Drug and Alcohol Dependence 132 (2013) 449–456 Contents lists available at ScienceDirect Drug and Alcohol Dependence jo ur nal homep ag e: www.elsevier.com/locate/drugalcdep Neighborhood socioeconomic characteristics, the retail environment, and alcohol consumption: A multilevel analysis Scott T. Shimotsu a,* , Rhonda J. Jones-Webb b , Richard F. MacLehose b , Toben F. Nelson b , Jean L. Forster b , Leslie A. Lytle b a Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, United States b Division of Epidemiology and Community Health, University of Minnesota, West Bank Office Building, 1300 S. Second Street, Suite 300, Minneapolis, MN 55454-1015, United States a r t i c l e i n f o Article history: Received 4 October 2012 Received in revised form 19 January 2013 Accepted 9 March 2013 Available online 4 May 2013 Keywords: Alcohol consumption Binge drinking Neighborhood characteristics Retail environment Alcohol outlet density a b s t r a c t Background: The neighborhoods where people live can influence their drinking behavior. We hypothe- sized that living in a neighborhood with lower median income, higher alcohol outlet density, and only liquor stores and no grocery stores would be associated with higher alcohol consumption after adjusting for individual demographic and lifestyle factors. Methods: We used two self-report measures to assess alcohol consumption in a sample of 9959 adults living in a large Midwestern county: volume of alcohol consumed (count) and binge drinking (5 or more drinks vs. < 5 drinks). We measured census tract median annual household income based on U.S. Census data. Alcohol outlet density was measured using the number of liquor stores divided by the census tract roadway miles. The mix of liquor and food stores in census tracts was assessed using a categorical variable based on the number of liquor and number of food stores using data from InfoUSA. Weighted hierarchical linear and Poisson regression were used to test our study hypothesis. Results: Retail mix was associated with binge drinking. Individuals living in census tracts with only liquor stores had a 46% higher risk of binge drinking than individuals living in census tracts with food stores only after controlling for demographic and lifestyle factors. Conclusion: Census tract characteristics such as retail mix may partly explain variability in drinking behav- ior. Future research should explore the mix of stores, not just the over-concentration of liquor stores in census tracts. Published by Elsevier Ireland Ltd. 1. Introduction Alcohol consumption is a significant public health problem in the U.S. Approximately two-thirds of adults in the U.S. consume some alcohol (Center for Disease Control (CDC), 2007). Studies suggest that about 15 percent of Americans engage in excessive drinking, defined as a pattern of alcohol consumption of 5 or more drinks on a single occasion for men or 4 or more drinks on a single occasion for women (CDC, 2007). Excessive drinking contributes to 79,000 excess deaths annually (CDC, 2004) and is associated with cardiovascular disease, several cancers, and liver cirrhosis (Alaniz, 1998; Corrao et al., 2004; Scribner et al., 1999). The neighborhoods where people live can influence their drinking behavior. Two neighborhood characteristics in particular are important in understanding alcohol outcomes: neighborhood median income, and the retail environment. Social systems theory, * Corresponding author. Tel.: +1 612 873 2389. E-mail address: shim0152@umn.edu (S.T. Shimotsu). which examines how individuals interact with their environment, suggests that alcohol problems are ultimately linked to larger social and economic systems such as the neighborhood and retail envi- ronment (Holder and Wallack, 1986). Some studies have found that living in a poor neighborhood is associated with increased alcohol consumption (Cerda et al., 2010; Galea et al., 2007; Jones-Webb et al., 1997; Pollack et al., 2005; Stimpson et al., 2007). In a recent prospective study, Cerda et al. (2010) found that a 1% increase in the number of adults living in poverty was associated with an 86% increase in odds of binge drinking. They also found that a 1% increase in mean neighbor- hood cumulative poverty was associated with a 53% increase in number of drinks per week after controlling for individual socio- economic status. Similarly, Stimpson et al. (2007) reported that higher neighborhood deprivation was positively associated with a higher odds of excessive drinking after controlling for demo- graphic variables (Stimpson et al., 2007). Some studies have also found no association between low neighborhood SES and increased alcohol consumption (Ecob and Macintyre, 2000; Mulia et al., 2008). 0376-8716/$ – see front matter. Published by Elsevier Ireland Ltd. http://dx.doi.org/10.1016/j.drugalcdep.2013.03.010