syracuse alcohol environment project - report

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SSyracuse

AAlcoholEEnvironment

PProject

A collaborative project between

the Onondaga County Health Department

and the Syracuse/Onondaga Drug & Alcohol Abuse Commission

Robert PezzolesiWalden University

February, 2009


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IIntroduction

The availability of alcohol has been linked to a panoply of harmful public healthand public safety outcomes including underage drinking, violence, motor vehicle

accidents, child abuse & neglect, sexually transmitted diseases, and alcohol-related

hospitalization. In order to begin to gauge these relationships locally, this project

encompasses an exploratory analysis of the alcohol environment in Syracuse, New York

utilizing geographic information system (GIS) mapping. The subjects of the maps were

suggested by extant research, dependant upon the availability and/or suitability of data.

Additionally, we opted for breadth (a wide range of issues) rather than depth (intensive

statistical analysis of any specific relationship).

The maps contained herein, even those with clearly definable patterns, are not

intended to establish a causal relationship between alcohol outlet placement/density

and the problems in question. Rather, as Gruenewald, Remer, & Lipton (2002) posit,

spatial analysis can reveal descriptive associations between events and places,

providing a preliminary look at potential causal associations between problems and

places (emphasis added).

It is hoped that these maps will spark conversation, spur further local research

on this important public health issue, and suggest (in tandem with the research

literature on alcohol availability) the value of environmental interventions to mitigatealcohol problems in the Syracuse area.


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Maps: Alcohol Outlets/Alcohol Outlet Density

Our Maps Indicate Clustering of alcohol outlets both in

commercial/entertainment areas (e.g., Armory Square)

and mixed-use areas.

Areas of intense clustering adjacent to residential

neighborhoods include Little Italy, James/Lodi,

Richmond/Frazer, Tipperary Hill, and Westcott.

Why It Matters Alcohol outlet density (AOD) has been linked togreater alcohol consumption, and greater consumption

has been linked to higher rates of alcohol-related

problems.(Babor, Caetano, Casswell, Edwards, Giesbrecht, Graham, et al., 2003; Livingston,

Chikritzhs, & Room, 2007)

Studies have correlated AOD with a number of health,

social, and economic harms including violent crime,

property crime, DWI, pedestrian injury, alcohol-related

hospitalization, gonorrhea, and child abuse & neglect.


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Map: Armory Square detail

Our Maps Indicate Armory Square features extremely dense clustering of

on-premise outlets.

Why It Matters Entertainment districts featuring high numbers of on-

premise alcohol outlets may intensify alcohol problems

by facilitating the circulation of large crowds.(Livingston, Chikritzhs, & Room, 2007)

At a certain point, additional outlets may have anexponential effect on alcohol related problems (see

figure below).

Figure from Livingston,

Chikritzhs, & Room (2007), p. 562


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Maps: Poverty and Off-Premise Alcohol Outlets

Our Maps Indicate A general pattern of placement of off-premise alcohol

outlets in relatively impoverished neighborhoods.

A noticeably smaller number of alcohol outlets inrelatively affluent neighborhoods, including

Meadowbrook, Sedgwick, South Valley, and

University neighborhoods.

Why It Matters The concentration of alcohol outlets in impoverished

neighborhoods amounts to a double whammy on

public health and public safety.

A 1995 Syracuse University study of OnondagaCounty commissioned by the Syracuse/Onondaga

Drug & Alcohol Abuse Commission found a clear,

inverse relationship between neighborhood income

and number of alcohol outlets.(Doherty, 1995)


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Map: Vacant Housing Units & Off-Premise Alcohol Outlets

Our Maps Indicate A modest relationship between off-premise outlets and

vacant housing units.

Why It Matters

Large numbers of vacant housing units have beenconnected with neighborhood crime.(Roncek & Maier, 1991; Parker, Luther, & Murphy, 2007)

The interrelationship of concentrated alcohol outlets

and vacant housing units may intensify the social

disorganization of Syracuse neighborhoods.(Gruenewald & Remer, 2006)


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Maps: Race/Ethnicity and Off-Premise Alcohol Outlets

Our Maps Indicate Little apparent relationship between either African-

American race or Hispanic ethnicity and location of

off-premise alcohol outlets.

Why It Matters Several studies have found disproportionate number

of alcohol outlets in minority neighborhoods.(Alaniz, Parker, Gallegos, & Cartmill, 1996; LaVeist & Wallace, 2000; Romley,Cohen, Ringel, & Sturm, 2007; Pollack, Cubbin, Ahn, & Winkleby, 2005)

African-Americans as a group paradoxically have

overall light patterns of drinking and

disproportionately high rates of alcohol problems.

Higher AOD may be one factor in this disparity.(Godette, Headen, & Ford, 2006)

Latinos are also disproportionately affected by alcohol-

related illness and violence, with higher AOD possibly

contributing to this disparity.(Alaniz, Cartmill, & Parker, 1998)


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Map: School Proximity to Off-Premise Alcohol Outlets

Our Maps Indicate 68% of Syracuse City schools have an off-premise alcohol

outlet within mile.

