Alcohol Outlet Density

A report of progress by Katie Meek

Special thanks to her supervisor Anna Buckner
What is alcohol outlet density?
According to the CDC Guide for Measuring Alcohol Outlet Density, alcohol outlet
density is “the concentration of retail alcohol outlets in a small area”

The manual does not give a hard and fast definition but suggests to determine alcohol
outlet density through either a container based approach (outlets per population in a
defined area), distance based (how many outlets are less than X miles away from each
other, or spatial-access based (measuring the inverse distance of the 5 nearest outlets
to a main point such as a population-weighted census tract centroid).
To see the manual: https://www.cdc.gov/alcohol/pdfs/CDC-Guide-for-Measuring-Alcohol-Outlet-Density.pdf
Purpose of this project:
To develop a baseline measurement of
on-premise alcohol outlet density it Utah in
order to:
-Assess disparities in alcohol outlet density
among communities.
-Reduce Excessive alcohol consumption
-Reduce specific alcohol-attributable
harms
-Manage the issuance of new alcohol
licenses, particularly in cluster areas.
-Conduct alcohol policy research, linking
harms to alcohol outlet density
METHODS
What counts as an alcohol outlet?
Which ones will be included in analysis
and surveillance?
Only outlets that served alcohol with the intention to be consumed on-site were included.

Outlets that are not set in one location (such as airlines and other transportation services) and/or are not
frequently accessible to the general public (private clubs and organizations) and/or do not generally cater to the
native Utah population (such as hotels) were excluded.

We essentially kept :

1. Restaurants that serve alcohol on site

2. Bars/taverns

These two categories were separately mapped and separate alcohol outlet densities were calculated based on
small statistical area boundaries and population counts.
Restaurant
Alcohol
Outlet Points
Throughout
Utah Small
Statistical
Areas
Bar Alcohol
Outlet
Points
Throughout
Utah Small
Statistical
Areas
Alcohol Density was then calculated by dividing the number
of bars and/or restaurants in an area by the total population
and then multiplying by 100,000.

The end result is a heat map that shows the bar/restaurant

locations per 100,000 individuals in a small statistical area.
(This is the definition currently being used to calculate and
see the effects of Alcohol Outlet Density...locations per
100,000 individuals.)
Restaurants
serving
alcohol per
100,000
individuals in
an area
Bars serving
alcohol per
100,000
individuals in an
area
Alcohol Attributable
Harms
According to the manual:
“Studies of the link between high alcohol outlet density and various harms related to
excessive alcohol use are useful to policy makers and other interested groups because
they can show the effects that changes to alcohol outlet density can have on health and
social outcomes (e.g., alcohol-impaired driving crashes, violence, unintentional injuries,
property damage, and quality of life issues). These assessments can also help policy
makers determine the need for additional controls on alcohol outlet density to reduce
the risk of alcohol-attributable harms in high-density areas.”
What we’ve looked at...
1. The rates of binge drinking in each small statistical area
2. The rates of heavy drinking in each small statistical area
3. The number of individuals using alcohol in each small statistical area
4. The counts of 100% alcohol attributable Emergency Department treat and release
encounters in each small statistical area
5. The counts of 100% alcohol attributable Hospital Discharges in each small
statistical area
6. The mortality rates of 100% alcohol attributable deaths in each small statistical
area
7. We just barely began looking at the location of alcohol related car crashes and
their proximity to bars and/or restaurant locations
Here are the heat maps of the various rates of alcohol
related harms by small statistical areas. Each map is
followed by the linear regression results comparing each
harm’s rates with the alcohol density of the area
(unadjusted for confounding factors and adjusted models
were done).

* I only displayed bar based alcohol outlet density regression tables for simplicity. If you’d like to see
restaurant based data, let me know.
Crude Rates of
Alcohol Attributable
Deaths Per
100,000 Persons
*Not mentioned in this figure is household income, marital
status, and unemployment that were also adjusted for
Crude Rates per
10,000- Alcohol
Attributable
Hospital Discharges
*Not mentioned in this figure is household income, marital
status, and unemployment that were also adjusted for
Crude Rates
per 10,000 -
Alcohol
attributable
Emergency
Department
Treat and
Release
Encounters
*Not mentioned in this figure is household income, marital
status, and unemployment that were also adjusted for
Age-adjusted
Percentage of
Population With
Current Alcohol
Use
*Not mentioned in this figure is household income, marital
status, and unemployment that were also adjusted for
Age-adjusted
Percentage, Binge
Drinking
*Not mentioned in this figure is household income, marital
status, and unemployment that were also adjusted for
Percentage of
Population
Participating
in Heavy
Drinking
*Not mentioned in this figure is household income, marital
status, and unemployment that were also adjusted for
So to summarize all the numbers here:
We can assume, with these confounders in consideration, bar alcohol outlet density is
impacting

1. Alcohol Attributable Deaths

2. Alcohol Attributable Hospital Discharges
3. Emergency Room Treat and Release Encounters
4. Heavy Drinking

And restaurant alcohol outlet density is impacting

1. Alcohol Attributable Deaths

2. Emergency Room Treat and Release Encounters
3. Heavy Drinking
And...this is just started...but here is a potential next step...
Looking at spatial associations between alcohol
related car crash locations and alcohol outlet
locations.
Alcohol related car crashes (yellow) and bar locations (blue
pins) in Weber and Morgan Counties:
Alcohol related car crashes (yellow) and restaurant
locations (red pins) for Weber and Morgan Counties:
Thank you for your insights!
References:
Centers for Disease Control and Prevention. Guide for Measuring Alcohol Outlet
Density. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health
and Human Services; 2017.

To see the manual: https://www.cdc.gov/alcohol/pdfs/CDC-Guide-for-Measuring-Alcohol-Outlet-Density.pdf