Citation

Nesoff ED, Milam AJ, Branas CC, Martins SS, Knowlton AR, Furr-Holden DM. Alcohol Clin. Exp. Res. 2018; 42(10): 1979-1987.

Affiliation

Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, Flint, Michigan.

Copyright

(Copyright © 2018, John Wiley and Sons)

DOI

10.1111/acer.13844

PMID

30102415

Abstract

BACKGROUND: Alcohol outlet density has been associated with increased pedestrian injury risk. It is unclear whether this is because alcohol outlets are located in dense retail areas with heavy pedestrian traffic or whether alcohol outlets contribute a unique neighborhood risk. We aimed to compare the pedestrian injury rate around alcohol outlets to the rate around other, similar retail outlets that do not sell alcohol.

METHODS: A spatial analysis was conducted on census block groups in Baltimore City. Data included pedestrian injury emergency medical services (EMS) records from January 1, 2014 to April 15, 2015 (n = 848); locations of alcohol outlets licensed for off-premise (n = 726) and on-premise consumption (n = 531); and corner (n = 398) and convenience stores (n = 192) that do not sell alcohol. Negative binomial regression was used to determine the relationship between retail outlet count and pedestrian injuries, controlling for key confounding variables. Spatial autocorrelation was also assessed and variable selection adjusted accordingly.

RESULTS: Each additional off-premise alcohol outlet was associated with a 12.3% increase in the rate of neighborhood pedestrian injury when controlling for convenience and corner stores and other confounders (incidence rate ratio [IRR] = 1.123, 95% confidence interval [CI] = 1.065, 1.184, p < 0.001). The attributable risk was 4.9% (95% CI = 0.3, 8.9) or 41 additional injuries. On-premise alcohol outlets were not significant predictors of neighborhood pedestrian injury rate in multivariable models (IRR = 0.972, 95% CI = 0.940, 1.004, p = 0.194).

CONCLUSIONS: Off-premise alcohol outlets are associated with pedestrian injury rate, even when controlling for other types of retail outlets.

FINDINGS reinforce the importance of alcohol outlets in understanding neighborhood pedestrian injury risk and may provide evidence for informing policy on liquor store licensing, zoning, and enforcement.

© 2018 by the Research Society on Alcoholism.

Language: en

Keywords

Alcohol Availability; Alcohol Outlets; Neighborhood; Pedestrian Injury; Spatial Analysis