As alcohol availability increases, alcohol consumption also increases. Alcohol availability can be operationalized based on respondent-reported perceptions or using objective administrative data. Studies using objective measures suggest neighborhood alcohol outlet density is associated with greater alcohol consumption83 and alcohol problems84. Similarly, greater neighborhood drug availability can increase substance use85, alcohol dependence86, and drug abuse relapse87. Some evidence suggests African Americans may be at even higher risk than other groups for alcohol-related health problems in areas with higher densities of off-premise alcohol outlets84. In addition to increasing alcohol availability, a high density of alcohol outlets also may operate as a trigger for heavy drinking or as a stressor, as some evidence suggests a proliferation of alcohol outlets can increase violence in the surrounding area84,88.
