Here’s another troubling development in the drive to erase alcohol from society. A study to be published next March in Alcoholism: Clinical and Experimental Research was featured in Science Daily last week based on an early view of the study online. (Thanks to Bulletin reader Pete M. for sending this to me.) That account was titled Alcohol Outlets Lead to Specific Problems Among Youth and Young Adults suggesting the issue is settled but the study’s title is a more vague: Ecological Associations of Alcohol Outlets With Underage and Young Adult Injuries. The Science Daily account is based on the study, but being unwilling to shell out the necessary doubloons for a subscription so I can read the whole thing means only the abstract is available to me, and it’s one of the least useful ones I’ve ever read, having almost no real information about the study at all. Here it is in its entirety.

Objective: This paper argues that associations between rates of 3 specific problems related to alcohol (i.e., accidents, traffic crashes, and assaults) should be differentially related to densities of alcohol outlets among underage youth and young adults based upon age-related patterns of alcohol outlet use.

Methods: Zip code-level population models assessed local and distal effects of alcohol outlets upon rates of hospital discharges for these outcomes.

Results: Densities of off-premise alcohol outlets were significantly related to injuries from accidents, assaults, and traffic crashes for both underage youth and young adults. Densities of bars were associated with more assaults and densities of restaurants were associated with more traffic crash injuries for young adults.

Conclusions: The distribution of alcohol-related injuries relative to alcohol outlets reflect patterns of alcohol outlet use.

From Science Daily’s account:

“Over the past four decades, public health researchers have come to recognize that although most drinkers safely purchase and enjoy alcohol from alcohol outlets, these places are also associated with serious alcohol-related problems among young people and adults,” said Paul J. Gruenewald, senior research scientist at the Prevention Research Center and corresponding author for the study.

“In the early studies, researchers believed associations were due to increased alcohol consumption related to higher alcohol outlet densities,” added Richard Scribner, D’Angelo Professor of Alcohol Research at the LSU School of Public Health. “However, as the research area has matured, the relations appear to be far more complex. It seems that alcohol outlets represent an important social institution within a neighborhood. As a result, their effects are not limited to merely the consequences of the sale of alcohol.”

So while admitting the problem is very complex, they nonetheless go on to leap to some pretty simple conclusions, that don’t seem at all supported by the evidence. At a minimum, their conclusions are only one of many possible reasons for the results their data seems to show, but which in no way leads to one inescapable conclusion, as they seem to think.

As my Bulletin reader Pete succinctly puts it:

It strikes me as another example of a giant leap of logic between an observed correlation and implied causation. There’s a link between, on the one hand, the residential ZIP Codes of patients of certain ages discharged from hospital for certain injuries, and on the other, the number of bars, restaurants, and liquor stores in those same ZIP Codes. Interesting, perhaps, but the real question is why?

Exactly. Why indeed?

But the truly scary bit is in their half-baked conclusions.

The key message, said both Gruenewald and Scribner, is that a neighborhood’s alcohol environment plays a role in regulating the risks that youth and young adults will be exposed to as they mature.

“From a prevention perspective, this represents an important refocusing of priorities, away from targeting the individual to targeting the community,” said Scribner. “This is hopeful because a community-based approach that addresses the over concentration of alcohol outlets in a neighborhood where youth injuries are a problem is relatively easy compared with interventions targeting each youth individually.”

So liquor stores are already subject to strict zoning in many places, will this be used to further isolate them next to the adult bookstores at the edge of towns? Won’t that just increase drunk driving?

Again, I turn to Pete’s assessment.

With no other supporting evidence, the study’s authors appear to suggest that more of these “alcohol outlets” in your neighborhood lead to more assaults, accidents, etc. They make this assertion despite the fact that the hospital data they used doesn’t say whether or not alcohol was even involved in those cases. Moreover, the ZIP Code of one’s residence is often not the ZIP Code where one purchases and consumes their alcohol; where we live and where we drink are not the same, particularly at the spatial resolution of ZIP Codes.

If they really want to explain the empirical patterns they found, I suggest the researchers look at other factors that might correlate with the geography of alcohol outlets. Check zoning ordinances, for example, and the neighborhoods in which such outlets are allowed. My guess is you’d find nearby residences populated disproportionately by less affluent households, ones who are either: (a) at more risk of being involved in an accident or assault regardless of any connection to alcohol, and/or (b) are less likely to have health insurance and thus more likely to end up in a hospital emergency room following minor altercations and accidents that would be treated on an outpatient basis in a more affluent part of town.

There are no doubt plenty of possible explanations; the quickness with which researches will jump to the conclusion that it’s the alcohol’s fault never ceases to amaze me.

Indeed, that is the mystery and the trouble, especially as this is the sort of thing that neo-prohibitionist groups, spearheaded by the Robert Wood Johnson Foundation, have been spending millions of dollars on, and not surprisingly getting the results that they want to further their agenda. There are research groups funded by the brewing industry that come to opposite conclusions, of course, but those are usually discounted or discredited for that affiliation, yet the media rarely does the same to studies like this one, not even bothering to ask about the funding or the agenda of the group. That such studies can then be published in “legitimate” science journals makes them even less likely to be questioned, even though that’s exactly what the media should be doing.

Don’t worry, it’s the not the individual person who abuses alcohol and good sense that’s at fault here, it’s the community where he lives. As a Monty Python skit once suggested, with a Bobby investigating a murder: “society’s to blame? Let’s lock them up instead.”