Maheswaran, Ravi, Green, Mark A 
ORCID: 0000-0002-0942-6628, Strong, Mark, Brindley, Paul, Angus, Colin and Holmes, John
(2018)
Alcohol outlet density and alcohol related hospital admissions in England: a national small-area level ecological study
ADDICTION, 113 (11).
pp. 2051-2059.
ISSN 0965-2140, 1360-0443
Abstract
Background and aims: Excessive alcohol consumption has a substantial impact on public health services. A key element determining alcohol availability is alcohol outlet density. This study investigated the relationship between on-trade and off-trade outlets and hospital admission rates in local neighbourhoods. Design: National small-area level ecological study. Setting and participants: All 32 482 lower layer super output census areas (LSOAs) in England (42 227 108 million people aged 15+ years). Densities for six outlet categories (outlets within a 1-km radius of residential postcode centroids, averaged for all postcodes within each LSOA) were calculated. Measurements: Main outcome measures were admissions due to acute or chronic conditions wholly or partially attributable to alcohol consumption from 2002/03 to 2013/14. Findings: There were 1 007 137 admissions wholly, and 2 153 874 admissions partially, attributable to alcohol over 12 years. After adjustment for confounding, higher densities of on-trade outlets (pubs, bars and nightclubs; restaurants licensed to sell alcohol; other on-trade outlets) and convenience stores were associated with higher admission rate ratios for acute and chronic wholly attributable conditions. For acute wholly attributable conditions, admission rate ratios were 13% (95% confidence interval = 11–15%), 9% (7–10%), 12% (10–14%) and 10% (9–12%) higher, respectively, in the highest relative to the lowest density categories by quartile. For chronic wholly attributable conditions, rate ratios were 22% (21–24%), 9% (7–11%), 19% (17–21%) and 7% (6–9%) higher, respectively. Supermarket density was associated with modestly higher acute and chronic admissions but other off-trade outlet density was associated only with higher admissions for chronic wholly attributable conditions. For partially attributable conditions, there were no strong patterns of association with outlet densities. Conclusions: In England, higher densities of several categories of alcohol outlets appear to be associated with higher hospital admission rates for conditions wholly attributable to alcohol consumption.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Admissions, alcohol, density, England, hospital, outlets |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 23 Aug 2018 09:54 |
| Last Modified: | 16 Jun 2026 15:54 |
| DOI: | 10.1111/add.14285 |
| Open Access URL: | https://doi.org/10.1111/add.14285 |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3021908 |
| Disclaimer: | The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate. |
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