Close proximity to alcohol outlets is associated with increased serious violent crime in New Zealand

Objective: To examine the association between geographic access to alcohol outlets and serious violent crime in New Zealand. Methods: A national study of alcohol outlet access and serious violent crime used a cross‐sectional ecological analysis. Serious violence offences recorded between 2005 and 2007 were aggregated for 286 police station areas. Using Geographical Information Systems (GIS), 9,320 licensed premises were geocoded and road travel distances to the closest alcohol outlet type/category were calculated for each area. Negative binomial regression models measured the association between the distance to the closest alcohol outlet and the number of serious violent offences in each police station area, controlling for area‐level measures of social deprivation, Māori population, young males 15–29 years and population density. Results: There were significant negative associations between distance (access) to licensed outlets and the incidence of serious violent offences with greater levels of violent offending recorded in areas with close access to any licensed premises compared to those areas with least access (IRR 1.5, 95% CI 1.10–2.03); with on‐licensed premises (IRR 1.6, 95% CI 1.16–2.08); and off‐licensed premises (IRR 1.4, 95% CI 1.05–1.93). Conclusion: Having greater geographic access to alcohol outlets was associated with increased levels of serious violent offending across study areas. Implications: Alcohol availability and access promoted under the current liberalised licensing regime are important contextual determinants of alcohol‐related harm within New Zealand communities.     

Alcohol Availability and Neighborhood Characteristics in Los Angeles, California and Southern Louisiana

The objective of this study was to examine the associations between alcohol availability types and community characteristics in randomly selected census tracts in Southern California and Southeastern Louisiana. Outlet shelf space and price by beverage type was collected from all off-sale alcohol outlets in 189 census tracts by trained research personnel. Three aspects of alcohol availability at the census tract level were considered—outlets per roadway mile, shelf space, and least price by beverage type. Using multivariate analyses, we examined the associations between census tract socioeconomic and demographic characteristics and alcohol availability types. Fifteen measures of alcohol availability were calculated—total shelf space and shelf space by beverage types (beer, malt liquor, and distilled spirits); outlets per roadway mile, per tract, and per capita; and least price by beverage type (including wine). In multivariate analyses controlling for state, male unemployment rate was inversely associated with total shelf space (p = 0.03) and distilled spirit shelf space (p = 0.05). Malt liquor shelf space was inversely associated with percent White (p = 0.02). Outlets per roadway mile was positively associated with household poverty (p < 0.0001), whereas percent African American was inversely associated with outlets per roadway mile (p = 0.03). Beverage-specific least prices were not associated with any socioeconomic or demographic community characteristics. Alcohol availability types, but not least price, were associated with some community characteristics. More research exploring how alcohol availability types vary by community and their relationship to alcohol-related harms should be conducted.     

Alcohol outlet density is related to police events and motor vehicle accidents in Manukau City,New Zealand

Objectives: To explore the cross‐sectional association between alcohol outlet density and police events in Manukau City, New Zealand. Methods: Using data for the Census Area Unit (suburb) level, per‐capita measures of alcohol outlet density for January 2009 were calculated for off‐licence outlets, clubs and bars, and restaurants and cafés. Data on police events and motor vehicle accidents were obtained for the period 1 July 2008 to 30 June 2009, and also converted into per capita measures. A spatial seemingly unrelated regression model was developed, which simultaneously assessed the relationship between densities and all nine categories of police events, and motor vehicle accidents, while controlling for relevant covariates. Results: All three outlet density measures were significantly associated with a range of police events, but only off‐licence density was significantly associated with motor vehicle accidents. An additional off‐licence outlet in a given area was associated with 85.4 additional police events and 10.3 additional motor vehicle accidents; an additional club or bar was associated with 34.7 additional police events and 0.5 additional motor vehicle accidents; and an additional restaurant or cafe was associated with 13.2 additional police events and 2.1 additional motor vehicle accidents. Conclusions: The results do not imply causality. However, they are broadly consistent with availability theory, and imply that local alcohol policy should account for the effects of additional outlets when new licences are granted. While the methodological approach described here is easily transferable to investigate the relationships elsewhere, we suggest some areas for improvement of future studies.     

Neighbourhood deprivation and access to alcohol outlets: A national study

People living in poor areas suffer higher mortality than those in wealthy areas. Environmental factors partly explain this association, including exposure to pollutants and accessibility of healthcare. We sought to determine whether proximity to alcohol outlets varied by area deprivation in New Zealand. Roadway travel distance from each census unit to the nearest alcohol outlet was summarised according to socioeconomic deprivation for each area. Analyses were conducted by license type (pubs/bars, clubs, restaurants, off-licenses) and community urban–rural status. Strong associations were found between proximity to the nearest alcohol outlet and deprivation, there being greater access to outlets in more-deprived urban areas.     

