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The availability of alcohol is a major policy issue.  A key measure of availability is the number, or density, of alcohol outlets in a given area.  Numerous international studies have looked at links between outlet density, overall consumption, and crime and disorder (Popova et al., 2009; Campbell et al., 2009; Bryden et al., 2012; Holmes et al., 2014).  However, few have examined associations between outlet density and alcohol-related hospital admissions (Tatlow et al., 2000; Livingston, 2011; Stockwell et al., 2013; Richardson et al., 2015; Fone et al., 2016;).

The purpose of this study was to investigate if alcohol outlet density was associated with hospital admissions for alcohol-related conditions in England.  We used hospital admissions data from 2002/03 to 2013/14 and data on alcohol outlets from a  market research company.

The study examines associations at the Lower Layer Super Output Area (LSOA) census area level using six categories of alcohol outlets.   Areas were split into four levels of outlet density, and the relationship between these densities and a range of hospital admissions measures were compared.  Outlet density was measured within a 1-km radius of postcodes, which were captured for all 32,482 LSOAs in England.

Key findings

  • A higher density of on-trade outlets is associated with higher hospital admissions for conditions wholly attributable to alcohol.
  • A higher density of licensed convenience stores is also associated with higher hospital admissions for conditions wholly attributable to alcohol.
  • The relationship between outlet density and hospital admissions is largely the same for men and women, though appears more pronounced for older people.
  • The overall relationship between outlet density and hospital admissions appears to be the same in deprived areas and affluent areas.

Research team

Professor Ravi Maheswaran, Dr Mark Strong, Dr Paul Brindley (Public Health GIS Unit, School of Health and Related Research, University of Sheffield, United Kingdom)

Dr Mark Green (Department of Geography & Planning, University of Liverpool, United Kingdom)

Mr Colin Angus, Dr John Holmes (Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, United Kingdom)