PRC Resources

Alcohol Outlet Control

The Role of Outlet Location and Density in Alcohol Problems: What Communities Can Do

Recent research carried out by the Prevention Research Center and other research groups shows that in neighborhoods where there are many bars, restaurants, and stores that sell alcohol, a host of alcohol-related problems are more frequent. These problems include:

This paper will answer questions about how alcohol outlet density is related to these problems and how communities can take action to control outlet location and density.

Why is outlet density important?

The strong connection between alcohol use and health and social problems has been clear for a long time - but now we know that this connection in part relates to the locations of places that sell alcohol. This is a very important finding because state and local governments control licenses to sell alcohol. Controlling where alcohol can be sold is an important tool in preventing the kinds of problems that are related to alcohol. Governments can make rules that set minimum distances between alcohol outlets; they can limit new licenses for areas that already have outlets too close together; they can stop issuing licenses when a particular location goes out of business; and they can permanently close outlets that repeatedly violate liquor laws.

What do we mean by outlet density and location?

Typically, alcohol is sold in specific types of outlets. These include places where alcohol is intended to be drunk on-site, such as bars, taverns, and restaurants that serve alcohol. It also includes places that sell bottles or cans of alcoholic beverages to be taken away and drunk elsewhere, such as liquor, convenience, and grocery stores. These outlets are usually not distributed evenly throughout a community. Sometimes they are concentrated in areas where people go for entertainment and nightlife. Often, they are concentrated near college campuses. Most often there are high concentrations of outlets in low income and minority neighborhoods. Each of these areas has different characteristics and draws different types of clientele. But they all have one thing in common: an increased level of alcohol related problems.

How is alcohol outlet density related to underage drinking?

How much any individual person drinks is related in part to how much alcohol costs - both in money and convenience. When alcohol is plentiful and inexpensive, many people drink more. This is true of underage drinkers as well as adult drinkers. Because the purchase of alcohol is illegal for young people under 21, easy access to several outlets in a small area makes it easy to find the one outlet that will sell to underage drinkers. In this way, high concentrations of outlets can increase underage use.

A number of studies have found that outlet density is related to underage drinking and problems. One study found that when all other factors were controlled, higher initial levels of drinking and excessive drinking were observed among youths who live in zip codes with higher alcohol outlet densities. Therefore, alcohol outlet density may play a significant role in how underage drinking starts during early teenage years, especially when teens have limited mobility. In another study, on- and off-license outlet density was found to be positively related to frequency of underage driving after drinking and riding with drinking drivers among 16 to 20-year-old youth.

Neighborhoods that have many outlets close together also convey the message that drinking - and even heavy drinking - is normal and expected. A study of the density of drinking establishments near college campuses found that more drinking took place among students on campuses with more outlets in the surrounding areas. Outlet density also was related to sexual violence among students.

In another study, greater numbers of off-premise outlets such as liquor stores or grocery and convenience stores that sell alcohol were associated with greater injuries from accidents, assaults, and traffic crashes for both underage and of-age young adults. The findings confirm prior studies showing that underage drinking is related to the number of off-premise establishments like liquor and grocery stores. The strong association between an increasing density of off-premise outlets and higher rates of injuries among both underage youth and young adults may be related to the way that being in a neighborhood with high concentrations of these types of outlets reinforces drinking, and in particular, heavy and high-risk drinking.

For more information on alcohol policy and its relationship to underage drinking, click here.

How is alcohol outlet density related to drinking and driving?

There is strong research evidence that density of alcohol outlets is related to alcohol-related motor vehicle crashes. Studies consistently find significant correlations between how easy access to alcohol and the occurrence of traffic crashes, even when may of the other features of the local environment are taken into account. Studies also show a similar correlation with pedestrian injury collisions. Most recently, these relationships have been examined over time within specific zip codes, showing that changes in numbers of bars and off-premise establishments over time are related to changes in rates of alcohol-related crashes.

