BACKGROUND: Excessive alcohol use is responsible for 88,000 deaths annually in the U.S., including 1 in 10 total deaths among working-age adults, and cost the U.S. $249 billion in 2010. High alcohol outlet density is known to be an important environmental risk factor for excessive drinking, but there is currently no standard methodology for assessing alcohol outlet density in states and communities.
METHODS: In May 2011, the CDC Excessive Alcohol Use Prevention Team (Alcohol Program) convened a Workgroup on Measuring Alcohol Outlet Density. The Workgroup included epidemiologists, geographers, and experts in alcohol policy working in federal and state public health agencies, academia, and private organizations. The Alcohol Program subsequently worked with Dr. Jeffrey Sacks and Workgroup participants to summarize key recommendations from this meeting, review current scientific literature on the measurement of alcohol outlet density, and develop a Guide for Measuring Alcohol Outlet Density, which will be released in 2017.
RESULTS: The Guide describes key issues that need to be considered before measuring alcohol outlet density; the steps involved in performing this public health surveillance activity; approaches to measuring alcohol outlet density and their pros and cons; and CDC guidance on measuring alcohol outlet density. Specific issues that need to be considered when assessing the relationship between alcohol outlet density and alcohol-related harms (e.g., violence) also are addressed.
CONCLUSIONS: Monitoring environmental health hazards, such as high alcohol outlet density, is an essential public health function that supports the regulation of this environmental risk factor for excessive drinking. The CDC Guide on Measuring Alcohol Outlet Density can facilitate the development of more consistent and scientifically rigorous methods for measuring alcohol outlet density, thereby supporting the prevention of excessive alcohol use and related harms at the state and local levels.