What does this indicator measure?
This indicator measures the percentage of people who live more than a quarter mile from a store that sells alcohol.
The connection to health
Everyone should have access to goods and services in their community that can support a healthy lifestyle. When there is a high concentration of places that do not promote and support health, including liquor stores, bars, and restaurants that sell alcohol, it can adversely affect the health of people living in those communities. Research has found that neighborhoods with a higher density of retail outlets selling alcohol are often the same neighborhoods with the highest rates of health inequities, including many low income and communities of color.150, 151 A study of alcohol retailers across the United States at the census tract level found alcohol density to be significantly higher in African American and Latino neighborhoods, and to be associated with higher levels of poverty.150 Alcohol outlets are also more concentrated in neighborhoods with higher residential instability and higher immigrant populations.152 Studies have also found that alcohol retailers tend to locate, as well as advertise, more in lower income neighborhoods.153 Demand for alcohol may not be any higher than it is in other neighborhoods, but the mere presence of more alcohol retailers encourages greater consumption. More troubling is that neighborhoods with a high concentration of alcohol outlets are associated with higher rates of crime, violence, intimate partner violence, and child maltreatment.152, 154 Therefore, neighborhoods with higher alcohol availability disproportionately deal with the effects of overconsumption of alcohol, including alcoholism and alcohol-related diseases like cirrhosis. Neighborhoods with higher alcohol availability also have been shown to have less healthy food options and a higher concentration of fast food restaurants and convenience stores.152 For more research on the health impacts of healthy food and retail options, see the Retail Density and Supermarket Access briefs. For more facts on alcohol outlet density and public health, see issue briefs from Alcohol Justice and the Ventura County Department of Behavioral Health.
Where to start?
Addressing the issues of Alcohol Availability at the community level requires a range of strategies to improve the retail environment and safety of the neighborhood. Communities should first seek to Plan Safe and Healthy Communities, first by using their zoning and permitting processes to limit the concentration of alcohol-selling outlets within the community, and also conducting studies of existing alcohol outlet density. They can also establish violence prevention and safety programs to reduce the crime and violence typically found in neighborhoods with a high concentration of alcohol outlets. Communities can also incorporate alcohol availability recommendations into their General Plan, studies or assessments, site plans, smart growth efforts and other land use and transportation planning efforts, alongside elements on healthy food and safety. They should also ensure that transportation options are available to existing and future healthy food outlets, including public transportation for those without cars.
Second, communities should strive to Increase Healthy Food Options through financial incentives. A good place to start is by reviewing the Healthy Food Access Portal’s recommendations for financing new healthy food options, including supermarkets but also smaller-scale providers like farmers markets and community supported agriculture (CSAs). Local governments should also build Community Power and Connection through community organizing efforts, youth development programs, and employment and workforce services that can support a healthy food system within the community. Jurisdictions are encouraged to explore the use of community land trusts and other land preservation strategies to ensure that each neighborhood’s mix of destinations is culturally and economically appropriate to its current residents and explore policy solutions to prevent displacement as new development or investments occur.
Addressing alcohol availability is not as simple as discouraging retailers from selling alcohol. It requires planning and a community-involved process to identify where there are gaps in healthy food access and assessing the types of options available, as well as addressing safety issues in the neighborhood. Two good resources are the U.S. Center for Disease Control (CDC)’s Guide to Measuring Alcohol Outlet Density and ChangeLab Solutions’ Guide to Local Authority to Regulate Alcohol Density, which identify additional resources that can be used to identify the most suitable policies for your community.