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THE CONTEXTUAL EFFECT OF THE PREVALENCE OF LIQOUR STORES AND BARS ON INTAKE OF HARD LIQOUR
Citation:
Morland, K., S. Wing, AND Roux, Ana Diez. THE CONTEXTUAL EFFECT OF THE PREVALENCE OF LIQOUR STORES AND BARS ON INTAKE OF HARD LIQOUR. Presented at Society of Epidemiologic Research, Palm Dessert, CA, June 19-21,2002.
Description:
The Contextual Effect of the Prevalence of Liquor Stores and Bars on Intake of Hard Liquor
Kimberly B. Morland PhD?, Steve Wing PhD?, Ana Diez Roux MD PhD?
?Department of Epidemiology, University of North Carolina, Chapel Hill, NC; ?The Department of Epidemiology and Division of Internal Medicine, Columbia University, New York, NY
BACKGROUND AND METHODS: Previous research shows that alcohol availability is associated with alcohol related problems (1-4). Fewer studies have shown a relationship between the availability and intake of alcohol (5). Recent research shows that liquor stores are disproportionately located in predominately black neighborhoods (6). With this study, we investigated if the prevalence of places to buy hard alcohol is differentially distributed in predominately black and racially mixed compared to predominately white neighborhoods. We further examined if the prevalence of places to buy hard liquor is associated with reported intake of hard alcohol. Forsyth County, North Carolina and Jackson, Mississippi were selected for these analysis because of the heterogeneity of race groups between census tracts and available information on hard alcohol intake. Atherosclerosis Risk in Communities (ARIC) participants living in these areas between 1993 to1995 reported usual number of servings of hard liquor per week (7). Alcohol beverage control permit lists were obtained from the Mississippi State Tax Commission Beverage Control Division and the North Carolina Alcoholic Beverage Control Commission. Bars and taverns license lists were obtained from state health departments. Addresses were geocoded to 1990 United Stated Census Bureau defined tracts. The proportion of black residents living in a census tract was used to estimate racial segregation; a census tract was categorized as predominately black when more than 80% of residents were black and predominately white when less than 20% of residents were black. Population density adjusted prevalence ratios (PR) were calculated using Poisson regression to quantify the difference in the distribution of liquor stores and bars. Odds ratios (OR) were calculated with mixed models to estimate the association between usual intake of any versus no hard alcohol comparing residents living in areas with any versus no liquor stores and any versus no bars. All models were stratified by state and race.
RESULTS: Four times as many liquor stores are located in predominately black and three times as many in racially mixed neighborhoods compared to predominately white neighborhoods in North Carolina (PR=4.7, [95% Confidence Interval (CI) 1.2, 4.3] and PR=3.3, [95% CI 1.7, 6.3] respectively). However, fewer liquor stores are located in predominately black neighborhoods compared to predominately white in Mississippi (PR=0.7, [95% CI 0.5, 0.8]). Little difference was observed between the prevalence of liquor stores in racially mixed and predominately white neighborhoods in Mississippi (PR=1.1, [95% CI 0.8, 1.3]). After adjusting for education, income and gender, black North Carolinians living in areas with liquor reported a lower usual intake of liquor compared to those living in neighborhoods without liquor stores (Odds Ratio (OR)=0.73, [95% CI 0.54, 0.98]). This association was not observed for black Mississippians (OR=0.95, [95% CI 0.80, 1.14]) nor for white North Carolinians (OR=0.97, [95% CI 0.82, 1.15]). In addition to the distribution of alcohol beverage controlled stores, racially mixed neighborhoods in North Carolina have a larger prevalence of bars and taverns compared to predominately white neighborhoods (PR=2.1, [95% CI 0.9, 5.0]). No bars and taverns are located in predominately black neighborhoods in North Carolina. Nevertheless, black Americans living in North Carolina and in areas with bars and taverns report increased intake of liquor (OR=1.60, [95% CI 1.08, 2.36]). No association was observed