Scribner, R. A., Cohen, D. A., & Fisher, W. (2000, February). Evidence of a structural effect for alcohol outlet density: A multi-level analysis. Alcoholism: Clinical and Experimental Research, 24(2), 188-195.
When George Bailey visited a town where he’d never been born in the movie, "It’s a Wonderful Life," he found a world run amok. "Pottersville" had been named after an unscrupulous banker, alcohol ran freely, and violence, gambling and crime were rampant. This image represents the findings of a study published in the February edition of Alcoholism: Clinical & Experimental Research, that the "wetter" a community is, the greater its problems.
"In the last four or five years," explained Richard Scribner, professor of preventive medicine at Louisiana State University Health Sciences Center and lead author of the study, "people in community-based organizations in cities like Los Angeles, Washington, New Orleans, Oakland and Chicago have become aware of a link between higher densities of alcohol outlets and higher incidences of alcohol-related outcomes." In other words, those neighborhoods with greater access to alcohol tend to have higher rates of homicides, violent assaults, drunk driving offenses, motor vehicle accidents, etc.
"Pottersville is a great metaphor for Dr. Scribner’s kind of study," said George Hacker, director of the Alcohol Policies Project at the Center for Science in the Public Interest. "It’s one of the best visual descriptions you will find for a society where norms changed because of the greater availability and consumption of alcohol. The changes were largely related to alcohol."
Scribner originally became involved in outlet-density research when community groups in South Central Los Angeles asked him to investigate the possible contribution of alcohol outlets to the 1992 riots. Although somewhat skeptical at first, his research found that there was indeed a relationship between the availability of alcohol and problem behaviors. Those findings were used by community activists to help halt the rebuilding of some of the alcohol outlets where gang and drug activity had previously existed.
In this latest round of research, Scribner and his colleagues looked at 24 urban residential tracts in New Orleans to see what effect the number of off-sales alcohol outlets (liquor, grocery and convenience stores) might have on individual attitudes toward drinking and alcohol consumption. They found an over concentration of off-sales outlets in many of the neighborhoods examined, about five outlets per 3,000 people. They also found that about a 15 to 16 percent difference in individuals’ drinking attitudes and an 11 percent difference in individuals’ alcohol consumption could be attributed to the density of alcohol outlets in their neighborhoods.
"There is a distribution of drinkers in every neighborhood," said Scribner, "that range from abstainers to heavy drinkers. In neighborhoods where alcohol availability is greater, the whole distribution of drinkers is shifted toward heavier drinking and more permissive norms. They all think it’s OK to drink a little bit more than people in other neighborhoods. This is what we call a group- or neighborhood-level effect, and it’s explained by the alcohol-outlet density in that neighborhood. It’s almost a cultural effect."
Both Scribner and Hacker believe these findings demonstrate the need for prevention, intervention and treatment options that go beyond individuals to their environment, in this case, their neighborhood. They also believe policy makers need to address issues concerning access to, and availability of, alcohol within communities.
"Everybody assumes that individual factors determine the way people are, and they just happen to live where they do," said Scribner. "Yet people’s drinking behaviors appear to be defined by the norms of the neighborhood where they live. They drink based on how much their friends and the people around them drink. They adopt the norms of the neighborhood they live in."
Hacker agrees. "This study sends a warning signal, and a message, to communities to take a good look beyond individual factors and start looking at community factors. Policies that guide zoning, conditional-use permits, stricter enforcement of underage sales, server training, regulation of the density of alcohol outlets – all of these are important." He added, "numerous community coalitions work on anti-drug issues but many have yet to tackle alcohol availability issues."
Hacker agrees that alcohol is a legal drug, but points out that "alcohol is only legal because of the historical reality." He noted that "we’ve learned not to protest against alcohol because Prohibition was such a social failure. If alcohol were invented today, it would probably be classified differently because of its pharmacological and psychosocial properties."
High levels of consumption have become one of the most "deadly, devastating, destructive and costly" problems in America, said Hacker. "If everyone drank at a responsible level, that would be fine. The problem is that many people don’t, or can’t. Part of our responsibility is to ensure that individuals and communities have enough information and encouragement to make reasonable, responsible choices. That’s not coercive, though it might threaten the alcoholic beverage industry with a potential reduction in sales."