The Geography of Availability
Principal Investigator: Paul J. Gruenewald, Ph.D.

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Our research has built upon the broad base of research in alcohol studies that shows that reducing the availability of alcohol appears to reduce use and related problems. We have gone on to ask (1) whether the geographic distribution of availability also affects the distribution of problems and whether such effects can be seen at the community level and (2) whether local differences in the distribution of availability affect drinking?

The answers to both questions are "yes".

Does the geographic distribution of availability affect the distribution of problems?

A series of detailed studies of the availability of alcohol and related problems in the state of California have revealed substantive associations between the availability of alcohol through alcohol outlets and several problem outcomes. These studies have shown that:

1. Alcohol-related motor vehicle crashes are associated with sales of alcohol at on-premise places, especially restaurants;

2. Alcohol-related pedestrian injuries are more likely to arise in areas of communities with high densities of bars, and;

3. Rates of violence are greatest around bars in densely packed urban areas.

Inquiries into the reasons why these associations exist remain an area of active research, but some basic stories can now be told.

It appears, for example, that alcohol-related motor vehicle crashes are greatest among those establishments located near high traffic flow areas of cities; near highways and freeway on-ramps that are difficult to negotiate and challenge driving skills.

It also appears that the presence of bars in dense urban environments with greater populations accelerates rates of assaults in neighborhoods of California communities. So, all populations produce some degree of violence that can result in hospitalizations related to assault. Those populations that produce the most violence have unique characteristics that account for substantial variations in assault rates.

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But, add greater densities of bars to the picture and one finds rates of violence produced in these populations once again accelerating.

All told, the new news about alcohol outlets is that they may not produce problems per se but they certainly appear to aggravate problems in those areas of our communities where availability is greatest.

Do local variations in the distribution of availability affect individual drinking?

As a look at the scientific literature reveals, it has been perilously difficult to study the relationships between the availability of alcohol and individual drinking behaviors. People move around so much between neighborhoods of communities that it is very difficult to pin down just what a good measure of availability might be. Should we measure the densities of outlets around their homes, their workplaces, in shopping areas, or all three?

There are no simple answers to these questions, but two observations are worth bearing in mind: First is the observation that despite these conceptual problems the range of availability across any given state can be enormous. In California, the range spans a factor of 5,000 or more (from 1 outlet every 150 roadway miles to 1 outlet every 150 feet, across zip codes). Second, it is not expected that individual drinkers per se will respond to these differences in availability, but rather the drinking of groups of drinkers; a group level effect.

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Using a very large study of 8000 drinkers in California from 1100 different zip code areas it might be possible to see availability effects. Using an appropriate multi-level model for this task we find that greater availability of alcohol has three separate effects.

Greater availability is related to:

• greater frequencies of drinking among drinking populations,
• greater use of specific drinking places for drinking (e.g., bars), and
• greater rates of drinking and driving.

This tripartite relationship of availability to drinking behaviors is displayed in this slide. Availability affects drinking, the choice of drinking places and drinking and driving; all components of which support drinking and driving in California communities.

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