How would the tobacco retail landscape change if tobacco was only sold through liquor stores,petrol stations or pharmacies?

Objective : To examine the potential impact of tobacco being available only from pharmacies, only from liquor stores or only from petrol stations on the New Zealand tobacco retail landscape. Methods : Tobacco retailers and pharmacies were mapped using GIS. Comparisons were made between tobacco retailers and pharmacies. Simple linear regression was used to assess the relationship between outlet types and deprivation. Results : A total of 5,243 tobacco outlets, including liquor stores and petrol stations, and 1,035 pharmacies were identified. The density of all outlets was greater in areas of higher deprivation. The majority of tobacco retailers and pharmacies were located in urban areas. Outlets were mapped in relation to walking distances from secondary schools; significant differences between outlet types are presented. Conclusions : The policy options examined in this study would considerably reduce the overall availability of tobacco, decrease cues to smoke and reduce the density of tobacco sales around schools. However, inequities in availability would exist with access to tobacco in rural areas disproportionately reduced, and a positive sociodemographic gradient remaining. Implications for public health : Substantially reducing tobacco availability has been identified as a crucial tobacco control strategy. This study provides information on the impact of different policy options to support Smokefree 2025.     

Area deprivation and the food environment over time: A repeated cross-sectional study on takeaway outlet density and supermarket presence in Norfolk,UK, 1990–2008

Socioeconomic disparities in the food environment are known to exist but with little understanding of change over time. This study investigated the density of takeaway food outlets and presence of supermarkets in Norfolk, UK between 1990 and 2008. Data on food retail outlet locations were collected from telephone directories and aggregated within electoral wards. Supermarket presence was not associated with area deprivation over time. Takeaway food outlet density increased overall, and was significantly higher in more deprived areas at all time points; furthermore, socioeconomic disparities in takeaway food outlet density increased across the study period. These findings add to existing evidence and help assess the need for environmental interventions to reduce disparities in the prevalence of unhealthy food outlets.     

The Premises is the Premise: Understanding Off- and On-premises Alcohol Sales Outlets to Improve Environmental Alcohol Prevention Strategies

Environmental strategies to prevent the misuse of alcohol among youth—e.g., use of public policies to restrict minors’ access to alcohol—have been shown to reduce underage drinking. However, implementation of policy changes often requires public and private partnerships. One way to support these partnerships is to better understand the target of many of the environmental strategies, which is the alcohol sales outlet. Knowing more about how off-premises outlets (e.g., liquor and convenience stores) and on-premises outlets (e.g., bars and restaurants) are alike and different could help community-based organizations better tailor, plan, and implement their environmental strategies and strengthen partnerships between the public and commercial sectors. We conducted a survey of managerial or supervisory staff and/or owners of 336 off- and on-premises alcohol outlets in six counties in South Carolina, comparing these two outlet types on their preferences regarding certain alcohol sales practices, beliefs toward underage drinking, alcohol sales practices, and outcomes. Multilevel logistic regression showed that while off- and on-premises outlets did have many similarities, off-premises outlets appear to engage in more practices designed to prevent sales of alcohol to minors than on-premises outlets. The relationship between certain Responsible Beverage Service (RBS) practices and outcomes varied by outlet type. This study furthers the understanding of the differences between off- and on-premises alcohol sales outlets and offers options for increasing and tailoring environmental prevention efforts to specific settings.     

Associations between alcohol outlets and emergency department injury presentations: effects of distance from the central business district

Objective : To examine the effects of licensed outlets and sales on levels of alcohol‐related injuries presenting to emergency departments (EDs) in the Inner, Middle and Outer postcode zones of Perth, Australia. Methods : Using panel data (2002–2010), a surrogate measure (based on day of week and time of day of presentation) was used to identify alcohol‐related injuries presenting at EDs. Postcodes were grouped according to their distance from the central business district (CBD). Numbers of alcohol outlets and their sales were the primary explanatory variables. Data were analysed using negative binomial regression with random effects. Results : In the Inner and Outer postcode zones, counts of on‐site outlets were positively associated with alcohol‐related injury (IRR: 1.008; 95%CI 1.003–1.013 and IRR: 1.021; 95%CI 1.013–1.030 respectively). An additional off‐site outlet was associated with 6.8% fewer alcohol‐related injuries (95%CI 0.887–0.980). In the Middle postcode zone, mean off‐site sales were positively associated with injury (IRR: 1.024; 95%CI 1.003–1.044). Conclusions : Associations between alcohol availability variables and injury differed by outlet type and distance from the CBD. Implications : These findings provide further evidence to support stronger controls on liquor licensing, and indicate the need for different controls according to the location and type of licence.     

