Cross-sectional analysis of the relationship between alcohol availability, neighbourhood deprivation and chronic mental health disorder in Scotland

Abstract

This study explores alcohol availability in Scotland. In particular it focuses on the relationship between availability, deprivation and mental health. The study aims to a) compare three supply-measures of availability and their associations with neighbourhood level deprivation, and b) examine the association between neighbourhood availabilities of on-sales and off-sales alcohol outlets and mental health disorders. This was a cross-sectional study where alcohol availability measures were calculated for the Scottish data zone administrative geography (n = 6,976 across Scotland). Using alcohol outlet data(2016) from the Liquor Licensing Board, three measures of availability were calculated for total, on and off-license alcohol outlets: 1) kernel density estimation at 800m and 1500m search distances; 2) counts within buffers at 800m and 1500m distances; 3) distance to the nearest outlet from the population-weighted centroid of each data zone. Average outlet densities and distances were calculated for neighbourhoods grouped by their level of income deprivation and compared using one-way analysis of variance (ANOVA). Multiple linear regression models were used to estimate the association between availability of alcohol outlets and chronic-related mental health disorder. This study found that the density-based supply-measures captured the same distribution of outlets and associations with the health outcome at 800m, but not for a 1500m travel distance. This emphasises the importance of sensitivity testing in studies of this nature. Additionally, this study observed a strong positive association between exposure to off-license outlets and chronic-related mental health disorder. These findings accentuate the need for alcohol-retail legislation, particularly for those populations most vulnerable.