Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA, 94608, USA.
Department of Health Law, Policy, and Management, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA.
J Urban Health. 2020 Feb;97(1):123-136. doi: 10.1007/s11524-019-00372-2.
Alcohol outlet clusters are an important social determinant of health in cities, but little is known about the populations exposed to them. If outlets cluster in neighborhoods comprised of specific racial/ethnic or economic groups, then they may function as a root cause of urban health disparities. This study used 2016 liquor license data (n = 1204) from Baltimore City, Maryland, and demographic data from the American Community Survey. We defined alcohol outlet clusters by combining SaTScan moving window methods and distances between outlets. We used multiple logistic regression to compare census block groups (CBGs) (n = 537) inside and outside of four types of outlet clusters: total, on-premise, off-premise, and LBD-7 (combined on-/off-premise). The most robust predictor of alcohol outlet cluster membership was a history of redlining, i.e., racially discriminatory lending policies. CBGs that were redlined had 7.32 times the odds of being in an off-premise cluster, 8.07 times the odds of being in an on-premise cluster, and 8.60 times the odds of being in a LBD-7 cluster. In addition, level of economic investment (marked by vacant properties) appears to be a key characteristic that separates CBGs in on- and off-premise outlet clusters. CBGs with racial/ethnic or socioeconomic advantage had higher odds of being in on-premise clusters and CBGs marked by disinvestment had higher odds of being in off-premise clusters. Off-premise clusters deserve closer examination from a policy perspective, to mitigate their potential role in creating and perpetuating social and health disparities. In addition to addressing redlining and disinvestment, the current negative effects of alcohol outlet clusters that have grown up in redlined and disinvested areas must be addressed if inequities in these neighborhoods are to be reversed.
酒精销售点集聚是城市健康的一个重要社会决定因素，但对于接触这些销售点的人群却知之甚少。如果销售点集中在特定种族/族裔或经济群体的社区中，那么它们可能是城市健康差异的根本原因。本研究使用了马里兰州巴尔的摩市 2016 年酒类许可证数据（n=1204）和美国社区调查的人口数据。我们通过结合 SaTScan 移动窗口方法和销售点之间的距离来定义酒精销售点集聚。我们使用多项逻辑回归比较了四个类型的销售点集聚（总计、现场、场外和 LBD-7（现场和场外相结合））内部和外部的普查区（CBG）。酒精销售点集聚成员身份的最有力预测因素是曾经的“红线”历史，即种族歧视性贷款政策。曾经受到“红线”政策影响的 CBG 成为场外销售点集聚的可能性是其 7.32 倍，成为现场销售点集聚的可能性是其 8.07 倍，成为 LBD-7 集聚的可能性是其 8.60 倍。此外，经济投资水平（以空置物业为标志）似乎是区分现场和场外销售点集聚 CBG 的关键特征。具有种族/族裔或社会经济优势的 CBG 更有可能成为现场销售点集聚，而投资不足的 CBG 更有可能成为场外销售点集聚。从政策角度来看，场外销售点集聚值得更仔细的研究，以减轻其在创造和延续社会和健康差异方面的潜在作用。除了解决“红线”和投资不足问题外，还必须解决在“红线”和投资不足地区形成的酒精销售点集聚的当前负面影响，才能扭转这些社区的不平等现象。
