The relationship between alcohol outlet density, reported alcohol intake, and reported health behavior: An examination of midwestern communities

Environmental research investigating neighborhood characteristics associated with alcohol use has focused on relationships of alcohol availability and alcohol-related events such as automobile crashes, injuries, and violence. To date, no studies have utilized in-depth direct observation of institutions and the physical environment to examine alcohol outlet density in relation to reported health behaviors. The purpose of the original study on which this dissertation was based was to investigate the feasibility of conducting intensive environmental assessment of two disparate census block groups using direct observation of businesses and content analyses of food establishments and grocery stores. Telephone interviews of 100 randomly selected households in each community were conducted to assess health and health behavior. The primary research question in this dissertation was whether there was a difference in alcohol outlet density between low-median income (Group 1) and high-median income (Group 2) census block groups, and if so, whether there were differences in reported alcohol consumption and reported health-related behaviors for these groups. Because the unit of analysis was at the group level and the pilot study contained 2 census block groups, analyses were restricted to a descriptive comparison of the frequency and density of alcohol outlets per area.; Reported alcohol consumption patterns were examined in relationship to the frequency and density of alcohol outlets and the proportion of the population of each block group who reported engaging in physical activity, healthy diets, and tobacco use. Geographical Information Systems mapping technology was used to examine alcohol outlet density. Group 1 had a noticeably higher density of alcohol outlets, grocery stores, restaurants, and parks than Group 2. About half of respondents from both block groups reported consuming alcohol in the last month, but a higher percentage in Group 1 reported drinking more often with more frequent binge drinking. A substantially higher percentage of respondents in Group 1 reported a sedentary lifestyle, less access to an athletic facility, perceptions that their neighborhood was unsafe, and smoking inside the home compared to Group 2. Given the fact that only two communities were examined, these results should be considered tentative until further research is conducted.