Geography of penetrating trauma and alcohol outlets in Boston

Purpose: We examine the relationship between alcohol outlet (type and density) and violence (penetrating trauma; shootings and stabbings) in the city of Boston, 1996-2006. Methods: Ten years of data (1996-2006) from the Boston emergency medical services (EMS) EMS patient care data, US census data (for 113 zip codes in the Boston area) , and Massachusetts alcohol beverage control commissions (MABCC) data on alcohol outlet type and location are used. Multi-level/hierarchal spatial modeling is employed and maps of hot spots for violence and alcohol outlet type and density are produced. Results: We found that zip codes with high rates of violence were relatively stable over 10 years of the study, although there were specific zip codes in south Boston that showed large fluctuations throughout the period. These zip codes were associated with high densities of liquor stores (b=.834, p=.03) and bars (b=.735, p=.05) and were positively related to increased percentage of males 18-25 (b=1.13, p=.02), as well as a combined measure of neighborhood disadvantage (b=.47, p=.05). Restaurant density was negatively associated with violence. Model based hot spots for higher than expected levels of violence were also identified. Hot spots were found to have higher levels of liquor stores and a high percentage of single mothers. This relationship was stable across the time periods. Conclusions: zip codes with high rates of violence are also places where there are high densities of certain types of alcohol outlets, (i.e. liquor stores and bars). Such findings can help with zoning and law enforcement efforts.