Alcohol Outlet Control Policy and Public Health in Baltimore

January 2013 / Abell-Supported Research / Community Development, Health and Human Services

Evidence and arguments about creating healthier residential neighborhoods.

Many urban areas across the United States and globally are considering policies to create healthier and safer community environments. The National Prevention Strategy released by the U.S. Surgeon General’s Office in March 2011 serves as the nation’s blueprint for advancing health and wellness. It also specifically highlights the importance of including health considerations in decision-making across multiple sectors in order to achieve healthier and safer community environments (National Prevention Council, 2011). This is in keeping with the growing emphasis among public health leaders on Health in All Policies approaches to health promotion and disease prevention. This policy brief presents the rationale, evidence and mechanisms for utilizing alcohol outlet-related policy to create healthier and safer communities. While some aspects of the brief are applicable to other urban areas, the specific focus is on Baltimore City, which is currently undergoing a comprehensive update of its zoning code for the first time since 1971.

Baltimore City residents suffer from excess mortality from almost all causes of death compared to Maryland residents overall (Maryland Department of Health and Mental Hygiene 2011). Furthermore, health outcomes vary widely for City residents depending on their City neighborhoods. A 2008 Baltimore City Health Department report showed a twenty year difference in average life expectancy between the City  neighborhoods with the highest and lowest longevity (Richards et al 2008). Given the health disparities between Baltimore City residents and Marylanders in general and between Baltimore City residents living in different City neighborhoods, there is a need to find ways to improve the health-promoting potential of City neighborhoods in order to decrease health disparities. The comprehensive zoning code rewrite presents Baltimore with a unique window of opportunity to increase the health-promoting potential of neighborhoods through urban planning (Thornton et al 2010). In particular, elements of the proposed new zoning code rewrite could impact the density and location of alcohol outlets in Baltimore and, thus have the potential to create healthier residential neighborhoods by decreasing violent crime. Thus, this brief pays special attention to addressing alcohol outlet density and location through zoning policy as one potential mechanism to create healthier and safer communities.

This brief does not address the potential personal health consequences associated with alcohol outlet density and location related to individual behaviors such as alcohol consumption (e.g. cirrhosis of the liver, alcohol poisoning). Rather, it focuses on the potential neighborhood-level health considerations associated with alcohol sales in residentially zoned areas in Baltimore City, focusing on the location and density of alcohol outlets. The main health topic of interest is the relationship between alcohol outlets and violent crime, such as homicide, aggravated assault, rape, robbery, and burglary. Furthermore, it provides a public health perspective on alcohol outlet-related policy and its potential impacts on crime. This brief does not, however, provide an authoritative review of all the legal issues and considerations that may impact such policy decisions.