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Research Summary

The Impact of Neighborhood Alcohol Outlet Density on Alcohol-related Health Outcomes

Researchers in Louisiana and California conducted a cross-sectional study to assess the association between alcohol outlet density and self-reported alcohol-related health outcomes (i.e., sexually transmitted infection [STI], motor vehicle accidents, injury, liver problems, hypertension, and violence) in the last year. They also sought to determine whether these associations were mediated by individual alcohol use. Three measures of alcohol outlet density were used: neighborhood density (number of outlets per square mile of census tract), individual density (number of outlets within 1 mile of each subject’s home), and distance to the nearest outlet from each subject’s home.

  • The average distance to the nearest outlet was 0.5 miles. The average outlet density within 1 mile was 1.1.
  • In analyses adjusted for age, sex, race, ethnicity, education, location, and income, individual outlet density was associated with STI (adjusted odds ratio [AOR],* 1.80), liver problems (AOR, 1.33), and violence (AOR, 1.31). Distance to the nearest outlet was not associated with STI, liver problems, or violence.
  • Individual alcohol use partially mediated the relationship between outlet density, STI, and violence and fully mediated the association between outlet density and liver problems.
*Indicates the change in likelihood when outlet density increased by 1 unit.


It is important for primary care physicians to be aware of community contextual effects on a patient’s health. In this study, the association between outlet density and some alcohol-related health outcomes is only partially explained by individual alcohol use. Clinicians should keep in mind the potential impact of alcohol outlet density in a patient’s neighborhood as a factor in his or her health, even in the absence of unhealthy alcohol use. Nicolas Bertholet, MD, MSc


Theall KP, Scribner R, Cohen D, et al. The neighborhood alcohol environment and alcohol-related morbidity. Alcohol Alcohol. 2009;44(5):491–499.