Evaluating alcohol access and the alcohol environment in neighborhood areas

Background: This paper examines neighborhood, outlet, and server characteristics related to successful purchases of alcohol by intoxicated patrons and underage drinkers at alcohol establishments. It is hypothesized that outlets in commercial areas near to other premises, with poor exterior maintenance, much advertising, and inexperienced youthful servers will be more likely to sell alcohol to intoxicated and underage patrons. Methods: Data were collected using pseudo-intoxicated patron and apparent minor surveys of randomly selected alcohol establishments in a metropolitan area of northern California. Data collection operations included independent surveillance of these drinking places to establish neighborhood And premise characteristics and pseudo-intoxicated patron and apparent minor stings to assess rates of these forms of illegal alcohol sales. Male actors feigning intoxication and female of-age youth identified as appearing to be 20 years or younger attempted to purchase alcohol at on- and off-premise establishments, respectively. Rates of sales (off-premise) and service (on-premise) were the primary outcomes. Results: Apparent minors purchased alcohol in 39% of attempts (95% CI, 34-45%) while pseudo-intoxicated patrons were served alcohol in 58% of attempts (95% CI, 50-67%). Sales to apparent minors were significantly related to percentage of Hispanic residents and areas with greater population density. Sales to pseudo-intoxicated patrons were more frequent when the server was male and appeared to be under the age of 30. These sales were also more frequent in Hispanic neighborhoods with high population density and high numbers of on-premise outlets but were less frequent in African American neighborhoods. Conclusion: The findings suggest that underage and intoxicated patron sales differ by areas. Both forms of illegal sales of alcohol are more likely in highly populated areas of communities. The findings also suggest that server characteristics are strongly related to sales to intoxicated patrons, suggesting some leverage for responsible beverage service programs in these environments.