Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #119211

Catherine Cubbin, PhD, Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, 1000 Welch Road, Palo Alto, CA 94304-1825, 6504984626, ccubbin@stanford.edu, Craig E. Pollack, MD, Division of General Internal Medicine, University of California, San Francisco and San Francisco General Hospital, 1001 Portrero Avenue, San Francisco, CA 94110, and Marilyn A. Winkleby, PhD, MPH, Stanford Prevention Research Center, Stanford School of Medicine, 211 Quarry Road, Room 229, Stanford, CA 94305-5705.

Previous studies suggest that the physical availability of alcohol may mediate the association between neighborhood-level material deprivation and alcohol consumption. This study tests the relationships between neighborhood-level deprivation, alcohol availability, and individual-level alcohol consumption using a multilevel analysis. Data are from cross-sectional surveys conducted between 1979-1990 as part of the Stanford Heart Disease Prevention Program (SHDPP). Women and men (N=8197) living in four northern/central California cities and 82 neighborhoods were linked to neighborhood deprivation variables derived from the U.S. census (e.g., unemployment, crowded housing) and to measures of alcohol availability (density of outlets in the respondent's neighborhood, nearest distance to an outlet from a respondent's home, and number of outlets within a half mile radius of a respondent's home). Separate analyses were conducted for on- and off-sale outlets. The most deprived neighborhoods had substantially higher levels of alcohol outlet density than the least deprived neighborhoods (45.5% versus 14.8% respectively). However, multilevel analyses showed that the least deprived neighborhoods were associated with the heaviest alcohol consumption, even after adjusting for individual-level sociodemographic characteristics (OR 1.30, CI 1.08-1.56). Alcohol availability was not associated with heavy drinking and thus did not mediate the relationship between neighborhood deprivation and heavy alcohol consumption. While alcohol availability is concentrated in the most deprived neighborhoods, women and men in the least deprived neighborhoods are the most likely to be heavy drinkers. This mismatch between supply and demand may cause people in the most deprived neighborhoods to disproportionately suffer the negative health consequences of living near alcohol outlets.

Learning Objectives:

• to educate participants about the association between neighborhood-level deprivation and alcohol consumption;
• to educate participants about whether alcohol availability, measured by three different methods (density of alcohol outlets, closest distance to respondent's home, number of outlets within a 0.5 mile buffer zone), mediates this relationship; and
• to discuss why the high level of alcohol outlet density in the more deprived neighborhoods requires examination of zoning practices, licensing procedures, and other system level policies from both a health and social justice perspective.

Keywords: Community-Based Public Health, Social Justice

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.