Retail Availability of Alcohol

Alcohol Outlet Density

Three aspects of alcohol availability are regulated to some extent by all states in the US; alcohol outlet types (e.g., bars vs liquor stores), numbers of outlets in neighborhood or community areas (outlet density) and permissible locations (e.g., proximity to schools).  In general, on-premise outlets, those that permit use at the point of purchase, are regulated somewhat differently than off-premise outlets, those that allow take-away sales and do not typically permit use at point of purchase.  Historically, on-premise outlets have been the subject of more stringent regulation since they have been perceived as exposing populations to greater health risks such as heavy use, drunkenness and violence.  Early international work indicated that, short of prohibition, regulations on outlet densities could ameliorate community problems such as public drunkenness and violence.  PRC researchers performed the first state-level panel study demonstrating that outlet densities were related to alcohol sales¹ and recently completed the first effective demonstration of relationships of densities to use of drinking contexts and heavier drinking.²  PRC researchers have also been at the forefront developing technologies for the analysis of these data³ and demonstrating relationships between outlet densities and violent assaults,⁴ alcohol-related motor vehicle crashes,⁵ intimate partner violence,⁶ and child abuse and neglect.⁷

More recently, in partnership with researchers at University of Pittsburgh, PRC researchers completed two in-depth investigations of the impacts of on- and off-premise outlets on neighborhood alcohol problems.  For on-premise outlets, both neighborhood and outlet characteristics contribute to neighborhood problems.  Neighborhoods with higher density of on-premise outlets, and outlets (barrooms) crowded with young male patrons were associated with increased area violence.⁸  Lax local ordinances contributed to higher density of barrooms in late night hours.⁹  On the other hand, off-premise outlets were not linked with greater alcohol use in local areas. Greater densities of outlets in poorer non-White neighborhoods—an artifact of segregation policies—means that these neighborhoods host more alcohol outlets.¹⁰  However, more drinking was found to occur in higher-income neighborhoods with fewer bars, and more among White compared to non-White consumers.¹¹  In California cities the majority of off-premise outlets, particularly in poor non-White areas, are run as small businesses.  Managers in these stores had limited ability to control crime in and around their stores compared to large and chain stores which could afford security systems.¹²  People who consumed more alcohol, however, mostly bought their alcohol in large chain stores, bundled with groceries and other goods.¹³ In these ways, the social ecology of alcohol availability is interconnected with but not a mirror of social inequalities.  

The findings of these extensive studies are reflected in some of our recent population studies of alcohol outlets.  Outlets tend to most frequently locate in areas with greater population density near to but not in neighborhoods with greater wealth (a classic not-in-my-backyard, NIMBY, phenomenon that reinforces social inequities).¹⁴  Outlets tend to agglomerate where other outlets have already opened, accelerating these processes, and harms related to outlet densities increase.¹⁵  Most remarkably, although alcohol sales through off-premise outlets are a critical facet of risks for many problems, locations of on-premise outlets, especially and particularly bars, taverns and pubs, are conclusively related to many harms.¹⁶

References cited:

1. Gruenewald, P.J.; Ponicki, W.R.; & Holder, H.D. The relationship of outlet densities to alcohol consumption: A time series cross-sectional analysis. Alcoholism: Clinical and Experimental Research 17(1):38-47, 1993. PMID: 8452207
2. Gruenewald, P.J.; Remer, L.R.; and LaScala, E.A. (2014) Testing a social ecological model of alcohol use: The California 50‐city study. Addiction, 109(5):736-745. PMCID: PMC4106302
3. Banerjee, A.; LaScala, E.A.; Gruenewald, P.J.; Freisthler, B.; Treno, A.; and Remer, L.G. “Social disorganization, alcohol, and drug markets and violence: A space-time model of community structure.” In Thomas, Y.F.; Richardson, D.; and Cheung, I. (eds.) Geography and Drug Addiction. New York, NY: Springer Science and Business Media, 2008, pp. 119-132.
4. Mair, C.; Gruenewald, P.J.; Ponicki, W.R.; & Remer, L.G. Varying impacts of alcohol outlet densities on violent assaults: Explaining differences across neighborhoods. Journal of Studies on Alcohol and Drugs, 74:50-58, 2013. PMCID: PMC3517264
5. Ponicki, W.R.; Gruenewald, P.J.; & Remer, L.R. Spatial panel analyses of alcohol outlets and motor vehicle crashes in California: 1999-2008. Accident Analysis and Prevention, 55:135-143, 2013. PMCID: PMC4207645
6. Cunradi, C.B., Mair, C., Ponicki, W.R., & Remer, L.G. Alcohol outlet density and intimate partner violence-related emergency department visits. Alcoholism: Clinical and Experimental Research, 36(5), 847-853, 2012. PMCID: PMC3342440
7. Freisthler B.; Midanik L.T.; & Gruenewald P.J. Alcohol outlets & child physical abuse & neglect: Applying routine activities theory to the study of child maltreatment. Journal of Studies on Alcohol, 65:586-592, 2004. PMID: 15536767
8. Morrison C, Mair CF, Lee JP, Gruenewald PJ (2015). Are barroom and neighborhood characteristics independently related to local-area assaults? Alcoholism: Clinical and Experimental Research 39(12): 2463–2470. PMCID: PMC4712721.
9. Lee JP, Pagano A, Morrison C, Gruenewald PJ, Wittman F. (2018). Late night environments: Bar “morphing” increases risky alcohol sales in on-premise outlets. Drugs: Education, Prevention, & Policy, 25(5), 431-437.  PMCID: PMC6208448
10. Lee JP, Ponicki W, Mair C, Gruenewald P, Ghanem L. (2020). What explains the concentration of off-premise alcohol outlets in Black neighborhoods?. SSM-Population Health. 1;12:100669. PMID: 33102679
11. Mair C, Sumetsky N, Gruenewald PJ, Lee JP. (2020). Microecological relationships between area income, off‐premise alcohol outlet density, drinking patterns, and alcohol use disorders: The East Bay Neighborhoods Study. Alcoholism: Clinical and Experimental Research. 44(8):1636-45. PMID: 32573798
12. Ghanem L, Lee JP, Sumetsky N, Pagano A, Gruenewald P, Mair C (2020). Place management in off-premise alcohol outlets: results of a multi-methods study in a six-city California area. International Journal of Drug Policy, 80, p.102735. PMCID: PMC7321895
13. Frankeberger J, Gruenewald P, Sumetsky N, Lee JP, Ghanem L, Mair C. (2021). Dual use of off-premise outlets for alcohol and grocery purchases: Results from the East Bay Neighborhoods Study Journal of Studies on Alcohol and Drugs 82(6), 758-766 PMID: 34762035
14. Morrison, C., Gruenewald, P.J. and Ponicki, W.R. (2016) Race, ethnicity and exposure to alcohol outlets.  Journal of Studies on Alcohol and Drugs, 77(1), 68-76. PMC4711321
15. Gruenewald, P.J., Sumetsky, N., Ponicki, W.R., Lee, J.P. and Mair, C. (2022) Assessing the impacts of alcohol outlets on crime as a natural experiment: Agglomeration, churning and spatial effects. Addiction, 117, 2614-2622.  PMC Journal – In process
16. Gruenewald, P.J., Sumetsky, N., Mair, C., Lee, J., Ponicki, W.R. (2023) Micro-temporal analyses of crime related to alcohol outlets: A comparison of outcomes over weekday, weekend, daytime and nighttime hours.  Drug and Alcohol Review, 42, 902-911.  PMC Journal – In process

Hours and Days of Sale

Regulations on outlet density are often supplemented by restrictions on the hours and days permitted for alcohol sales. Examples of these restrictions include Sunday “blue laws” which originally precluded alcohol sales for religious reasons and regulations on hours of sale common to all states. The impacts of these restrictions on use and problems have been much debated, with advocates claiming policy effects and opponents arguing that, at best, these restrictions serve to redistribute use and problems to other days and times. PRC researchers have related later trading hours to increased homicides in a study of one change in Brazil¹. But few other studies have been executed by PRC researchers or anyone else in the U.S. The particular problem in the U.S. has been that suitable natural experiments by which to test these effects have rarely occurred. Changes in hours and days of sale typically take place as part of a bundle of other privatization steps (see above) making it very difficult to disentangle policy effects.

Reference cited:

1. Duailibi, S.; Ponicki, W.; Grube, J.W.; Pinsky, I.; Laranjeira, R.; & Raw, M. The effect of restricting opening hours on alcohol-related violence. American Journal of Public Health, 97:2276-2280, 2007. PMID: 17971559