Neighborhood Alcohol Outlets and the Association with Violent Crime in One Mid-Atlantic City: The Implications for Zoning Policy

Violent crime such as homicide causes significant excess morbidity and mortality in US urban areas. A health impact assessment (HIA) identified zoning policy related to alcohol outlets as one way to decrease violent crime. The objectives were to determine the relationship between alcohol outlets including off-premise alcohol outlets and violent crime in one urban area to provide local public health evidence to inform a zoning code rewrite. An ecologic analysis of census tracts in Baltimore City was conducted from 2011 to 2012. The data included violent crimes (n = 51,942) from 2006 to 2010, licensed alcohol outlets establishments (n = 1,327) from 2005 to 2006, and data on neighborhood disadvantage, percent minority, percent occupancy, and drug arrests from 2005 to 2009. Negative binomial regression models were used to determine the relationship between the counts of alcohol outlets and violent crimes controlling for other factors. Spatial correlation was assessed and regression inference adjusted accordingly. Each one-unit increase in the number of alcohol outlets was associated with a 2.2 % increase in the count of violent crimes adjusting for neighborhood disadvantage, percent minority, percent occupancy, drug arrests, and spatial dependence (IRR = 1.022, 95 % CI = 1.015, 1.028). Off-premise alcohol outlets were significantly associated with violent crime in the adjusted model (IRR = 1.048, 95 % CI = 1.035, 1.061). Generating Baltimore-specific estimates of the relationship between alcohol outlets and violent crime has been central to supporting the incorporation of alcohol outlet policies in the zoning code rewrite being conducted in Baltimore City.     

Tobacco outlet density,neighbourhood stressors and smoking prevalence in Toronto,Canada

A growing body of research has shown that neighbourhood-level factors, such as the density of retail outlets selling tobacco and neighbourhood socioeconomic disadvantage affect smoking prevalence, with high levels of outlet density and neighbourhood disadvantage related to higher smoking prevalence.However, few studies have considered the role of other neighbourhood processes like stressors including perceived neighbourhood disorder in these effects. The present study examined the effects of tobacco outlet density, neighbourhood income and perceived neighbourhood disorder on smoking prevalence among a representative sample of 2,412 adult neighbourhood residents in a large urban centre in Canada. Tobacco outlet density and perceived neighbourhood disorder were significantly associated with smoking in an unadjusted multilevel model, but only perceived neighbourhood disorder remained significant in a model adjusting for other confounders. Findings suggest the need for community-based interventions to address the relationship between neighbourhood disorder and smoking, as well as more research on the combined role of tobacco availability and neighbourhood stressors, beyond neighbourhood socioeconomic disadvantage, on smoking behaviour.     

