An effective way to reduce the harms caused by excessive drinking is to reduce the density of outlets selling alcohol, whether it’s for drinking on or off premises, according to a new systematic review just released by health authorities in the US.
The review, published in the latest American Journal of Preventive Medicine, was undertaken for the influential Task Force on Community Preventive Services.
It also has some mixed lessons about the impact of alcohol bans in particular communities.
Most studies included in the review found that greater outlet density is associated with increased alcohol consumption and related harms, including medical problems, injury, crime, and violence. The authors concluded: “The regulation of alcohol outlet density may be a useful public health tool for the reduction of excessive alcohol consumption and related harms.”
On the basis of the review, the Task Force says there is enough evidence to recommend limiting alcohol outlet density through the use of regulatory authority, such as licensing and zoning. The Task Force said: “This recommendation can be used to support efforts by community-based and grassroots organizations to limit the density of alcohol outlets in their communities. State and local ofﬁcials can use this recommendation to help enact or reform laws concerning density of outlets where alcohol is available.”
The review has some sections which are particularly relevant for those concerned with alcohol bans in remote and other communities.
It says that all of the studies that evaluated the effect of bans in isolated communities found substantial reductions in alcohol-related harms with the exception of suicide. In the communities that instituted bans, rates of harm, as measured by alcohol-related medical visits and injury deaths, were reduced. One study found that the effects were reversed when the ban was lifted, and found similar beneﬁts when the ban was then reimposed. Two studies suggested that bans on alcohol sales in isolated communities led residents to decrease their use of other intoxicants.
However, studies assessing the impact of bans (particularly bans on on-premises sales) in less-isolated communities have produced mixed results. Some have found that bans are associated with increases in alcohol-related harms, including motor-vehicle crashes and alcohol-related arrests.
The authors concluded that the effectiveness of bans in reducing alcohol-related harms appears to be highly dependent on the availability of alcohol in the surrounding area. In isolated communities, bans can substantially reduce alcohol-related harms. However, where alcohol is available in areas nearby those with bans, travel between these areas may lead to serious harms.
No doubt this is a review that will be picked up widely in public health circles, if not by the industry…