Mapping Patterns and Trends in the Spatial Availability of Alcohol Using Low-Level Geographic Data: A Case Study in England 2003–2013

Abstract

Much literature examines the relationship between the spatial availability of alcohol and alcohol-related harm. This study aims to address an important gap in this evidence by using detailed outlet data to examine recent temporal trends in the sociodemographic distribution of spatial availability for different types of alcohol outlet in England. Descriptive analysis of measures of alcohol outlet density and proximity using extremely high resolution market research data stratified by outlet type and quintiles of area-level deprivation from 2003, 2007, 2010 and 2013 was undertaken and hierarchical linear growth models fitted to explore the significance of socioeconomic differences. We find that overall availability of alcohol changed very little from 2003 to 2013 (density +1.6%), but this conceals conflicting trends by outlet type and area-level deprivation. Mean on-trade density has decreased substantially (−2.2 outlets within 1 km (Inter-Quartile Range (IQR) −3–0), although access to restaurants has increased (+1.0 outlets (IQR 0–1)), while off-trade access has risen substantially (+2.4 outlets (IQR 0–3)). Availability is highest in the most deprived areas (p < 0.0001) although these areas have also seen the greatest falls in on-trade outlet availability (p < 0.0001). This study underlines the importance of using detailed, low-level geographic data to understand patterns and trends in the spatial availability of alcohol. There are significant variations in these trends by outlet type and deprivation level which may have important implications for health inequalities and public health policy.

Alcohol outlet density and alcohol related hospital admissions in England: a national small‐area level ecological study

“…We grouped on‐trade outlets into: (i) pubs, bars and nightclubs; (ii) restaurants with a licence to sell alcohol; and (iii) all other on‐trade outlets and off‐trade outlets into: (i) supermarkets; (ii) convenience stores; and (iii) all other off‐trade outlets, as described previously . Pubs, bars and nightclubs decreased from 55 105 in 2003 to 49 940 in 2013 and other on‐trade outlets decreased from 48 727 to 36 191, but licensed restaurants increased from 18 410 to 21 433 . Off‐trade outlets increased in all three categories (convenience stores from 8083 to 16 467; supermarkets from 4417 to 5859; and other off‐trade outlets from 20 892 to 23 134) .…”

“…Data on on‐trade and off‐trade alcohol outlets were obtained from CGA Strategy (Stockport, UK), a market research company, for the years 2003, 2007, 2010 and 2013. Details have been provided previously . The company estimated that the databases included approximately 98% of all outlets in England.…”

“…Outlet types were available in a 69‐category classification for on‐trade and an eight‐category classification for off‐trade outlets. We grouped on‐trade outlets into: (i) pubs, bars and nightclubs; (ii) restaurants with a licence to sell alcohol; and (iii) all other on‐trade outlets and off‐trade outlets into: (i) supermarkets; (ii) convenience stores; and (iii) all other off‐trade outlets, as described previously . Pubs, bars and nightclubs decreased from 55 105 in 2003 to 49 940 in 2013 and other on‐trade outlets decreased from 48 727 to 36 191, but licensed restaurants increased from 18 410 to 21 433 .…”

“…Pubs, bars and nightclubs decreased from 55 105 in 2003 to 49 940 in 2013 and other on‐trade outlets decreased from 48 727 to 36 191, but licensed restaurants increased from 18 410 to 21 433 . Off‐trade outlets increased in all three categories (convenience stores from 8083 to 16 467; supermarkets from 4417 to 5859; and other off‐trade outlets from 20 892 to 23 134) .…”

“…Few studies, however, have distinguished between on‐trade and off‐trade outlets, and none have examined subcategories of on‐ and off‐trade outlets . Recent trends in outlet types in England include an increase in the number of restaurants licensed to sell alcohol and especially the marked increase in convenience stores selling alcohol, accompanied by a decrease in the number of pubs and bars . In addition, alcohol consumption has both acute and chronic adverse effects on health and examination of hospital admissions offers the opportunity to examine such effects.…”