Why It Matters Radius of 0.5 mile represents a 1015 minute walk,

considered a standard maximum walking distance.(Lee, Reese-Smith, Regan, Booth, & Howard, 2003)

Syracuse City School District walking distance is 1.5 miles for

elementary school students and 2 miles for junior/senior high

school students.(Stonecash, 2007)

According to SAMHSA, a large number (30.6%) of underage

drinkers ages 12-20 purchased the last alcohol they used(SAMHSA, 2008)

In a US study, the vast majority (94%) of stores that sold

alcohol displayed alcohol ads. 44% of those stores displayedsuch ads within 3.5 feet of the floor.(Terry-McElrath, Harwood, Wagenaar, Slater, Chaloupka, Brewer, et al., 2003)

Exposure to in-store alcohol advertising has been associated

with increased adolescent drinking.(Hurtz, Henriksen, Wang, Feighery, & Fortmann, 2007; Ellickson, Collins,

Hambarsoomians, & McCaffrey, 2005)


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Map: School Detail

Our Maps Indicate Our example - Franklin Magnet School - is proximate

to several off-premise alcohol outlets which have been

cited for selling to underage patrons.

Why It Matters At least 50% of alcohol outlets within mile of

Franklin Magnet School have been cited for underage

sales in the last 8 years.(Syracuse Post-Standard, 2001-2006)

This analysis did not include the considerable number

of other crimes committed at the other outlets.

The rate of illegal merchant sales in communities has

been linked to youth drinking frequency, binge

drinking, drinking at school, and drinking and driving.(Dent, Grube, & Biglan, 1995)


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Map: Youth Program Proximity to Off-Premise Alcohol Outlets

Our Maps Indicate 88% of identified youth programs have an off-premise

alcohol outlet within mile.

Why It Matters A community GIS project in Tucson, Arizona, found the ratio

of alcohol retailers to youth attractions to be 3:1 (within 1 mile

radius).(Baldasare & Palm, 2008)

According to SAMHSA, a large number (30.6%) of underage

drinkers ages 12-20 purchased the last alcohol they used(SAMHSA, 2008)

In a US study, the vast majority (94%) of stores that sold

alcohol displayed alcohol ads. 44% of those stores displayed

such ads within 3.5 feet of the floor.(Terry-McElrath, Harwood, Wagenaar, Slater, Chaloupka, Brewer, et al., 2003)

Exposure to in-store alcohol advertising has been associated

with adolescent drinking.(Hurtz, Henriksen, Wang, Feighery, & Fortmann, 2007; Ellickson, Collins,

Hambarsoomians, & McCaffrey, 2005)


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Map: Homeless Transitional Housing Proximity to Alcohol Outlets

Our Maps Indicate 88% of identified homeless transitional housing sites

have alcohol outlets within mile.

Why It Matters

Alcoholism may be the most widespread of thenumerous health problems faced by homeless people.(Committee on Health Care for Homeless People, 1988)

45-57% of homeless people have been estimated to

suffer from alcohol use disorders.(National Institute on Alcohol Abuse and Alcoholism [NIAAA], 1991, p. 541)

Environmental contingencies can play a powerful

role in encouraging or discouraging drinking among

homeless people.(Smith, Meyers, & Delaney, 1998, p. 541)


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Map: Esophageal Cancer & On-Premise Alcohol Outlets

Our Maps Indicate

Ambiguous relationship between cases of esophageal

cancer and on-premise alcohol outlets.

Why It Matters

Approximately 40% of cases of esophageal cancer in

males and 29% of cases in females are attributable to

alcohol ingestion.

(Rehm, Room, Graham, Monteiro, Gmel, & Sempos, 2003)

Average cost per case for esophageal cancer is

approximately $35,000.(Max, Stark, Wittman, & West, 2004)

Other Risk Factors African-American race (Steyerberg, Earle, Neville, & Weeks, 2005)

Smoking (Veugelers, Porter, Guernsey, & Casson, 2006)

Obesity (Veugelers, Porter, Guernsey, & Casson, 2006)

Male sex (Veugelers, Porter, Guernsey, & Casson, 2006)


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Map: Liver Cirrhosis & On-Premise Alcohol Outlets

Our Maps Indicate Ambiguous relationship between cases of liver

cirrhosis and on-premise alcohol outlets.

Why It Matters

Approximately 61% of cases of liver cirrhosis in males

and 35% of cases in females are attributable to alcohol

ingestion.

