Today’s Pennsylvania liquor laws are controversial, as consumers cannot buy beer, wine, and liquor at the same location. That said, although the commonwealth’s laws may be inconvenient for some, the idea of adding inconvenience may help the public’s health, according to new data from researchers at the Urban Health Collaborative at Drexel’s Dornsife School of Public Health, recently published in the journal Substance Abuse Treatment, Prevention, and Policy.
In the study, the researchers looked at the effect of Acts 39 and 166 becoming law in the commonwealth in 2016 — which for the first time — allowed many large grocery stores to sell beer and wine. They found that Philadelphians living in close proximity to those grocery stores drank more alcohol than those living farther away.
“When alcohol is less available, people may drink less, and experience fewer health risks from alcohol,” said the study’s lead author Amy Auchincloss, PhD, an associate professor in the Dornsife School of Public Health. “Even moderate alcohol consumption can have negative effects on health, including mental health problems, injury, increased cancer risk, liver disease, and higher blood pressure.”
The team used data on alcohol retail locations and phone surveys collected during 2016-2018 from adult residents in Philadelphia and surrounding areas and compared alcohol use in Philadelphia to counties in New Jersey and Delaware that have permitted private alcohol and beer sales in the same location for years. They analyzed data from 772 residents and found that higher outlet density – a count of the number of places where someone can buy alcohol within a mile of participants’ residences – was associated with consuming 34% more drinks per week and residing farther from an outlet was associated with less alcohol consumption.
When they examined 1-year changes in the number of places that sold alcohol, residents who had access to more outlets increased their drinking days per week and had more drinks when drinking, compared to residents who lived in areas where there was no increase in places to buy alcohol. The Drexel News Blog checked in with Auchincloss to see what the takeaways are as the weather warms up and more people may be drinking socially.
Although living near an alcohol outlet was associated with an increase in days of drinking and number of drinks, you found no association between location and binge drinking. Did that surprise you?
ANS: Yes, that was an interesting finding. Following standard measurement practices, we defined binge drinking as having consumed a large volume of alcohol during a single occasion at least once during the past 30 days (where large volume was > = 5 drinks for males and > = 4 drinks for females). Drinking this way can pose serious health and safety risks, including car crashes, drunk-driving arrests, sexual assaults, and other serious injuries. But binge drinking may be less sensitive to having an alcohol outlet nearby. We think our findings can be explained by the fact that — in many populations — binge drinking is once per week or a couple times per month whereas habitual lower-volume alcohol consumption (such as one drink per day) may be more influenced by seeing alcohol outlets every day nearby one’s residence.
The findings follow previous studies that found living near an alcohol outlet was associated with an increase in sales. Why is it valuable to look at consumption in addition to sales?
ANS: Alcohol sales data are very useful for identifying overall consumer trends in alcohol purchases and types of alcohol purchased. However, sales data do not provide details on the frequency and volume of alcohol actually consumed by an individual nor on changes in individual consumption – for that we need individual-level data.
People have debated Pennsylvania’s liquor laws for many years, having state-run liquor stores, for example. What role should the commonwealth play in regulating beer, wine and liquor sales while considering the public’s health?
ANS: As public health researchers, we are acutely aware of the harms of alcohol. In order to mitigate harm, public health advocates generally support restricting alcohol sales including retaining state monopolies over alcohol sales. Monopolies can quite easily set limits on sale hours, retail locations, and minimum prices; whereas private businesses are more likely to push for greater availability and incentivize alcohol purchases via prices and marketing.
The paper mentions the importance of studying associations between alcohol access and alcohol use in various commercial and socio-cultural contexts. Since we are in University City — a university context — how might your study inform alcohol access in our community?
ANS: In the past few years, there have been dramatic shifts in availability of alcohol in the University City area. Now that grocery stores are allowed to sell beer and wine, alcohol is available for retail purchase just steps from our campus and those stores are marketing alcohol like they would any other beverage they are trying to sell. It is reasonable to expect that this has increased alcohol consumption among our students — and perhaps even staff and faculty. And increased retail access next to campus comes on top of campus restaurants that have already been selling alcohol for on-premise consumption, such as the sports bar Landmark Americana that shares the block with the gymnasium.
The team geocoded alcohol outlet data to count how many are located within 1-mile around a participants’ address. Why did you choose this more precise way to measure that using ZIP codes or census tracts, like previous studies have done?
ANS: Many studies do not have access to actual addresses so they assign alcohol outlet exposure using ZIP code or census tract. We were fortunate that we had survey participants’ home address and alcohol outlet addresses thus, we used geographic information systems software to precisely assign each participants’ exposure to alcohol outlets nearby their home. This reduced measurement error and likely improved our ability to detect an association with alcohol consumption.
The paper points out a general trend of privatization in liquor sales leading to an increase in places to buy alcohol, more money spent on alcohol advertising, and more alcohol consumed. How can public health experts address this trend and give the general public the information needed to make informed choices?
ANS: On an individual level, an important first step is educating ourselves on the harms of alcohol, how to assess alcohol use problems, and where to get help. There are many great resources available.
Key public health strategies will continue to be using laws, policies, and programs to regulate commercial and public availability of alcohol. In our community, university retail services and student public health advocates could partner and work to remove or limit advertising and availability of alcohol products on or near campus. Just like with tobacco, protecting a community’s health will mean prioritizing health over revenue gained from alcohol. On an individual-level, an important first step is educating ourselves on the harms of alcohol, how to assess alcohol use problems, and where to get help. There are many great resources available. Those looking for more information may be interested on this interactive self-test to measure one’s own drinking, information on college drinking, Drexel’s policies on drinking and Drexel’s Counseling and Health Services office.
I would also urge consumers to increase their skepticism of the alcohol industry and recognize that all discounts and promotions and increased access are primarily intended to increase industry sales and that those initiatives can negatively impact consumers’ health.
Media interested in speaking with Auchincloss should contact Greg Richter, news manager, at firstname.lastname@example.org or 215-895-2614.