The simplest explanation for these relationships is that the costs of alcohol to consumers include not only its retail price but also convenience costs that occur when alcohol is purchased (for example, the time it takes to travel to an outlet). On the other hand, when drinkers don't have to drive far to get to an outlet, that may reduce their risk of having a crash. Both of these effects are possible and, in fact, when studied in communities, reduced exposure to driving risks is overwhelmed by greater frequencies of drinking when alcohol is widely available. Therefore, the greater numbers of traffic crashes and pedestrian motor vehicle injuries in neighborhoods with greater numbers of alcohol establishment appears to be due to greater drinking in these areas.

The density of alcohol outlets - especially on-premise outlets such as bars and restaurants - may also increase drinking and driving in other ways. For example, if drivers drink in a place (such as a bar) where heavy drinking is acceptable and even encouraged, they are more likely to drink enough to become impaired - and to drive. This is particularly true in drinking locations where there are strong social relationships among drinkers - for example a bar where people know each other or interact with each other and can therefore influence each other.

Research is ongoing to show whether, when drinkers have many different drinking locations to choose from, they are more likely to find locations that match their personal preferences. This can create more opportunities for heavy drinkers to drink among other heavy drinkers, encouraging more alcohol consumption, more drinking away from home - and driving after drinking. This could be one mechanism by which a higher number of conveniently located alcohol outlets leads to more impaired driving.

For more information how alcohol policy is related to drinking and driving, click here.

How is alcohol outlet density related to violence?

The strong connection between alcohol and violence has been clear for a long time - but now we know that this connection doesn't just relate to drinking by victims or perpetrators; it also relates to the location of places that sell alcohol. Controlling where and how alcohol is sold can be an important tool in fighting crime.

A number of studies have found that in and near neighborhoods where there is a high density of places that sell alcohol, more assaults and other violent crimes occur. This association is strong even when other neighborhood characteristics such as poverty and age of residents were taken into account. Research has also shown that an increase in the number of bars and off-premise outlets over time was related to an increase in the rate of violence. These effects were largest in poor, minority areas of the state: those areas already saturated with the greatest numbers of outlets. Even when levels of poverty and the age and the ethnic background of residents are taken into account, however, a high density of outlets is strongly related to violence.

All of the characteristics of alcohol outlet location can be important. It is easy to see that a town with many bars, restaurants, and stores that sell alcohol could be different from one that has fewer outlets. It is also easy to see that a neighborhood that has a bar on each corner and a liquor store on each block has a completely different environment than one that has few outlets or none at all. Other characteristics of the environment make a difference, of course. For example, a strip of bars near a college campus presents a different environment than a similar density of bars in an upscale city center and also different than a similar density in a poor neighborhood. But in each case, some form of increased violence would be expected as compared to similar areas with fewer alcohol outlets.

The research that has been done so far cannot fully explain why having more outlets in a small area seems to result in more violence. Various explanations have been proposed. One is that alcohol outlets can be a source of social disorder. A liquor store parking lot full of people drinking in their cars or on the curb or broken bottles littering the area outside a bar may send a message that this is a neighborhood in which normal rules about orderly behavior are not enforced. Another possible explanation is that a neighborhood with a large number of outlets acts as a magnet for people who are more inclined to be violent or more vulnerable to being assaulted. It is also possible that a high number of outlets results in a large number of people under the influence of alcohol - which makes people both more likely to be violent and less able to defend themselves. It is probable that all of these factors come into play.

For more information about alcohol policy and violence, click here.

How is alcohol outlet density related to domestic violence?

The presence of a high density of alcohol outlets in a neighborhood affects both child abuse and neglect and violence between intimate partners (such as husbands and wives).

Child abuse and neglect
Regarding child abuse and neglect, alcohol use by parents appears to play a key role in child maltreatment. But even when parents do not drink heavily, alcohol availability in the neighborhood may contribute to child maltreatment. Previous research has shown that families that live in neighborhoods that have many liquor stores or bars or other alcohol outlets close together are more likely to have problems with child abuse and neglect.

A high number of alcohol outlets can make it more likely that parents will drink more heavily. In addition, having many alcohol outlets in a particular area can lead to neighborhoods that are more disorganized and in which it becomes more difficult to raise a family. A higher density of alcohol outlets is related to more crime and more strangers coming into a neighborhood. This may make it more difficult for families to have close relationships with neighbors and to rely on friends and neighbors for social support that can help in raising children.

For more information about alcohol policy and child abuse and neglect, click here.

