Citation

Ahern J, Margerison-Zilko C, Hubbard A, Galea S. Am. J. Public Health 2013; 103(4): e81-7.

Affiliation

Jennifer Ahern and Claire Margerison-Zilko are with the Division of Epidemiology, University of California, Berkeley School of Public Health, Berkeley. Claire Margerison-Zilko is also with the School of Social Work and Population Research Center, University of Texas at Austin. Alan Hubbard is with the Division of Biostatistics, University of California, Berkeley School of Public Health. Sandro Galea is with the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.

Copyright

(Copyright © 2013, American Public Health Association)

DOI

10.2105/AJPH.2012.301203

PMID

23409908

Abstract

Objectives. Alcohol outlet density has long been associated with alcohol-related harms, and policymakers have endorsed alcohol outlet restriction to reduce these harms. However, potential nonlinearity in the relation between outlet density and alcohol consumption has not been rigorously examined. Methods. We used data from the New York Social Environment Study (n = 4000) to examine the shape of the relation between neighborhood alcohol outlet density and binge drinking by using a generalized additive model with locally weighted scatterplot smoothing, and applied an imputation-based marginal modeling approach. Results. We found a nonlinear relation between alcohol outlet density and binge drinking; the association was stronger at densities of more than 80 outlets per square mile. Binge drinking prevalence was estimated to be 13% at 130 outlets, 8% at 80 outlets, and 8% at 20 outlets per square mile. Conclusions. This nonlinearity suggests that reductions in alcohol outlet density where density is highest and the association is strongest may have the largest public health impact per unit reduction. Future research should assess the impact of policies and interventions that aim to reduce alcohol outlet density, and consider nonlinearity in effects. (Am J Public Health. Published online ahead of print February 14, 2013: e1-e7. doi:10.2105/AJPH.2012.301203).

Language: en