The Geography of Violence,Alcohol Outlets,and Drug Arrests in Boston

Objectives. We examined the relationship between alcohol outlets, drug markets (approximated by arrests for possession and trafficking), and violence in Boston, Massachusetts, in 2006. We analyzed geographic and environmental versus individual factors related to violence and identified areas high in violent crime.Methods. We used data from the Boston Police Department, US Census, and Massachusetts State Alcohol Beverage Control Commission. Spatial modeling was employed at the block group level, and violent crime, alcohol outlets, and drug markets were mapped.Results. Relative to other block groups, block groups in the highest decile of violent crime (n = 55) were found to be poorer (e.g., lower incomes, higher percentages of vacant homes), and they had greater numbers of alcohol outlets and higher drug arrest rates. Alcohol outlets and drug possession and trafficking arrests were predictive of violent crime. Also, spatial effects resulting from neighboring block groups were related to violent crime. Both alcohol outlet density and type were associated with violent crime in a differentiated and complex way.Conclusions. With drug possession and trafficking arrests as a proxy for drug markets, spatial relationships between alcohol outlets and violence were found in addition to typical sociodemographic predictors.Understanding the environmental and social contexts in which violence occurs has been an increasingly important area of research, one that has broad applicability to public policies on violence mitigation far beyond purely research issues. Increased theoretical understanding of the spatial and environmental contexts of violence, such as theories relating alcohol outlets to violence, have gone hand in hand with improvements in spatial techniques and computing power, transforming this area of research. Furthermore, although there have been studies on violence related to types and densities of alcohol outlets,1–5 there has been less research attempting to include measures of drug arrests and to more fully incorporate spatial features such as characteristics of adjacent geographic areas.Locations of alcohol outlets are frequently related to occurrence of violence. The incidence of interpersonal violence appears to increase in and around locations with alcohol outlets, particularly bars and liquor stores.1,3–5 There are several possible mechanisms. First, bars and liquor stores often attract individuals likely to be involved in violent interactions, such as young males (alcohol availability theory).6 Second, these retail alcohol outlets are often located in areas with less guardianship than others (social disorganization theory).1,3,7 Third, these types of outlets provide opportunities for social interactions that may lead to violence (alcohol availability and niche theory).Finally, establishments serving alcohol can foster increased expressions of aggression.6 Empirical studies have shown a correlation between higher rates of violence and increased proximity to bars and liquor stores1,8–10 as well as sales through alcohol outlets.11 Similar arguments have been suggested to support empirically observed cross-sectional relationships between rates of violence and locations of off-premise establishments.9,12Establishment effects, however, may be related to other crime-related aspects of the environments of off-premise outlets, such as illegal drug activity and prostitution.13 Questions remain as to whether effects related to alcohol outlets are due to the outlets themselves or the general characteristics of the areas in which they are located. Recent criminological research on bars and taverns suggests that managers of these establishments create environments that suppress or facilitate violence through business-related choices such as types of activities and entertainment, staff and training, and property characteristics.14Two theoretical concerns have guided much of the empirical work over the past 2 decades. First, alcohol outlets might serve as markers for other population or environmental features that are related to violence. These markers could consist of specific population characteristics related to greater levels of violence (e.g., poverty, female-headed households)10 or place-based characteristics related to lower levels of police enforcement and surveillance (e.g., vacant retail establishments).15 Second, violence and alcohol outlets are part of the continuous spatial fabric of communities, and thus standard statistical analyses of data, which assume independence of observations, are complicated by spatial autocorrelation between observations.16 Spatial models have been applied to help correct for bias or increased sampling variation of effect estimates arising from a lack of spatial independence in modeling violence outcomes.17We examined the relationship between alcohol outlets and violent crime in an analytical framework that treats alcohol outlets as potentially both “producers” of violent behavior and markers or attractors of violence. Our initial assessments of the effects of typical sociodemographic measures demonstrated that there remained effects of alcohol outlet presence not accounted for by these features. Subsequently, to capture more spatial and environmental characteristics and to illustrate the presence of spatial effects that were distinct from the 2 types of effects just mentioned, we assessed how adjacent area characteristics relate to violent crime in the target area. To deal with the different ways in which outlets are posited to be related to violence, we accounted for outlet density and type and whether a violent crime occurred on a weekend or weekday.In addition, we included information on drug arrests for trafficking and possession (as estimators of drug markets) to properly account for the relationship between violence and drug markets when assessing the effects of alcohol outlets. Although Martinez et al.18 found a significant relationship between drug markets and violence when accounting for social disorganization, our analysis is the first, to our knowledge, to also include alcohol outlet type and density.     

The Moderating Role of Gender in the Relationship Between Tobacco Outlet Exposure and Tobacco Use Among African American Young Adults

Tobacco outlet exposure is a correlate of tobacco use with potential differences by gender that warrant attention. The aim of this study is to explore the moderating role of gender in the relationship between tobacco outlet exposure and past month tobacco use among African American young adults 21 to 24 years old. This cross-sectional study (n?=?283) used geospatial methods to determine the number of tobacco outlets within walking distance (i.e., a quarter mile) of participants’ homes and distance to the nearest outlet. Logistic regression models were used to test interactions between gender and tobacco outlet exposure (i.e., density and proximity). Tobacco outlets were classified based on whether or not they were licensed to sell tobacco only (TO outlets) or tobacco and alcohol (TA outlets). Neither density nor proximity was associated with past month tobacco use in the pooled models. However, gender modified the relationship between TO outlet density and tobacco use, and this relationship was significant only among women (OR?=?1.02; p?<?0.01; adjusted OR?=?1.01; p?<?0.05). This study underscores the importance of reducing tobacco outlet density in residential neighborhoods, especially TO outlets, as well as highlights potential gender differences in the relationship between tobacco outlet density and tobacco use.     

