely purchase and enjoy alcohol from alcohol outlets, these places are also associated with serious alcohol-related problems among young people and adults," said Paul J. Gruenewald, senior research scientist at the Prevention Research Center and corresponding author for the study.
"In the early studies, researchers believed associations were due to increased alcohol consumption related to higher alcohol outlet densities," added Richard Scribner, D'Angelo Professor of Alcohol Research at the LSU School of Public Health. "However, as the research area has matured, the relations appear to be far more complex. It seems that alcohol outlets represent an important social institution within a neighborhood. As a result, their effects are not limited to merely the consequences of the sale of alcohol."
For this study, researchers obtained non-public hospital discharge data from the California Office of Statewide Health Planning and Development, including residential zip code and patient age for all patients discharged. Ninety-nine percent of the injury records were successfully mapped to zip codes. Population demographics, place characteristics, and data related to alcohol outlets were also collected from various sources, and modeled in relation to two age groups: underage youth between 18 and 20 years of age, and of-age young adults 21 to 29 years of age.
"Greater numbers of off-premise outlets such as take-out establishments were associated with greater injuries from accidents, assaults, and traffic crashes for both underage and of-age young adults," said Gruenewald. "But only among of-age young adults were greater number of restaurants related to traffic crash injuries and greater numbers of bars related to assault injuries. These findings confirm previous observations that drinking at bars may be a particular risk for aggression and alcohol-related assaults while drinking at restaurants may be a particular risk for drunken driving and alcohol-related traffic crashes. The findings also confirm prior studies that indicate underage risks are uniquely associated with off-premise establishments."
"In other words," said Scribner, "the pattern of alcohol-related injuries among underage youth and young adults is not random; their occurrence is shaped by the density and type of alcohol outlets in a neighborhood. For example, when young adults reach the minimum legal drinking age, they begin legally drinking in bars where events such as bar fights are relatively common, and more likely when the density of bars increases. A little more complex is the strong association between an increasing density of off-premise outlets such as convenience stores and liquor stores, and higher rates of all injury outcomes among both underage youth and young adults. The authors indicate this association may be related to broader social factors where the concentration of these types of alcohol outlets in a neighborhood influences the social networks of both youth and young adults by reinforcing high-risk drinking practices. Clearly this type of research can help to develop informed policy in areas where high rates of youth injuries are considered a problem."
The key message, said both Gruenewald and Scribner, is that a neighborhood's alcohol environment plays a role in regulating the risks that youth and young adults will be exposed to as they mature.
"From a prevention perspective, this represents an important refocusing of priorities, away from targeting the individual to targeting the community," said Scribner. "This is hopeful because a community-based approach that addresses the over concentration of alcohol outlets in a neighborhood where youth injuries are a problem is relatively easy compared with interventions targeting each youth individually."
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