Change in alcohol outlet density and alcohol-related harm to population health

Lead investigator
Professor David Fone, Cardiff University

Excess alcohol consumption has serious adverse effects on health and violence-related harm. In the UK, around 37% of men and 29% of women drink to excess, and 20% and 13% repectively report binge drinking. The potential impact on population health from a reduction in consumption is considerable.

One proposed method to reduce consumption is to reduce availability through controls on alcohol outlet density.

Aims & objectives
Develop a new method of measuring alcohol outlet density using Geographical Information Systems, which include a more realistic and robust measure of population accessibility to alcohol outlets than previously published methods. Investigate the impact of a change in the density of alcohol outlets on alcohol consumption and alcohol-related harms to health in the community.
Study design

Natural experiment investigating the effect of change in outlet density between 2005 and 2009 in Wales.

Data on outlets are held by the 22 local authorities in Wales under The Licensing Act 2003. Study outcomes are change in:

  • Alcohol consumption, using data from annual Welsh Health Surveys;
  • Alcohol-related hospital admissions, using the Patient Episode Database for Wales;
  • Accident & Emergency (A&E) department attendances between midnight and 6am;
  • Alcohol-related violent crime against the person, using police data.

Data will be anonymously record-linked using the Secure Anonymised Information Linkage databank, at individual- and 2001 Census Lower Super Output Area-level. New methods of network analysis will be used to estimate outlet density.

Longitudinal statistical analysis will use:

  • Multilevel ordinal models of consumption, and logistic models of hospital admissions and A&E attendance as a function of change in individual outlet exposure (adjusting for confounding variables);
  • Spatial models of the change in counts/rates of each outcome measure and outlet density. We will assess the impact on health inequalities and will correct for population migration.
Further information & publications
Start date
July 2011
End date
March 2013