Bottle shops, pubs and clubs: Why location matters for the health of disadvantaged communities

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The findings can be used to inform Australian urban planning policies to help support appropriate regulation of alcohol outlets. 

Lead author Dr Hannah Badland and colleagues from the University of Melbourne and the University of New South Wales, examined the health of more than 3000 people in metropolitan Melbourne and mapped the location and density of alcohol outlets in their areas. 

Dr Badland said the location and density of alcohol outlets had no impact on the long-term health of people in better-off communities, but it was a different story for disadvantaged communities. 

“People in disadvantaged areas were more likely to rate their long-term health as poor if there was an on-licence alcohol outlet, such as a pub or restaurant, within 400 metres, or a bottle shop within 800 metres,” she said. 

“Most research to date has measured the density of alcohol outlets by looking at immediate impacts, such an injury and domestic violence, rather than a more comprehensive measure of long-term health across the community,” Dr Badland said. 

“Self-rated health is a very stable measure of mental and physical health across the population, regardless of level of disadvantage.” 

The study pointed to a need to further develop state policies to regulate the location of alcohol outlets to create safer and healthier communities, especially for disadvantaged communities. 

“These policies would give policy makers and planners more teeth to say yes or no to applications for alcohol outlets because currently there’s limited information to guide what’s okay and what’s not, and where.” 

Dr Badland said the study, supported by The Australian Prevention Partnership Centre and published in Drug and Alcohol Review, was the first to measure the impact of the density of alcohol outlets on self-rated health. 

While conducting the study, the research team discovered only a few state policies about where to locate alcohol outlets and none took the demographics of the region into account. 

“Reducing access to alcohol is an important and cost-effective way to decrease alcohol consumption and associated harm, but it is not commonly used to control alcohol in Australia,” Dr Badland said.  

“Instead, Australian strategies to reduce alcohol-related harm tend to focus on marketing and education interventions, and there is limited evidence internationally that these are the most effective strategies.” 

The results are the first published results from the National Liveability Study, which is measuring the key factors that make our cities healthy and liveable.  

The National Liveability Study is one of more than 20 research projects supported by The Australian Prevention Partnership Centre, a national collaboration of researchers, policy makers and practitioners identifying what works to prevent lifestyle-related chronic health problems in Australia. 

The Australian Prevention Partnership Centre is funded by the NHMRC, the Australian Government Department of Health, the NSW Ministry of Health, ACT Health and the HCF Research Foundation. It is administered and hosted by the Sax Institute, and co-hosted by the Centre of Excellence in Intervention and Prevention Science.  

Key points 

Why was this study done? 

  • Reducing access to alcohol is an important and cost-effective way to decrease alcohol consumption and associated harm, but it is a less common approach to alcohol control in Australia. 

Why is this study different? 

  • Most research has measured the impact of density of alcohol outlets by looking at immediate impacts, such as injury and domestic violence, rather than comprehensive measures of health across the community. 
  • It is first to measure the impact of the density of alcohol outlets on self-rated health. 
  • There has been little research examining whether the density of alcohol outlets has a different health impact for those living in areas of more or less social disadvantage. 

What did they do? 

  • Reviewed existing Australian policies about where alcohol outlets should be located. 
  • Measured the location and density of alcohol outlets and linked that information with self-rated health data drawn from 3141 adults in metropolitan Melbourne to examine the association between the density of alcohol outlets, self-rated health and disadvantage. 

What did they find? 

  • There are few spatial alcohol policies in Australia – that is policies around the location and density of alcohol outlets. 
  • A higher density of alcohol outlets has little impact on areas of less disadvantage. 
  • But people in disadvantaged areas are more likely to rate their long-term health as poor if there is an on-licence alcohol outlet (eg, pub or restaurant) within 400 metres or a retail alcohol outlet (eg bottle shop) within 800 metres.