Impact on alcohol-related mortality of a rapid rise in the density of private liquor outlets in British Columbia: A local area multi-level analysis

Abstract

Aims: To study relationships between rates of alcohol-related deaths and (i) the density of liquor outlets and (ii) the proportion of liquor stores owned privately in British Columbia (BC) during a period of rapid increase in private stores. Design: Multi-level regression analyses assessed the relationship between population rates of private liquor stores and alcohol-related mortality after adjusting for potential confounding. Setting: The 89 local health areas of BC, Canada across a 6-year period from 2003 to 2008, for a longitudinal sample with n=534. Measurements: Population rates of liquor store density, alcohol-related death and socio-economic variables obtained from government sources. Findings: The total number of liquor stores per 1000 residents was associated significantly and positively with population rates of alcohol-related death (< 0.01). A conservative estimate is that rates of alcohol-related death increased by 3.25% for each 20% increase in private store density. The percentage of liquor stores in private ownership was also associated independently with local rates of alcohol-related death after controlling for overall liquor store density (< 0.05). Alternative models confirmed significant relationships between changes in private store density and mortality over time. Conclusions: The rapidly rising densities of private liquor stores in British Columbia from 2003 to 2008 was associated with a significant local-area increase in rates of alcohol-related death.