![]() ![]() This method yielded 8 off-premises clusters and 12 on-premises clusters in 2017. Clusters were those overlapping areas with at least 5 outlets for both premise types. After comparing the Durham context to Atlanta, we defined clusters on the basis of an overlapping 0.15-mile radius (ie, spatial buffer) around outlets active on January 1, 2017. A spatial outlet cluster was defined similarly to that in the Zhang study (9) but with parameters modified for a smaller city context. Distance-to-nearest-outlet calculations reached outside of county boundaries to maintain accuracy for residents living near borders (eg, when a Durham resident’s nearest outlet was in a neighboring county). Permits were filtered to 38 types of alcohol outlets that sell to individuals, excluding catering, shipping, and wholesalers.ĭistances between populations and outlets were calculated by Euclidean (ie, straight line) methods, because of the ease of communication and because it is unclear whether relationships of alcohol outlets and populations operate by driving along roads in a smaller, walkable city. We derived alcohol outlet locations in Durham from the North Carolina Alcoholic Beverage Control license database for 2007 through 2017, representing over 165,000 outlet licenses of more than 60 permit types. Hereafter, Durham refers to the county, except when stated otherwise. ![]() Durham is the name of both a North Carolina county and the largest city within that county. We report on-premises (eg, sit-down restaurant) and off-premises (eg, liquor store or gas station) results separately because off-premises settings carry unique and increased population health harms (10). We expanded on that study by using alcohol outlet density metrics (spatial access index, minimum distance) to describe racial and ethnic disparities in the alcohol outlet environment in the city of Durham, North Carolina. Using the Centers for Disease Control and Prevention (CDC) publication, Guide for Measuring Alcohol Outlet Density (8), Zhang et al identified outlet clusters in Atlanta, Georgia, and found that reducing outlet density was associated with reductions in violent incidents (9). After conversations with community partners, we contextualized these metrics by using maps to emphasize spatial associations of historic racial disenfranchisement and present-day alcohol outlet clusters. Given the community context and the role of racism as a fundamental cause of health disparities (7), we supplemented the community-led analysis of racial and ethnic disparities with measures of spatial access and distance to the nearest alcohol outlet. Denser alcohol environments are associated with multiple chronic disease pathways (3), neighborhood-level social effects (4), and increased rates of alcohol-related morbidities and mortalities, such as from motor vehicle crashes, pedestrian injuries, and various types of violence (5).Ĭommunity partners in Durham County, North Carolina, explored the alcohol and tobacco exposure environment during community-wide conversations about gentrification and neighborhood change (6), laying the groundwork for our study. Policies limiting high densities of alcohol outlets (places where alcohol can be sold or consumed) can curb excessive alcohol consumption (2). Įxcessive alcohol consumption is responsible for more than 95,000 deaths in the US each year (1). Data sources: 2017 American Community Survey (ACS) 5-year block group estimates, 2013–2017 North Carolina Alcoholic Beverage Control license database. Historic redlined areas from the same region are inset, established in 1933 by the Home Owners’ Loan Corporation (HOLC). Static display of Durham County, North Carolina’s on- and off-premises alcohol outlets in 2017. High-resolution JPG for print image icon image icon image icon ![]()
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