title: Alcohol-selling outlets and mortality in Switzerland--the Swiss National Cohort.
abstract: OBJECTIVE
  To examine the association of alcohol-related mortality and other causes of death with neighbourhood density of alcohol-selling outlets for on-site consumption.
  
  
  METHODS
  Longitudinal study of the adult Swiss population (n = 4 376 873) based on census records linked to mortality data from 2001 to 2008.
  
  
  METHODS
  Sex-specific hazard ratios (HR) for death and 95% confidence intervals (95%CI) were calculated using Cox models adjusting for age, educational level, occupational attainment, marital status and other potential confounders. The density of alcohol-selling outlets within 1000 m of the residence was calculated using geocodes of outlets and residences.
  
  
  RESULTS
  Compared with >17 outlets within 1000 m the HR for alcohol-related mortality in men was 0.95 (95%CI: 0.89-1.02) for 8-17 outlets, 0.84 (95%CI: 0.77-0.90) for 3-7 outlets, 0.76 (95%CI: 0.68-0.83) for 1-2 outlets and 0.60 (95%CI: 0.51-0.72) for 0 outlets. The gradient in women was somewhat steeper, with a HR comparing 0 with >17 outlets of 0.39 (95%CI: 0.26-0.60). Mortality from mental and behavioural causes and lung cancer were also associated with density of alcohol-selling outlets: HRs comparing 0 outlets with >17 outlets were 0.64 (95%CI: 0.52-0.79) and 0.79 (95%CI: 0.72-0.88), respectively, in men and 0.46 (95%CI: 0.27-0.78) and 0.63 (95%CI: 0.52-0.77), respectively, in women. There were weak associations in the same direction with all-cause mortality in men but not in women.
  
  
  CONCLUSIONS
  In Switzerland, alcohol-related mortality is associated with the density of outlets around the place of residence. Community-level interventions to reduce alcohol outlet density may usefully complement existing interventions.
authors.affiliation: Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Spoerri
authors.forename: Marcel
authors.initials: M
authors.lastname: Zwahlen
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Panczak
authors.forename: Matthias
authors.initials: M
authors.lastname: Egger
authors.forename: Anke
authors.initials: A
authors.lastname: Huss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000191:economics / Q000401:mortality*; D003132:Commerce; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011633:Public Facilities / Q000706:statistics & numerical data; D012147:Restaurants / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013557:Switzerland / Q000453:epidemiology
keywords: Alcohol-related mortality; Switzerland; cohort studies; density of alcohol outlets