Neighborhood Typologies Associated with Alcohol Use among Adults in Their 30s: a Finite Mixture Modeling Approach

There has been increasing interest in how neighborhood context may be associated with alcohol use. This study uses finite mixture modeling to empirically identify distinct neighborhood subtypes according to patterns of clustering of multiple neighborhood characteristics and examine whether these subtypes are associated with alcohol use. Neighborhoods were 303 census block groups in the greater Seattle, WA, area where 531 adults participating in an ongoing longitudinal study were residing in 2008. Neighborhood characteristics used to identify neighborhood subtypes included concentration of poverty, racial composition, neighborhood disorganization, and availability of on-premise alcohol outlets and off-premise hard liquor stores. Finite mixture models were used to identify latent neighborhood subtypes, and regression models with cluster robust standard errors examined associations between neighborhood subtypes and individual-level typical weekly drinking and number of past-year binge drinking episodes. Five neighborhood subtypes were identified. These subtypes could be primarily characterized as (1) high socioeconomic disadvantage, (2) moderate disadvantage, (3) low disadvantage, (4) low poverty and high disorganization, and (5) high alcohol availability. Adjusted for covariates, adults living in neighborhoods characterized by high disadvantage reported the highest levels of typical drinking and binge drinking compared to those from other neighborhood subtypes. Neighborhood subtypes derived from finite mixture models may represent meaningful categories that can help identify residential areas at elevated risk for alcohol misuse.     

Is access to alcohol associated with alcohol/substance abuse among people diagnosed with anxiety/mood disorder?

ObjectivesTo investigate the relationship between access to off-license alcohol outlets and areas with dual treatment for alcohol/drug abuse and anxiety/mood disorder compared to areas with anxiety/mood disorder only in an urban setting in New Zealand.Study designEcologic study.MethodsWithin small areas (2840 meshblocks, mean size 0.05 km²) in the city of Auckland, New Zealand, counts of adults receiving anxiety/mood disorder treatment (2008–9) were identified and the proportions of these individuals also receiving treatment for alcohol/drug abuse were generated. Access to off-license alcohol outlets were defined as: 1) shortest road distance from the population-weighted centroid of each small area to an outlet; 2) count of outlets within a 3 km road network buffer; and 3) relative density of outlets across Auckland (determined through kernel density estimates). To test for the relationship between access to alcohol outlets and dual diagnosis, meshblocks without any cases of anxiety/mood disorder were excluded from analyses. Remaining meshblocks were dichotomized into any or no dual diagnosis. Logistic regression was used to estimate the association between access to alcohol outlets and treatment for the dual conditions.ResultsNeighbourhoods with dual diagnosis were generally similar to those with anxiety/mood disorder only, in terms of ethnic and gender/age composition. Regression analyses indicated statistically significant decreased risk of dual diagnosis for those areas with the lowest density (using a buffer) of alcohol outlets (OR = 0.75, P-value = 0.027) compared with areas with the highest density, after adjustment for deprivation and population density. All access measures also indicated significant linear trends where dual diagnosis was more likely in areas with greater access.ConclusionsGenerally, decreased access to alcohol outlets was associated with decreased odds of dual diagnosis of alcohol/drug abuse and anxiety/mood disorder. Measures to control access to alcohol outlets may be an important area for alcohol/substance abuse intervention, particularly for vulnerable sub-populations.     

Density of tobacco retail outlets near schools and smoking behaviour among secondary school students

Objective: To investigate whether the density of tobacco retail outlets near schools in Victoria, Australia, is associated with adolescent smoking behaviour. Methods: Cross‐sectional survey data of 2,044 secondary school students aged 12–17 years was combined with tobacco outlet audit data. Associations between students' self‐reported tobacco use and the density of tobacco outlets near schools was examined using multilevel logistic and negative binomial regression models, with cigarette price at local milk bars and key socio‐demographic and school‐related variables included as covariates. Results: Increased tobacco retail outlet density was associated with a significant increase in the number of cigarettes smoked in the previous seven days among students who smoked in the past month (IRR=1.13; 95% CI 1.02–1.26), but not the odds of smoking in the past month in the larger sample (OR=1.06; 95% CI 0.90–1.24), after controlling for local mean price of cigarettes and socio‐demographic and school‐related variables. Conclusions and implications: This study suggests there is a positive association between tobacco retail outlet density and cigarette consumption among adolescent smokers, but not smoking prevalence, in the Australian context. There is value in considering policy measures that restrict the supply of tobacco retail outlets in school neighbourhoods as a means of reducing youth cigarette consumption.     

