TY - JOUR
T1 - Alcohol Outlets, Neighborhood Retail Environments, and Pedestrian Injury Risk
AU - Nesoff, Elizabeth D.
AU - Milam, Adam J.
AU - Branas, Charles C.
AU - Martins, Silvia S.
AU - Knowlton, Amy R.
AU - Furr-Holden, Debra M.
N1 - Funding Information:
This work was supported by the National Institute on Alcohol Abuse and Alcoholism (grant numbers F31AA023716 and R01AA024941) and the National Institute on Drug Abuse (grant numbers T32DA031099 and R34DA034314). Food outlet data were provided by the Johns Hopkins Center for Livable Future. The authors thank Alex Freed and Brian Weir for their help in preparing this manuscript. All authors have no possible conflicts of interest to disclose.
Publisher Copyright:
© 2018 by the Research Society on Alcoholism
PY - 2018/10
Y1 - 2018/10
N2 - Background: 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. Methods: 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. Results: 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). Conclusions: 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.
AB - Background: 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. Methods: 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. Results: 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). Conclusions: 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.
KW - Alcohol Availability
KW - Alcohol Outlets
KW - Neighborhood
KW - Pedestrian Injury
KW - Spatial Analysis
KW - Cross-Sectional Studies
KW - Commerce/economics
KW - Humans
KW - Risk Factors
KW - Residence Characteristics/statistics & numerical data
KW - Male
KW - Alcoholic Beverages/economics
KW - Baltimore/epidemiology
KW - Female
KW - Pedestrians/statistics & numerical data
KW - Accidents, Traffic/economics
KW - Alcohol Drinking/economics
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U2 - 10.1111/acer.13844
DO - 10.1111/acer.13844
M3 - Article
C2 - 30102415
AN - SCOPUS:85052481355
SN - 0145-6008
VL - 42
SP - 1979
EP - 1987
JO - Alcoholism: Clinical and Experimental Research
JF - Alcoholism: Clinical and Experimental Research
IS - 10
ER -