Disparities in alcohol environments and adolescent drinking across sociodemographic groups in California

Study Design: Geo-coded individual level data from the California Health Interview Survey is merged to alcohol license data from the California Department of Alcoholic Beverage Control. We use ArcMaps to generate varying radii centered at adolescent residence, and measure all alcohol retails sources in each geographical unit. We examine how alcohol availability differs systematically across sociodemographic groups, and analyze how total number of outlets, off-sale retails, and on-sale establishments located within various distances from homes affect adolescents' self-reported alcohol use in the past month and ever driving after drinking. Principal Findings: Alcohol availability is consistently higher in minority, lower income, and lower education groups. Adolescent heavy drinking episodes are statistically and significantly associated with total number of licenses, on-sale establishments, off-sale retails, respectively, after controlling for individual, family, and neighborhood factors. Driving after drinking is statistically and significantly associated with each measure of alcohol availability except for off-sales. These relationships hold for alcohol outlets located within 1 mile radius from adolescent homes and diminish for those located further out. Prevalence of binge drinking in the past month among those who ever had a few sips of alcoholic drinks is about 40% and increases to 44% if on-sale licenses increase to its 90 percentile of the current distribution. Conclusions: Our findings provide evidence of the relationship between adolescent drinking, its associated risky behavior and alcohol environments. As alcohol outlets are more present in disadvantaged neighborhoods, disparities in health risks are worsened by outlets' direct effects on drinking and through alcohol-related problems.