Anywhere,anytime: Retail access to tobacco in New South Wales and its potential impact on consumption and quitting

Relatively little attention has been given to the retail availability of tobacco products despite the likelihood that ubiquitous supply may represent a primary form of tobacco promotion in Australia. This study aimed to explore the number and distribution of tobacco outlets, smokers’ perceptions about the availability of tobacco and the role availability may play in tobacco consumption and quitting attempts in Australia. The study comprised two parts: Part A involved mapping retail tobacco outlets in the Hunter Region of NSW, Australia. Part B involved a statewide telephone survey of 539 current smokers aged 18 years and over in NSW. Part A identified 1270 retail tobacco outlets, giving a density of one outlet per 384 persons aged over 15 years, or one outlet per 77 smokers. Associations between socioeconomic status of areas and retail availability of tobacco were not found. Of the survey respondents in Part B, 87.5% indicated that they would be within walking distance of a retail tobacco outlet during their daily activities. Those who were younger, male and single were more likely to purchase tobacco at convenience-type outlets. We therefore conclude that some groups of smokers appear vulnerable to the availability of tobacco and a reduction in the availability of tobacco is likely to benefit smokers who wish to quit.     

The density of alcohol outlets and adolescent alcohol consumption: An Australian longitudinal analysis

Higher density of alcohol outlets has been linked to increased levels of adolescent alcohol-related behaviour. Research to date has been cross-sectional. A longitudinal design using two waves of annual survey data from the Australian arm of the International Youth Development Study was used. The sample comprised 2835 individuals with average age at wave 2 of 14 years (SD=1.67; range=11–17 years). GSEM was used to examine how absolute levels of alcohol outlet density was associated with student-reported alcohol use one year later, while controlling for prior alcohol use, risk factors at wave one and changes in density over the 2 years. Adolescents' perception of alcohol availability and friends' alcohol use were tested as potential mediators of the association between alcohol outlet density and adolescent alcohol use. Elasticity modelling identified a 10% increase in overall density at wave one was associated with an approximately 17% increase in odds of adolescent alcohol consumption at wave two. Living in areas with a higher density of outlets was associated with a statistically significant increase in the likelihood of adolescents developing early age alcohol consumption.     

Does Alcohol Outlet Density Affect Youth Access to Alcohol?

PurposeTo investigate how community alcohol outlet density may be associated with alcohol access among adolescents.MethodsData were collected through a three-wave panel study with youth aged 14–16 at baseline using computer-assisted telephone interviews. Study participants were recruited from 50 zip codes with varying alcohol outlet density and median household income in California. Data analyses were conducted using multilevel, linear growth models and data from 1028 youth (52% male, 51% white).ResultsAfter taking into account individual-level factors and zip code median household income, zip code alcohol outlet density was significantly and positively related to the initial levels of the likelihood and frequency of getting alcohol through various sources including commercial outlets, shoulder tapping, home or family members, and underage acquaintances.ConclusionsHigh levels of alcohol outlets in the community enable youth access to alcohol through commercial outlets, family, and social networks.     

Evaluation of alcohol outlet density and its relation with violence

OBJECTIVES: The current study set out to investigate alcohol availability in a densely populated, residential area of suburban S?o Paulo associated with high levels of social deprivation and violence. Gun-related deaths and a heavy concentration of alcohol outlets are notable features of the area surveyed. Given the strong evidence for a link between alcohol availability and a number of alcohol-related problems, including violent crime, measures designed to reduce accessibility have become a favored choice for alcohol prevention programs in recent years. METHODS: The interviewers were 24 residents of the area who were trained for the study. It was selected an area of nineteen streets, covering a total distance of 3.7 km. A profile of each alcohol outlet available on the area was recorded. RESULTS: One hundred and seven alcohol outlets were recorded. The number of other properties in the same area was counted at 1,202. Two measures of outlet density may thus be calculated: the number of outlets per kilometer of roadway (29 outlets/km); and the proportion of all properties that sold alcohol (1 in 12). CONCLUSIONS: The results of this study is compared with others which are mainly from developed countries and shown that the area studied have the highest density of alcohol outlet density ever recorded in the medical literature. The implication of this data related to the violence of the region is discussed. By generating a profile of alcohol sales and selling points, it was hoped to gain a better understanding of alcohol access issues within the sample area. Future alcohol prevention policy would be well served by such knowledge.