Citation

Trangenstein PJ, Sadler RC, Morrison CN, Jernigan DH. Addict. Res. Theory 2021; 29(2): 117-128.

Copyright

(Copyright © 2021, Informa - Taylor and Francis Group)

DOI

10.1080/16066359.2020.1751128

PMID

unavailable

Abstract

BACKGROUND: The literature consistently finds that areas with greater density of alcohol outlets (places that sell alcohol) tend to have higher levels of public health harms. However, conflicting findings arise when researchers drill down to identify the type(s) of alcohol outlets with the strongest associations with harms and the mechanisms that explain these associations. These disagreements could be a result of the outdated methods commonly used to quantify the alcohol environment: counts of the number of outlets in an area.

METHODS This manuscript reviews the events and ideas that shaped the literature on the physical alcohol environment. It then defines the three main methods used to measure alcohol outlet density and conduct an exploratory factor analysis to explore the constructs underlying each method.

RESULTS We present a novel conceptual framework that summarizes the three most common measurement methods, their respective underlying constructs, and the setting(s) in which each may be most appropriate. The framework proposes that counts of alcohol outlets measure availability, proximity to the nearest outlet measures accessibility, and spatial access measures measure access, which comprises both availability and accessibility.

DISCUSSION Researchers should consider using proximity and spatial access measures when possible, because this may present opportunities to advance theory and the design and implementation of regulations. Researchers can also draw on innovations used in other areas of the built environment to suggest opportunities to use novel methods to overcome common hurdles (e.g., separating subtypes of outlets, ecologic designs) and a new challenge on the horizon: home delivery.

Language: en

Keywords

Alcohol; alcohol outlet density; alcohol policy; spatial access methods