The association between alcohol retail access and health care visits attributable to alcohol for individuals with and without a history of alcohol‐related health‐care use

Author:

Myran Daniel T.1234ORCID,Friesen Erik5ORCID,Talarico Robert3,Gaudreault Adrienne1,Taljaard Monica16,Hobin Erin78,Smith Brendan T.78ORCID,Schwartz Naomi7,Giesbrecht Norman89,Crépault Jean‐François89,Tanuseputro Peter1234,Manuel Douglas G.12346

Affiliation:

1. Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada

2. Department of Family Medicine University of Ottawa Ottawa Ontario Canada

3. ICES uOttawa Ottawa Hospital Research Institute Ottawa Ontario Canada

4. Bruyère Research Institute Ottawa Ontario Canada

5. Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada

6. School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada

7. Health Promotion, Chronic Disease and Injury Prevention Public Health Ontario Toronto Ontario Canada

8. Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada

9. Institute for Mental Health Policy Research Centre for Addiction and Mental Health Toronto Ontario Canada

Abstract

AbstractBackground and aimsAlcohol retail access is associated with alcohol use and related harms. This study measured whether this association differs for people with and without heavy and disordered patterns of alcohol use.DesignThe study used a repeated cross‐sectional analysis of health administrative databases.Setting, participants/casesAll residents of Ontario, Canada aged 10–105 years with universal health coverage (n = 10 677 604 in 2013) were included in the analysis.MeasurementsQuarterly rates of emergency department (ED) and outpatient visits attributable to alcohol in 464 geographic regions between 2013 and 2019 were measured. Quarterly off‐premises alcohol retail access scores were calculated (average drive to the closest seven stores) for each geographic region. Mixed‐effect linear regression models adjusted for area‐level socio‐demographic covariates were used to examine associations between deciles of alcohol retail access and health‐care visits attributable to alcohol. Stratified analyses were run for individuals with and without prior alcohol‐attributable health‐care use in the past 2 years.FindingsWe included 437 707 ED visits and 505 271 outpatient visits attributable to alcohol. After adjustment, rates of ED visits were 39% higher [rate ratio (RR) = 1.39, 95% confidence interval (CI) = 1.20–1.61] and rates of outpatient visits were 49% higher (RR = 1.49, 95% CI = 1.26–1.75) in the highest versus lowest decile of alcohol access. There was a positive association between alcohol access and outpatient visits attributable to alcohol for individuals without prior health‐care attributable to alcohol (RR = 1.65, 95% CI = 1.39–1.95 for the highest to lowest decile of alcohol access) but not for individuals with prior health‐care attributable to alcohol (RR = 1.08, 95% CI = 0.90–1.30). There was a positive association between alcohol access and ED visits attributable to alcohol for individuals with and without prior health‐care for alcohol for ED visits.ConclusionIn Ontario, Canada, greater alcohol retail access appears to be associated with higher rates of emergency department (ED) and outpatient health‐care visits attributable to alcohol. Individuals without prior health‐care for alcohol may be more susceptible to greater alcohol retail access for outpatient but not ED visits attributable to alcohol.

Funder

Canadian Institutes of Health Research

Publisher

Wiley

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