Publication Date: 
Wednesday, July 31, 2019

The Problem: Alcohol consumption is a risk factor for many public health harms. Impaired driving is one of the largest contributors to motor vehicle crashes. Each year in the United States roughly 10,500 people die in motor vehicle crashes involving an alcohol-impaired driver. In 2016, these crashes accounted for almost a third of all U.S. traffic-related deaths. CDC: Impaired Driving Factsheet. Alcohol consumption is also a risk factor for cancer and other chronic conditions such as cirrhosis. One established risk factor for excessive alcohol consumption is high density of outlets that sell alcohol.

The Law: The density of alcohol outlets is regulated primarily through local zoning and licensing laws. In general, localities have wide authority under each body of law to determine when and where alcohol may be delivered through retail sale. Both types of law may be used to advance public health priorities.  For examples of local laws regulating alcohol outlet density, with specific reference to reducing health related harms, see San Francisco Ordinance 781.9 and Orlando Ordinance 5-1. In some instances, state governments prescribe rules regulating the density of alcohol outlets and other features of retail alcohol sale. For examples of state laws, see N.H. Stat. § 179.19 (New Hampshire) and CA. Bus. & Pro. Code § 25631-25633 (California).

The Evidence: An expert panel at the Community Guide systematically reviewed studies assessing the effect of limiting alcohol density on alcohol-related harms. Campbell et al, The Effectiveness of Limiting Alcohol Outlet Density As a Means of Reducing Excessive Alcohol Consumption and Alcohol-Related Harms, Am J Prev Med 2009;37(6). The reviewers identified 9 studies that fit their criteria of evaluating the relationship between legally imposed limitations on alcohol outlet density and one or more health outcomes. Each of the nine studies employed a time series design that compared health outcomes before and after the adoption of density-limiting law. Though acknowledging that other factors related to density of alcohol outlets may be contributing to poor health outcomes, the reviewers found sufficient evidence to conclude that limiting alcohol density reduces alcohol consumption as well as some types of violent crime.

The Bottom Line: According to the authors of a Community Guide systematic review, there is sufficient evidence to support the effectiveness of laws limiting density of alcohol outlets as a means of decreasing alcohol-related harms.

Impact: Effective