Alcohol Availability Across Neighborhoods in Ontario Following Alcohol Sales Deregulation, 2013-2017

Abstract

Objectives. To examine the association between neighborhood socioeconomic status (SES) and alcohol availability before and after deregulation in 2015 of the alcohol market in Ontario, Canada. Methods. We quantified alcohol access by number of alcohol outlets and hours of retail for all 19 964 neighborhoods in Ontario. We used mixed effects regression models to examine the associations between alcohol access and a validated SES index between 2013 and 2017. Results. Following deregulation, the number of alcohol outlets in Ontario increased by 15.0%. Low neighborhood SES was positively associated with increased alcohol access: lower-SES neighborhoods had more alcohol outlets within 1000 meters and were closer to the nearest alcohol outlets. Outlets located in low-SES neighborhoods kept longer hours of operation. Conclusions. We observed a substantial increase in alcohol access in Ontario following deregulation. Access to alcohol was greatest in low-SES neighborhoods and may contribute to established inequities in alcohol harms. Public Health Implications. Placing limits on number of alcohol outlets and the hours of operation in low-SES neighborhoods offers an opportunity to reduce alcohol-related health inequities.

FIGURE 1—

Change in Number of Alcohol Outlets and Number of Grocery Stores Selling Alcohol: Ontario, Canada, 2013–2017 Note. The dashed line separates measurements from the pre- and postderegulation periods. The mean number of alcohol outlets measures the average number of alcohol outlets within 1000 meters of the geographic center of an urban neighborhood in Ontario. Whiskers indicate 95% confidence intervals.