Off-premise alcohol outlet characteristics and violence

Examining the role of social vulnerability, neighborhood characteristics, and geospatial patterns of firearm-related injuries and clinical outcomes in Milwaukee county

BACKGROUND

Previous work has shown socioenvironmental factors can influence firearm injury. Milwaukee County, Wisconsin is a diverse midwestern county with historic disinvestment in marginalized communities yielding stark segregation along racial and ethnic lines. It is also one of the many U.S. counties burdened by surging firearm injuries. The differences among communities within Milwaukee County provides a unique opportunity to explore the intersection of socioenvironmental factors that may affect clinical outcomes and geospatial patterns of firearm injury.

METHODS

The trauma registry from the regional adult level 1 trauma center was queried for patients who sustained a firearm-related injury from 2015 to 2022 (N = 2402). The Social Vulnerability Index (SVI) ranking was derived using patient residence addresses to evaluate its association with traumatic injury clinical outcomes (i.e., in-hospital mortality, length of hospital stay, ICU or ventilator treatment, or injury severity score) and risk screening results for alcohol use disorder (AUD), posttraumatic stress disorder (PTSD), and depression. We evaluated hotspots of firearm injury density over time for patient residences and injury locations and distances between locations. A spatially lagged regression model tested the association between firearm injury density and SVI domains, alcohol outlet types, and park coverage.

RESULTS

Most firearm injury patients were younger, male, racial or ethnic minorities from disadvantaged neighborhoods (SVI total; M = 0.86, SD = 0.15). SVI was not associated with any clinical outcomes. Of those screened, 12.9% screened positive for AUD and 44.5% screened at risk for PTSD, depression, or both. Hotspot analysis indicated consistent concentrations of firearm injury density. There were no differences in clinical outcomes between those injured inside or outside the home. Census tracts with lower socioeconomic status, greater off-premises and lower on-premises alcohol outlet density were associated with greater firearm injury density.

CONCLUSIONS

In Milwaukee County, firearm injury patients are injured in and often return to the same disadvantaged neighborhoods that may hamper recovery. Results replicate and expand previous work and implicate specific socioenvironmental factors for intervention and prevention of firearm injury.

The Relationship Between Alcohol Beverage Types and Violence

There is substantial evidence of an ecological association between off-premise alcohol outlets and violence. We know less, however, about how specific beverage types that are sold in the outlets might explain the difference in violence rates across different alcohol outlets. Data on alcohol beverage types were collected for all off-premise alcohol outlets in Milwaukee, Wisconsin, using a systematic social observation instrument. Spatially lagged regression models were estimated to determine whether the variation in alcohol beverage types is related to robbery density net of important neighborhood predictors of crime rates. Availability of all alcohol beverage types (beer, wine, spirits, premixed, single beer, single spirits, single premixed) was positively associated with the density of robberies, net of neighborhood characteristics. Reducing alcohol beverages, regardless of the beverage type, sold at off-premise alcohol outlets may reduce violence in communities.

Violent crime redistribution in a city following a substantial increase in the number of off-sale alcohol outlets: A Bayesian analysis

INTRODUCTION AND AIMS

This study examined whether the introduction of a large number of off-premise alcohol outlets into a city over a brief period of time could affect rates of violent crime.

DESIGN AND METHODS

The study analysed annual counts of violent crime across 172 US Census block groups in Lubbock, Texas from 2006 through 2011. Spatial Poisson models related annual violent crime counts within each block group to off-premise and on-premise alcohol outlets active during this time period as well as neighbourhood socio-demographic characteristics. The effects of alcohol outlets were assessed both within block groups and across adjacent block groups.

RESULTS

On-premise outlets had a small, significant positive association with violence within a given block group. A similar well-supported local effect for off-premise outlets was not found. However, the spatially lagged effect for off-sale premises was well-supported, indicating that greater densities of these outlets were related to greater rates of violent crime in adjacent areas.

DISCUSSION AND CONCLUSIONS

While these analyses confirmed a previous time-series analysis in finding no city-wide effect of the increase in off-premise outlets, they do suggest that such outlets in a local area may be related to violence in nearby geographic areas. They indicate the importance of examining neighbourhood-specific effects of alcohol outlets on violence in addition to the city-wide effects. They also present further evidence supporting the need to examine the differential effects of on-sale and off-sale premises.

Matching study areas using Google Street View: A new application for an emerging technology

Google Street View (GSV) can be used as an effective tool to conduct virtual neighborhood audits. We expand on this research by exploring the utility of a GSV-based neighborhood audit to measure and match target and comparison study areas. We developed a GSV-based inventory to measure characteristics of retail alcohol stores and their surrounding neighborhoods. We assessed its reliability and assessed the utility of GSV-based audits for matching target and comparison study areas. We found that GSV-based neighborhood audits can be a useful, reliable, and cost-effective tool for matching target and comparison study areas when archival data are insufficient and primary data collection is prohibitive. We suggest that researchers focus on characteristics that are easily visible on GSV and are relatively stable over time when creating future GSV-based measuring and matching tools. Dividing the study area into small segments may also provide more accurate measurements and more precise matching.

Alcohol outlets, social disorganization, and robberies: accounting for neighborhood characteristics and alcohol outlet types

We estimated spatially lagged regression and spatial regime models to determine if the variation in total, on-premise, and off-premise alcohol outlet(1) density is related to robbery density, while controlling for direct and moderating effects of social disorganization.(2) Results suggest that the relationship between alcohol outlet density and robbery density is sensitive to the measurement of social disorganization levels. Total alcohol outlet density and off-premise alcohol outlet density were significantly associated with robbery density when social disorganization variables were included separately in the models. However, when social disorganization levels were captured as a four item index, only the association between off-premise alcohol outlets and robbery density remained significant. More work is warranted in identifying the role of off-premise alcohol outlets and their characteristics in robbery incidents.