Division of Epidemiology, University of California, Berkeley School of Public Health, Berkeley, CA 94720-7358, USA.
Am J Public Health. 2013 Apr;103(4):e81-7. doi: 10.2105/AJPH.2012.301203. Epub 2013 Feb 14.
Alcohol outlet density has long been associated with alcohol-related harms, and policymakers have endorsed alcohol outlet restriction to reduce these harms. However, potential nonlinearity in the relation between outlet density and alcohol consumption has not been rigorously examined.
We used data from the New York Social Environment Study (n = 4000) to examine the shape of the relation between neighborhood alcohol outlet density and binge drinking by using a generalized additive model with locally weighted scatterplot smoothing, and applied an imputation-based marginal modeling approach.
We found a nonlinear relation between alcohol outlet density and binge drinking; the association was stronger at densities of more than 80 outlets per square mile. Binge drinking prevalence was estimated to be 13% at 130 outlets, 8% at 80 outlets, and 8% at 20 outlets per square mile.
This nonlinearity suggests that reductions in alcohol outlet density where density is highest and the association is strongest may have the largest public health impact per unit reduction. Future research should assess the impact of policies and interventions that aim to reduce alcohol outlet density, and consider nonlinearity in effects.
长期以来，酒吧、酒馆等酒水销售点的密度与酒精相关危害之间存在关联，政策制定者也支持通过限制酒水销售点来减少这些危害。然而，酒水销售点密度与酒精摄入量之间的关系是否存在非线性尚未得到严格检验。
我们利用纽约社会环境研究（New York Social Environment Study）的数据（n=4000），通过广义加性模型（generalized additive model）和局部加权散点平滑法（locally weighted scatterplot smoothing），检验了社区酒水销售点密度与狂饮行为之间的关系形状，并采用基于插补的边缘模型化方法（imputation-based marginal modeling approach）进行了分析。
我们发现，酒精销售点密度与狂饮行为之间存在非线性关系；在密度超过每平方英里 80 个销售点的情况下，这种关联更为强烈。在每平方英里 130 个、80 个和 20 个销售点的情况下，狂饮行为的流行率估计分别为 13%、8%和 8%。
这种非线性关系表明，在密度最高且关联最强的地区减少酒精销售点密度，可能会对每单位减少产生最大的公共卫生影响。未来的研究应评估旨在减少酒精销售点密度的政策和干预措施的影响，并考虑效果的非线性。
