Density of neighborhood liquor stores is especially risky for African-Americans who drink

Previous studies have shown a strong link between neighborhood alcohol environments and outcomes such as drunk driving and violence. This study investigated linkages between neighborhood liquor stores, on-premise outlets, convenience stores, and supermarket densities and at-risk drinking among African Americans. Researchers found that a neighborhood's liquor-store density had a significant impact on at-risk drinking among African Americans who consumed alcohol, particularly for women who drink.

Results will be published in the May 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"There has been limited research on this topic among specific minority groups or by sex," said Katherine P. Theall, associate professor in the department of community health sciences at Tulane University School of Public Health & Tropical Medicine. "Researchers have only recently begun to examine in greater detail the impact of the neighborhood and other distal factors on health outcomes."

It was not because researchers did not think distal influences were important, explained Theall, also corresponding author for the study, but because methods for testing the role of social and physical neighborhood context in human health have only become available during the last decade.

"Investigations that examine neighborhood influences according to specific demographic characteristics such as differential impacts by gender or race," she said, "are still emerging as we think of ways to best intervene and prevent adverse health outcomes based on neighborhood changes or polices."

Researchers recruited 321 African Americans (229 women, 92 men), ages 21 to 65 years of age, during April 2002 through to May 2003 from three community-based healthcare clinics in New Orleans, Louisiana. All participants answered quantitative questionnaires. Individuals with hazardous or harmful patterns of alcohol consumption were classified as engaging in at-risk drinking based on the Alcohol Use Disorders Identification Test (AUDIT).

"Among African Americans in our sample who drank, those who lived in neighborhoods with a greater concentration of liquor stores were more likely to be classified as at-risk drinkers compared to those living in neighborhoods with fewer liquor stores per population," said Theall. "Furthermore, the influence of liquor store concentration on at-risk drinking was much greater for African American women."

Theall noted that liquor stores are the dominant alcohol establishment in many minority communities, as opposed to supermarkets. "Therefore they may play a larger role in risky drinking among those who already drink," she said. "Other studies have shown high concentrations of liquor stores, as well as physical shelf space devoted to alcohol, in minority and lower-income neighborhoods."

As far as the gender differences were concerned, Theall hypothesized that stress was a factor.

"Women and men differ in their response to stress and I think that one primary reason for this finding was due to differential psychological coping among women who do drink," she explained. "While we do not know the specific neighborhood characteristics of the at-risk drinkers, our guess is that many were dealing with cumulative ecologic, family/household, and individual stressors. If drinking is a coping mechanism, then greater availability of alcohol may lead to riskier consumption patterns."

Theall said these findings would suggest to clinicians that they take into account not only individual and interpersonal influences on their patient's consumption patterns, but also ecologic factors that may lead to riskier drinking.

"As well, individuals themselves can examine the broader social and physical environment of their neighborhood and consider what role it plays in their lives – shaping behavior, increasing disorders, or bringing something positive to the neighborhood. If the role is a negative one, then individuals might consider what steps can be taken to help change the environment or how to become more resilient in such an environment."