title: Does alcohol outlet density differ by area-level disadvantage in metropolitan Perth?
abstract: Research suggests that there are area-level disparities in alcohol outlets, with greater density in disadvantaged areas. In part, this might be explained by the inequitable distribution of retail, attracted by lower rents to disadvantaged neighbourhoods. This ecological study examines the distribution of liquor licences in Perth, Australia, and whether discrepancies in the distribution of retail land-uses could account for a socio-economic gradient.
  
  
  
  Area disadvantage was determined for each Statistical Area 1 (SA1) using the Australian Bureau of Statistics Index of Relative Socio-economic Disadvantage, and licence locations were mapped in GIS. Negative binomial loglinear models examined whether licence densities within SA1s differed by area disadvantage, controlling for demographics and spatial correlation. Models included an offset term, so the estimated effects of area-level disadvantage were on licences per km2, or licences per retail destination.
  
  
  
  In the area-based analyses, for every unit increase in disadvantage decile (i.e. a reduction in relative disadvantage), general licences reduced by 15% (P = 0.000) and liquor stores reduced by 7% (P = 0.004). These gradients were not apparent when licences were examined as a function of retail; however, for every unit increase in disadvantage decile, the density of on-premise licences per retail destination increased by 14% (P = 0.000).
  
  
  
  The direction of the socio-economic gradient for general licences and liquor stores in Perth is concerning, as all licences selling packaged alcohol were more abundant in disadvantaged areas. However, the over-representation of packaged liquor in disadvantaged areas may relate to the increased provision of retail.
authors.affiliation: Centre for the Built Environment and Health, School of Sport Science, Exercise & Health and School of Earth and Environment, The University of Western Australia, Perth, Australia.
authors.forename: Sarah
authors.identifier: 0000-0002-8624-4908
authors.initials: S
authors.lastname: Foster
authors.affiliation: Centre for the Built Environment and Health, School of Sport Science, Exercise & Health and School of Earth and Environment, The University of Western Australia, Perth, Australia.
authors.forename: Paula
authors.initials: P
authors.lastname: Hooper
authors.affiliation: School of Population Health, The University of Western Australia, Perth, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Knuiman
authors.affiliation: Centre for the Built Environment and Health, School of Sport Science, Exercise & Health and School of Earth and Environment, The University of Western Australia, Perth, Australia.|School of Population Health, The University of Western Australia, Perth, Australia.|Telethon Kids Institute, Perth, Australia.
authors.forename: Georgina
authors.initials: G
authors.lastname: Trapp
authors.affiliation: School of Population Health, The University of Western Australia, Perth, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wood
mesh_terms: D000434:Alcoholic Beverages / Q000191:economics*; D003132:Commerce / Q000706:statistics & numerical data*; D006801:Humans; D008004:Licensure / Q000706:statistics & numerical data; D016014:Linear Models; D012959:Socioeconomic Factors; D035862:Vulnerable Populations / Q000706:statistics & numerical data*; D014904:Western Australia
keywords: Australia; alcoholic beverages; geographic information systems; licensure; vulnerable populations