A Geographic Relation Between Alcohol Availability and Gonorrhea Rates

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Abstract
Background and Objectives: The availability of alcohol measured as alcohol outlet density is associated with numerous alcohol-related outcomes in small area analysis. A number of studies suggest that high-risk sexual behavior should also be considered an alcohol-related outcome. Goal of this Study: To assess the geographic relationship between alcohol availability and high-risk sexual behavior at the neighborhood level. Study Design: Ecological analysis of the geographic relation between off-premise, on-premise, and total alcohol outlet density and reported gonorrhea rates among 155 urban residential census tracts in New Orleans during 1995. Results: All alcohol outlet density variables were positively related to gonorrhea rates. Off-premise outlets per square mile was most strongly related to gonorrhea rates (β ± SE) (β = 0.582 ± 0.073), accounting for 29% of the variance in gonorrhea rates. Interpreted as an elasticity, a 10% increase in off-sale alcohol outlet density accounts for a 5.8% increase in gonorrhea rates. Including the covariates percent black and percent unemployed to the model reduced but did not remove the effect of off-sale outlet density (β = 0.192 ± 0.047). Conclusions: These results indicate there is a geographic relationship between alcohol outlet density and gonorrhea rates at the census tract level. Although these results cannot be interpreted causally, they do justify a public health intervention as a next step in defining the relation between alcohol availability and high-risk sexual behavior.