Intimate partner violence
Heavy drinking has been linked with increased risk of intimate partner violence, that is, physical or emotional violence between spouses or other people in intimate relationships. Of course, alcohol is neither a necessary nor sufficient cause of violence. Violence can and does occur in the absence of drinking or alcohol problems and not everyone who drinks also engages in violence.

While the characteristics of the individuals involved in partner violence have been studied in the past, there is a growing body of research that indicates that the type of neighborhood people live in affects intimate partner violence. Couples who live in impoverished neighborhoods are more likely to engage in violence against each other.
It is well known that there tend to be more places that sell alcohol closer together in impoverished and socially disorganized neighborhoods than in more stable and affluent neighborhoods. Especially for couples in socially disorganized neighborhoods, it is possible that greater alcohol availability provided by bars and off-premise packaged goods stores will result in heavier drinking on the part of one or both members of the couple, and thereafter increased the risk of violence towards their partners.

Greater alcohol outlet density, especially in disorganized neighborhoods, may contribute to increased violence towards partners in other ways - even if the members of the couple themselves are not drinking. For example, alcohol outlets are often surrounded by signs of physical disorder, such as empty or broken bottles, loiterers, and publicly intoxicated patrons. Together with other disorganized neighborhood conditions, the presence of alcohol outlets may indicate that the usual social rules are not enforced. Under such conditions, residents may be less likely to become involved if they witness or hear a couple involved in violent behavior. Lack of informal social control may also lead residents of disorganized neighborhoods to be less concerned about social consequences of engaging in violence against their partners.

Living in a disorganized neighborhood may also raise the level of stress experienced by individuals and families (for example, from crime, abandoned buildings, poverty, and unemployment). This exposure may directly or indirectly lead to heavier drinking.

For more information about alcohol policy and intimate partner violence, click here.

How do governments regulate outlet density?

Given the serious problems that alcohol outlet density can contribute to, state regulatory agencies, local planning agencies, and concerned citizens should consider controlling alcohol outlets as an important strategy for creating safer and healthier communities. States and communities can regulate the number of bars, restaurants, and stores that sell alcohol in a given area in a variety of ways. In some jurisdictions, the number of alcohol outlets is limited based on the population of the area - only so many outlets per thousand residents, for example. In other cases, the location of the outlets is regulated - for example, some states or communities set minimum distances from schools or churches. Research increasingly finds, however, that geographic density is a key aspect of outlet location - that is, the distance between outlets. Where over-concentrations of outlets occur, greater problems arise.

Governments can use their regulatory powers to reduce alcohol problems related to outlet density by:

  • Making rules that set minimum distances between alcohol outlets;
  • Limiting new licenses for areas that already have outlets too close together;
  • Not issuing a new license when a particular location goes out of business;
  • Permanently closing outlets that repeatedly violate liquor laws (such as by selling alcohol to minors or to intoxicated persons or allowing illicit drug sales or prostitution on the premises).

What implications do these findings have for state and local licensing policies?

There are still some unanswered questions about outlet density and the occurrence of alcohol related problems such as violence. The research strongly suggests, however, that limits on outlet density may be an effective means of reducing a variety of alcohol problems, such as those discussed above. States and communities can use controls on the number and location of places that sell alcohol as a tool for reducing alcohol problems and for creating a safer and healthier alcohol environment.

What other alcohol policies important?

Alcohol is a legal and widely consumed commodity; but it is also a commodity that can create a variety of serious health and social problems. Alcohol policies are an important tool for preventing these problems. Every day, states and communities make decisions about the sale of alcohol: who can sell it, when and where it can be sold, who it can be sold to. State and local laws and policies control many aspects of the system by which alcohol is manufactured, marketed, sold, purchased, and consumed. Each element of the regulatory system provides opportunities for creating a healthier social environment with respect to alcohol. For example, regulations can prevent unsafe sales practices - such as all-you-can-drink specials that encourage intoxication. Regulations can control advertising and promotion that appeals to minors or establish the minimum age and training qualifications for people who sell and serve alcohol. Each type of regulation has the potential to ensure that alcohol is consumed in a safe and healthy manner.

For more information about ongoing projects at the Prevention Research Center to study the role of alcohol outlet density in alcohol problems, click here.


