Social disadvantage and exposure to lower priced alcohol in off-premise outlets

Dual Use of Off-Premise Outlets for Alcohol and Grocery Purchases: Results From the East Bay Neighborhoods Study

OBJECTIVE

Alcohol privatization efforts have enabled consumers in many states in the United States to purchase alcohol in a variety of off-premise outlets, including grocery stores. This study examines the dual use of outlets to purchase both alcohol and groceries and the extent to which dual use is related to individual income, neighborhood income, and local physical availability of alcohol.

METHOD

The East Bay Neighborhoods Study surveyed residents from 72 microecological neighborhoods across six cities in Alameda County, California. Eligible respondents who purchased alcohol in the last year (n = 707) were asked about the off-premise outlet in which they most often purchase alcohol. Purchasing behaviors within this outlet, including purchasing groceries and frequency of visits to the outlet, were assessed. Multilevel logistic regression and negative binomial models assessed outcomes.

RESULTS

Seventy-three percent of participants reported dual use of their most used outlet for groceries and alcohol. In adjusted models, dual use of the outlet was not associated with individual income, alcohol use, or neighborhood outlet density but was positively associated with neighborhood income and the number of outlet visits. After adjustment, dual use of the most used outlet was associated with 0.77 more visits per 28 days.

CONCLUSIONS

Results suggest that convenience and reduced time costs for purchasing alcohol encourage the dual use of outlets, particularly in high-income neighborhoods. Differences in the dual use of outlets and frequency in outlet use by neighborhood environments highlight the importance of understanding the role of alcohol availability in distinct neighborhood income and outlet-level contexts.

Leisure activity participation in relation to alcohol purchasing and consumption in adolescence

BACKGROUND

Building upon the socioecological perspective, this study examines prospective associations linking leisure activity participation with alcohol purchasing and consumption in early adolescence.

METHODS

A total of 1763 seventh graders (age 12-13 years) were recruited from middle schools in urban Taiwan via multi-stage sampling and followed-up 1.5 years later during ninth grade. Information about leisure activities, covariates (i.e., gender, puberty development, family structure, parental educational attainment, monthly allowance, peer drinking, and childhood alcohol experience), and two outcome variables (i.e., alcohol purchasing and drinking behaviors) was gathered via web-based self-administered questionnaires. Data concerning alcohol outlets and recreational resource for each community district were retrieved from official statistics and commercial sources. Two-level hierarchical generalized linear models were used to evaluate association estimates.

FINDINGS

Five percent of ninth graders ever purchased alcohol and nearly one in seven drank alcohol on three or more occasions (i.e., occasional drinking) in the past year. Sports, unstructured, and organized leisure activities were not linked with illegal alcohol purchasing when community contexts were statistically adjusted; a higher community on-premised alcohol outlet density increased alcohol purchasing by 94% (95% CI = 1.24-3.06). In contrast, unstructured leisure activity participation at 7th grade predicted occasional drinking (adjusted Odds Ratio [aOR] = 5.52; 95% CI = 3.13-9.74). Sports participation was associated with reduced risk of occasional drinking in the communities with high unregulated alcohol outlets (aOR for interaction = 0.58; P < .001).

CONCLUSION

Our research provides insights to differential roles of leisure activity participation in shaping adolescents' commercial alcohol access and occasional drinking. Macro-social contexts should be considered in the efforts to reduce underage drinking problems through leisure activities.

The role of neighborhood disadvantage, physical disorder, and collective efficacy in adolescent alcohol use: a multilevel path analysis

Research into the salient exposures which explain neighborhood variation in adolescent alcohol use remains inconclusive. The Social Disorganization Theory suggests that neighborhood-level disadvantage may reduce collective efficacy to control adolescent risky behavior. Collective perceptions of physical disorder are also implicated in this neighborhood pathway. Drawing on data from a nationally-representative survey of urban high school students in New Zealand, multilevel path analysis was used to estimate the direct and mediating effects of neighborhood disadvantage, physical disorder, and collective efficacy on current drinking, frequency of binge drinking, and typical quantity of alcohol consumed. The findings supported an indirect pathway from disadvantage to binge drinking and high typical quantities in young adolescents (<16 years), mediated by physical disorder and reduced collective efficacy. Collective efficacy was not associated with current drinking in young adolescents. An opposing indirect effect was evident among older adolescents (≥16 years), whereby collective efficacy was positively associated with drinking outcomes. Implications for future research are discussed.

Price elasticity of on- and off-premises demand for alcoholic drinks: A Tobit analysis

BACKGROUND

Understanding how price policies will affect alcohol consumption requires estimates of the impact of price on consumption among different types of drinkers and across different consumption settings. This study aims to estimate how changes in price could affect alcohol demand across different beverages, different settings (on-premise, e.g., bars, restaurants and off-premise, e.g., liquor stores, supermarkets), and different levels of drinking and income.

METHODS

Tobit analysis is employed to estimate own- and cross-price elasticities of alcohol demand among 11 subcategories of beverage based on beverage type and on- or off-premise supply, using cross-sectional data from the Australian arm of the International Alcohol Control Survey 2013. Further elasticity estimates were derived for sub-groups of drinkers based on their drinking and income levels.

RESULTS

The results suggest that demand for nearly every subcategory of alcohol significantly responds to its own price change, except for on-premise spirits and ready-to-drink spirits. The estimated demand for off-premise beverages is more strongly affected by own price changes than the same beverages in on-premise settings. Demand for off-premise regular beer and off-premise cask wine is more price responsive than demand for other beverages. Harmful drinkers and lower income groups appear more price responsive than moderate drinkers and higher income groups.

CONCLUSION

Our findings suggest that alcohol price policies, such as increasing alcohol taxes or introducing a minimum unit price, can reduce alcohol demand. Price appears to be particularly effective for reducing consumption and as well as alcohol-related harm among harmful drinkers and lower income drinkers.

Testing spatial measures of alcohol outlet density with self-rated health in the Australian context: Implications for policy and practice

INTRODUCTION AND AIMS

Reducing access to alcohol is an important and cost-effective strategy for decreasing alcohol consumption and associated harm. Yet this is a less common approach to alcohol control in Australia. The aim of this research was to ascertain which alcohol outlet density spatial measures were related to long-term health outcomes, and the extent to which this differs for those living in more or less disadvantaged neighbourhoods.

DESIGN AND METHODS

Existing Australian state-level spatial alcohol policies were reviewed. No appropriate spatial policies were identified; therefore, the literature was used to identify potential alcohol-related spatial measures. Spatial measures of alcohol outlet density were generated in a geographical information system and linked with health survey data drawn from 3141 adults living in metropolitan Melbourne. Logistic regression analysis was used to examine associations between alcohol outlet density measures, self-rated health and area-level disadvantage.

RESULTS

Twelve spatial measures of alcohol outlet density were generated. Alcohol outlet density and self-rated health associations varied by area-level disadvantage. For those living in more disadvantaged areas, not having off-licenses available within 800 m, or on-licenses available within 400 m were protective of self-rated health.

DISCUSSION AND CONCLUSIONS

Local alcohol outlet density may have a more detrimental effect on self-rated health for those living in more disadvantaged neighbourhoods, compared with those living in more advantaged areas. There is a need for spatial alcohol policies to help reduce alcohol-related harm. This research proposes a set of spatial measures to generate a more consistent understanding of alcohol availability in Australia. [Badland H, Mavoa S, Livingston M, David S, Giles-Corti B. Testing spatial measures of alcohol outlet density with self-rated health in the Australian context: Implications for policy and practice. Drug Alcohol Rev 2016;35:298-306].