Alcohol Outlets Increase Hospitalizations for Assault

Violence is a well-described consequence of unhealthy alcohol use. In this study, researchers from California examined whether violent assaults are related to the density of alcohol outlets in certain communities. They linked hospital discharge data on people with interpersonal violence injuries; industry data on the location of liquor stores, restaurants, bars, and pubs; and census data by zip code.

• Rates of hospitalization for assault were highest in densely populated, poor urban areas with a large proportion of minorities and substantial instability (e.g., high unemployment).
• In analyses adjusted for neighborhood characteristics, a greater density of liquor stores was directly related to higher assault rates.
• A greater density of bars was associated with higher assault rates only in unstable, poor urban areas with many minorities and in middle-income rural areas.

Comments:

This study of assaults leading to overnight hospitalization, which are more serious and less common than other assaults, is less subject to community reporting bias than are studies based on police reports. The relationship of liquor outlets to community assaults naturally raises questions about the mechanism of action: Does greater availability of alcohol lead to greater consumption and therefore more belligerence? Or, are people who congregate near liquor stores more prone to hostility? Whatever the reason, clinicians have sufficient evidence to advocate for public health initiatives that limit licensure of liquor outlets in vulnerable neighborhoods.

Peter D. Friedmann, MD, MPH

Reference:

Gruenewald PJ, Freisthler B, Remer L, et al. Ecological models of alcohol outlets and violent assaults: crime potentials and geospatial analysis. Addiction. 2006;101(5):666–677.