Alcohol Outlet Density and Violence: The Role of Risky Retailers and Alcohol-Related Expenditures

Aims: The aim of the study was to assess the association between alcohol outlet density and violence controlling for alcohol expenditures and the density of other retailers. Methods: Cross-sectional ecological study of 1816 block groups in Philadelphia. We obtained 2010 data for aggravated assaults, alcohol outlets, alcohol expenditures, business points, land use and socioeconomic and demographic characteristics. We mapped the spatial distribution of alcohol outlets and aggravated assaults using a geographic information system. We estimated the association between assault density and total, on-premise and off-premise alcohol outlet densities using spatial regression models and controlling for the covariates of urban crime rates, alcohol expenditures, and the presence of other general and risky commercial retail outlets. Results: The strong and positive association between alcohol outlet density and violence remained after controlling for alcohol expenditures and the density of other retailers. Conclusion: Findings support the concept that off-premise alcohol outlets in the neighborhood environment may impact health and social outcomes. The positive outlet-violence association in the face of these controls means it is not an association due solely to alcohol availability or to retail density. It also suggests that there is something unique about alcohol outlets or their density that makes them crime generators and links them to violence.