(Rehm, Room, Graham, Monteiro, Gmel, & Sempos, 2003)

Average cost per case for liver cirrhosis is

approximately $17,000 - $21,000.(Max, Stark, Wittman, & West, 2004)

Other Risk Factors African-American race (Hurwitz, Holman, Strine, & Chorba, 1995)

Lower socioeconomic status (Najman, Williams, & Room, 2007)

Hepatitis C (Freeman, Law, Kaldor, & Dore, 2003)


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Map: Gonorrhea & Off-Premise Alcohol Outlets

Our Maps Indicate Ambiguous relationship between cases of gonorrhea

and off-premise alcohol outlets.

Why It Matters Studies have shown a strong relationship between

alcohol outlets and gonorrhea rates.(Scribner, Cohen, & Farley, 1998; Cohen, Ghosh-Dastidar, Scribner, Miu, Scott,

Robinson, et al., 2006)

Average cost per case for gonorrhea is $343 in directmedical costs and $47 in lost productivity for females;

$68 in direct medical costs and $10 in lost productivity

for males.(Chesson, Collins, & Koski, 2008)

Other Risk Factors African-American race (Einwalter, Ritchie, Ault, & Smith, 2005)

Lower socioeconomic status (Lacey, Merrick, Bensley, Fairley, 1997)

Neighborhood deterioration (Cohen, Spear, Scribner, Kissinger, Mason, &Wildgen, 2000)

Age


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Map: Chlamydia & Off-Premise Alcohol Outlets

Our Maps Indicate Ambiguous relationship between cases of chlamydia

and off-premise alcohol outlets.

Why It Matters Studies have shown relationship between alcohol

outlets and gonorrhea rates and HIV/AIDS rates.(Scribner, Cohen, & Farley, 1998; Cohen, Ghosh-Dastidar, Scribner, Miu, Scott, Robinson,

et al., 2006; Scribner, Johnson, Cohen, Robinson, Farley, & Gruenewald, 2008)

By analogy, alcohol outlet density may affect other

STDs.

Average cost per case for chlamydia is $315 in direct

medical costs and $47 in lost productivity for females;

$26 in direct medical costs and $10 in lost productivity

for males.(Chesson, Collins, & Koski, 2008)

Other Risk Factors African-American race (Einwalter, Ritchie, Ault, & Smith, 2005)

Lower socioeconomic status (Shahmanesh, Gayed, Ashcroft, Smith,Roopnarainsingh, Dunn, et al., 2000)

Age


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Map: DWI Arrests & On-Premise Alcohol Outlets

Our Maps Indicate An apparent correlation between DWI arrests and on-

premise alcohol outlets.

Why It Matters Approximately 40% of motor vehicle accident injuries

are alcohol-involved.(Rehm, Patra, & Popova, 2006)

Each year about 1,900 youth die as the result of

alcohol-related motor vehicle crashes.(National Institute on Alcohol Abuse and Alcoholism, 2006)

Average cost per case for injured motor vehicle driveris $33,731 - $50,583. Average cost per case for injured

pedestrian is $31,414 - $57,103. Two-thirds of those

expenditures are for teenagers.(Pressley, Trieu, Kendig, & Barlow, 2007)


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Map: Aggravated Assault Arrests & Alcohol Outlets

Our Maps Indicate An apparent modest correlation between arrests for

aggravated assault and alcohol outlets.

Why It Matters Approximately 50% of those committing violent

crimes consumed alcohol prior to the act. About 40%

of state prisoners report being under the influence of

alcohol at the time of the crime.(Martin, 2001)

Average cost per case for a non-fatal assault is $23,353

in medical costs and $57,209 in lost productivity.(Corso, Mercy, Simon, Finkelstein, & Miller, 2007)


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Map: Domestic Calls for Service & Off-Premise Alcohol Outlets

Our Maps Indicate Little apparent relationship between domestic calls for

service and off-premise alcohol outlets.

Why It Matters 51% of victims of intimate partner violence (IPV)

perceived their attacker to be using alcohol.(Greenfeld & Henneberg, 2001)

Total mean medical and mental health care cost per IPV

victimization is $816, with additional costs in lost

productivity.(National Center for Injury Prevention and Control, 2003)

Other Risk Factors Poverty and associated stress (Jewkes, 2002)

Illicit drug use (Coker, Smith, McKeown, & King, 2000)


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Map: TANF Substance Abuse Screening & Alcohol Outlets

Our Maps Indicate Ambiguous relationship between alcohol outlet placement

and positive TANF substance abuse screens. (Note:

screening statistics did not separate alcohol from illicit drugs.)

Why It Matters

One study found that 9% of welfare recipients were alcohol-

dependent, compared to 5% of nonrecipient single mothers.(Jayakody, Danziger, & Pollack, 2000)

A 2004 study suggested that a need for substance abuseservices was correlated with going on and off welfare more

than once, leaving welfare for negative reasons, failing to find

employment, and a low trajectory of earned income.

Furthermore, alcohol dependence was negatively related to

working >32 hours per week.(Chandler, Meisel, Jordan, Rienzi, & Goodwin, 2004, p. 628)

syracuse alcohol environment project - report

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