Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Alcohol Clin Exp Res. 2018 Oct;42(10):1979-1987. doi: 10.1111/acer.13844. Epub 2018 Aug 13.
Alcohol outlet density has been associated with increased pedestrian injury risk. It is unclear whether this is because alcohol outlets are located in dense retail areas with heavy pedestrian traffic or whether alcohol outlets contribute a unique neighborhood risk. We aimed to compare the pedestrian injury rate around alcohol outlets to the rate around other, similar retail outlets that do not sell alcohol.
A spatial analysis was conducted on census block groups in Baltimore City. Data included pedestrian injury emergency medical services (EMS) records from January 1, 2014 to April 15, 2015 (n = 848); locations of alcohol outlets licensed for off-premise (n = 726) and on-premise consumption (n = 531); and corner (n = 398) and convenience stores (n = 192) that do not sell alcohol. Negative binomial regression was used to determine the relationship between retail outlet count and pedestrian injuries, controlling for key confounding variables. Spatial autocorrelation was also assessed and variable selection adjusted accordingly.
Each additional off-premise alcohol outlet was associated with a 12.3% increase in the rate of neighborhood pedestrian injury when controlling for convenience and corner stores and other confounders (incidence rate ratio [IRR] = 1.123, 95% confidence interval [CI] = 1.065, 1.184, p < 0.001). The attributable risk was 4.9% (95% CI = 0.3, 8.9) or 41 additional injuries. On-premise alcohol outlets were not significant predictors of neighborhood pedestrian injury rate in multivariable models (IRR = 0.972, 95% CI = 0.940, 1.004, p = 0.194).
Off-premise alcohol outlets are associated with pedestrian injury rate, even when controlling for other types of retail outlets. Findings reinforce the importance of alcohol outlets in understanding neighborhood pedestrian injury risk and may provide evidence for informing policy on liquor store licensing, zoning, and enforcement.
酒精销售点密度与行人受伤风险增加有关。目前尚不清楚这是因为酒精销售点位于行人流量大的繁华零售区，还是因为酒精销售点造成了独特的邻里风险。我们旨在比较酒精销售点周围的行人受伤率与不销售酒精的其他类似零售销售点周围的受伤率。
在巴尔的摩市的普查街区组进行了空间分析。数据包括 2014 年 1 月 1 日至 2015 年 4 月 15 日期间的行人伤害急诊医疗服务（EMS）记录（n=848）；有执照的非现场（n=726）和现场消费（n=531）酒精销售点以及街角（n=398）和便利店（n=192）的位置，这些便利店不销售酒精。采用负二项回归来确定零售销售点数量与行人伤害之间的关系，同时控制关键混杂变量。还评估了空间自相关，并相应调整了变量选择。
在控制便利店和街角商店以及其他混杂因素的情况下，每增加一个非现场酒精销售点，附近行人受伤的发生率就会增加 12.3%（发病率比[IRR]=1.123，95%置信区间[CI]=1.065，1.184，p<0.001）。归因风险为 4.9%（95%CI=0.3，8.9）或 41 例额外伤害。在多变量模型中，现场酒精销售点不是附近行人受伤率的显著预测因子（IRR=0.972，95%CI=0.940，1.004，p=0.194）。
即使在控制其他类型的零售销售点的情况下，非现场酒精销售点与行人受伤率有关。这些发现强调了酒精销售点在理解邻里行人受伤风险方面的重要性，并且可能为有关酒类商店许可、分区和执法的政策提供证据。
