Pamela J Trangenstein1,2, Raimee H Eck3, Yi Lu2, Daniel Webster4, Jacky M Jennings5, Carl Latkin6, Adam J Milam7, Debra Furr-Holden8, David H Jernigan2. 1. Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 2. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts. 3. National Cancer Institute, Bethesda, Maryland. 4. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 5. Johns Hopkins Bloomberg School of Medicine, Baltimore, Maryland. 6. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 7. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 8. Michigan State University College of Human Medicine, Flint, Michigan.
Abstract
OBJECTIVE: There are few cost-effectiveness analyses that model alcohol outlet zoning policies. This study determines the potential decreases in homicides, disability-adjusted life years (DALYs), and victim and criminal justice costs associated with four policy options that would reduce the alcohol outlet access in Baltimore. METHOD: This cost-effectiveness analysis used associations between on-premise (incidence rate ratio [IRR] = 1.41), off-premise (IRR = 1.76), and combined on- and off-premise outlet density (IRR = 1.07) and homicide in Baltimore. We determined the potential change in the level of homicide that could occur with changes in the density of alcohol outlets, assuming that 50% of the association was causal. RESULTS: Reducing alcohol outlet density in Baltimore City by one quintile was associated with decreases of 51 homicides per year, $63.7 million, and 764 DALYs. Removing liquor stores in residential zones was associated with 22 fewer homicides, which would cost $27.5 million and lead to 391 DALYs. Removing bars/taverns operating as liquor stores was associated with a decrease of one homicide, $1.2 million, and 17 DALYs. Removing both the liquor stores in residential zones and the bars/taverns operating as liquor stores was associated with 23 fewer homicides, which translated to $28.7 million and 409 DALYs. CONCLUSIONS: For preventing homicides, the strategy of removing liquor stores in residential zones was preferred because it was associated with substantial reductions in homicides without closing unacceptably high numbers of outlets. It is possible that policies that close the bars/taverns operating as liquor stores would be associated with decreases in other types of violent crime.
OBJECTIVE: There are few cost-effectiveness analyses that model alcohol outlet zoning policies. This study determines the potential decreases in homicides, disability-adjusted life years (DALYs), and victim and criminal justice costs associated with four policy options that would reduce the alcohol outlet access in Baltimore. METHOD: This cost-effectiveness analysis used associations between on-premise (incidence rate ratio [IRR] = 1.41), off-premise (IRR = 1.76), and combined on- and off-premise outlet density (IRR = 1.07) and homicide in Baltimore. We determined the potential change in the level of homicide that could occur with changes in the density of alcohol outlets, assuming that 50% of the association was causal. RESULTS: Reducing alcohol outlet density in Baltimore City by one quintile was associated with decreases of 51 homicides per year, $63.7 million, and 764 DALYs. Removing liquor stores in residential zones was associated with 22 fewer homicides, which would cost $27.5 million and lead to 391 DALYs. Removing bars/taverns operating as liquor stores was associated with a decrease of one homicide, $1.2 million, and 17 DALYs. Removing both the liquor stores in residential zones and the bars/taverns operating as liquor stores was associated with 23 fewer homicides, which translated to $28.7 million and 409 DALYs. CONCLUSIONS: For preventing homicides, the strategy of removing liquor stores in residential zones was preferred because it was associated with substantial reductions in homicides without closing unacceptably high numbers of outlets. It is possible that policies that close the bars/taverns operating as liquor stores would be associated with decreases in other types of violent crime.
Authors: Robert A Hahn; Jennifer Cook Middleton; Randy Elder; Robert Brewer; Jonathan Fielding; Timothy S Naimi; Traci L Toomey; Sajal Chattopadhyay; Briana Lawrence; Carla Alexia Campbell Journal: Am J Prev Med Date: 2012-04 Impact factor: 5.043
Authors: Adam J Milam; C Debra M Furr-Holden; Paul Harrell; Nicholas Ialongo; Philip J Leaf Journal: Subst Use Misuse Date: 2013-08-02 Impact factor: 2.164
Authors: Charles C Branas; Michael R Elliott; Therese S Richmond; Dennis P Culhane; Douglas J Wiebe Journal: Alcohol Clin Exp Res Date: 2009-03-11 Impact factor: 3.455
Authors: Traci L Toomey; Darin J Erickson; Bradley P Carlin; Kathleen M Lenk; Harrison S Quick; Alexis M Jones; Eileen M Harwood Journal: Alcohol Clin Exp Res Date: 2012-05-15 Impact factor: 3.455