Spatial relationships between alcohol-related road crashes and retail alcohol availability.

BACKGROUND This study examines spatial relationships between alcohol outlet density and the incidence of alcohol-related crashes. The few prior studies conducted in this area used relatively large spatial units; here we use highly resolved units from Melbourne, Australia (Statistical Area level 1 [SA1] units: mean land area=0.5 km(2); SD=2.2 km(2)), in order to assess different micro-scale spatial relationships for on- and off-premise outlets. METHODS Bayesian conditional autoregressive Poisson models were used to assess cross-sectional relationships of three-year counts of alcohol-related crashes (2010-2012) attended by Ambulance Victoria paramedics to densities of bars, restaurants, and off-premise outlets controlling for other land use, demographic and roadway characteristics. RESULTS Alcohol-related crashes were not related to bar density within local SA1 units, but were positively related to bar density in adjacent SA1 units. Alcohol-related crashes were negatively related to off-premise outlet density in local SA1 units. CONCLUSIONS Examined in one metropolitan area using small spatial units, bar density is related to greater crash risk in surrounding areas. Observed negative relationships for off-premise outlets may be because the origins and destinations of alcohol-affected journeys are in distal locations relative to outlets.