Chen, M. , Grube, J. , Gruenewald, P. , Community alcohol outlet density and underage drinking, Addiction, 105, 270-278, 2010.8

Treno, A. J. , J. W. Grube, and S. Martin. Alcohol Outlet Density as a Predictor of Youth Drinking and Driving: A Hierarchical Analysis. Alcoholism: Clinical and Experimental Research, Vol. 27, 2003, pp. 835-840.

Scribner RA, Mason KE, Simonsen NR, Theall K, Chotalia J, Johnson S, Schneider SK, DeJong W. . An ecological analysis of alcohol-outlet density and campus-reported violence at 32 U.S. colleges.
J Stud Alcohol Drugs 2010; 71(2): 184-91.

Gruenewald, P. , Freisther, B. , Remer, L. , LaScala, E. , Treno, A. , and Ponicki, W. "Ecological Associations of Alcohol Outlets with Underage and Young Adult Injuries," Alcoholism: Clinical & Experimental Research , March 2010.

Gruenewald, P. , Limits on Outlet Density and Location: Effects on Traffic Safety, in Stewart, K. , (ed. ) Traffic Safety and Alcohol Regulation, Transportation Research Circular E-C123, ISSN 0097-8515, pp 109-119.

LaScala, E. A. , Gerber, E. , & Gruenewald, P. J. (2000). Demographic and environmental correlates of pedestrian injury collisions: a spatial analysis. Accident Analysis and Prevention, 32, 651-658.

Treno, A.J. , Johnson, F. , et al (2006a) The impact of outlet densities on alcohol-related crashes. In press , Acc. Anal. & Prev. .

Gruenewald, P.J. , Millar, A. , Ponicki, W.R. and Brinkley, G. (2000a) Physical and economic access to alcohol. R. Wilson and M. DuFour (Eds. ) NIAAA Research Monograph, Small Area Analysis. 163-212.

Ahlin, E.M. , Rauch, P.L. , et al. , (2002) Social bonds as predictors of recidivism. In D.R. Mayhew and C. Dussault (Eds. ), Procs. of the 16th Intl. Conf. on Alc. , Drugs, and Traffic Safety, 177-184. Montreal, Canada.

Gorman. D. , Speer. P. , Gruenewald, P. , and Labouvie, E. (2001) Journal of Studies on Alcohol, 62: 628-636.

Gruenewald, P.J. and Remer, L. Changes in outlet densities affect violence rates. In review, Alcoholism: Clinical and Experimental Research, 2004.

Gorman, et al. (2001).

Sun, A. , Shillington, A.M. Hohman, M. , Jones, L. (2001) Caregiver AOD use, case substantiation, & AOD treatment: Studies based on two southwestern counties. Child Welfare, 80, 151-177. Kelleher, K. , Chaffin, M. , Holleberg, J. , & Fischer, E. (1994) Alcohol & drug disorders among physically abusive & neglectful parents in a community-based sample. American Jrnl of Public Health, 84, 1586-1590.

Freisthler, B. (2004) A spatial analysis of social disorganization, alcohol access, & rates of child maltreatment in neighborhoods. Children & Youth Services Review, 26(9), 307-319. Freisthler, B. , Needell, B. , & Gruenewald, P.J. (2005) Is alcohol & drug availability related to neighborhood rates of child maltreatment? Child Abuse & Neglect, 29(9), 1049-1060.

Leonard, K. , Alcohol and intimate partner violence: When can we say that heavy drinking is a contributing cause of violence? Addiction, 2005, 100, 422-425.

LaVeist,, T. & Wallace J. , Health risk and equitable distribution of liquor stores in African American neighborhood, Soc. Sci. Med. , 2000: 51, 613-617.

Gorman. D. , Speer. P. , Gruenewald, P. , and Labouvie, E. (2001) Journal of Studies on Alcohol, 62: 628-636.

Van Wyk, J. , Benson, M. , Fox, G. , Demaris, A. , Detangeling individual-, partner-, and community-level correlates of partner violence, Crime Delinquency 49: 412-438,  2003

Hill, T. and Angel, R. "Neighborhood Disorder, Psychological Distress, and Heavy Drinking. "
Social Science & Medicine 61:965-975.