Online Program

Spatial Relationships between Alcohol Outlet Density and Alcohol-Related Motorvehicle Crashes

Tuesday, November 3, 2015 : 1:10 p.m. - 1:30 p.m.

Christopher Morrison, MPH, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
William Ponicki, MA, Prevention Research Center of Pacific Institute for Research and Evaluation, Oakland, CA
Karen Smith, PhD, Ambulance Victoria, Doncaster, Australia

Spatial relationships between alcohol outlets and motorvehicle crashes are not well understood. Greater densities of outlets provide greater availability of alcohol, potentially leading to more drunk driving and more crashes; while at the same time reducing driving distance between outlets and destinations, potentially leading to fewer crashes. This study examined spatial relationships between crashes and outlet densities in local and spatially lagged areas of Melbourne, Australia.


A Bayesian conditional autoregressive Poisson model predicted counts of non-fatal alcohol-related motorvehicle crashes in 9,214 SA1 census areas (mean population = 415.2). Cases were all ambulance-attended crashes occurring between 2010 and 2012 in which paramedics noted the patient was alcohol affected (n = 2,056). The main dependent measures were the densities of bars, restaurants, and off-premise alcohol outlets per square kilometer in local and lagged (adjacent) SA1 areas. To account for differences in overall crash risks between areas the model expectancy was a count of all crashes over the study period. We also adjusted for areal demographic characteristics (proportion male, socio-economic status, median age), zoning (proportion retail), and roadway characteristics (total kms, proportion highway, proportion arterial).  


Relationships between greater densities of outlets and alcohol-related crashes were not detected in local SA1 areas, however lagged SA1 areas with one additional bar per square kilometer (i.e. an 85% increase compared to the study area mean) had 27% greater incidence of alcohol-related crashes (IRR = 1.267; 95% CI: 1.013, 1.633).


Policy limiting bar density may lead to fewer alcohol-related crashes in adjacent areas.

Learning Areas:

Social and behavioral sciences

Learning Objectives:
Describe potential effects of policy limiting alcohol outlet density on alcohol-related crashes

Keyword(s): Alcohol Use, Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-investigator on a current NIH-funded grant examining spatial relationships between exposure to alcohol outlets, alcohol use and alcohol-related harms, and a principal investigator for a small research grant examining similar relationships in Australia. I have authored multiple peer reviewed publications assessing the spatial dynamics of alcohol, tobacco and marijuana markets.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.