title: Alcohol outlets, gonorrhea, and the Los Angeles civil unrest: a longitudinal analysis.
abstract: This study tests the effect of neighborhood changes on gonorrhea rates. Prior studies that indicate gonorrhea rates are associated with alcohol outlet density and neighborhood deterioration have been cross-sectional and cannot establish causality. After the 1992 Civil Unrest in Los Angeles, 270 alcohol outlets surrendered their licenses due to arson and vandalism thus providing a natural experiment. We geocoded all reported gonorrhea cases from 1988 to 1996 in LA County, all annually licensed alcohol outlets, and all properties damaged as a result of the civil unrest. We ran individual growth models to examine the independent effects of changes in alcohol outlets and damaged buildings on gonorrhea. The individual growth model explained over 90% of the residual variance in census tract gonorrhea rates. After the civil unrest, a unit decrease in the number of alcohol outlets per mile of roadway was associated with 21 fewer gonorrhea cases per 100,000 (p<.01) in tracts affected by the Unrest compared to those not affected. Neighborhood alcohol outlets appear to be significantly associated with changes in gonorrhea rates. The findings suggest that efforts to control sexually transmitted diseases, including gonorrhea and HIV, should address contextual factors that facilitate high-risk behaviors and disease transmission.
authors.affiliation: RAND Corp., 1776 Main Street, Santa Monica, CA 90407, USA. dcohen@rand.org
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Cohen
authors.forename: Bonnie
authors.initials: B
authors.lastname: Ghosh-Dastidar
authors.forename: Richard
authors.initials: R
authors.lastname: Scribner
authors.forename: Angela
authors.initials: A
authors.lastname: Miu
authors.forename: Molly
authors.initials: M
authors.lastname: Scott
authors.forename: Paul
authors.initials: P
authors.lastname: Robinson
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Farley
authors.forename: Ricky N
authors.initials: RN
authors.lastname: Bluthenthal
authors.forename: Didra
authors.initials: D
authors.lastname: Brown-Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000428:Alcohol Drinking; D000434:Alcoholic Beverages / Q000600:supply & distribution*; D001213:Asian / Q000706:statistics & numerical data; D019352:Censuses; D003132:Commerce / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D003256:Community Participation; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D005260:Female; D005391:Firesetting Behavior; D019649:Food Industry / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006069:Gonorrhea / Q000453:epidemiology* / Q000208:ethnology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008004:Licensure; D008137:Longitudinal Studies; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D012111:Residence Characteristics / Q000145:classification*; D012305:Riots; D012931:Social Environment; D014505:Urban Population