Neighborhood alcohol outlet density and rates of child abuse and neglect: Moderating effects of access to substance abuse services

Abstract

This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed.

Testing a Social Mechanism: Does Alcohol Outlet Density Moderate the Relationship Between Levels of Alcohol Use and Child Physical Abuse?

“…The extent to which heavy drinkers are exposed to this higher level of alcohol-related aggression due to higher densities of bars in their local areas may increase their use of aggressive parenting techniques. Taken together, these complexity of these findings may help explain why ecological studies have found differential relationships of outlets on rates of child physical abuse (Freisthler et al, 2004; Morton et al, 2014), as the moderating role of outlets appears to differ by drinking pattern. This suggests that multi-level studies which are able to connect ecological features with individual behaviors and outcomes may be the best way to understand the nuances of these relationships.…”

“…This is one of the first studies to explicitly examine how all levels of drinking may affect use of physical abuse. With regards to alcohol outlet density, ecological studies conducted using administrative units have found that density of bar and off-premise outlets are related to official reports of child maltreatment (Freisthler, 2004; Freisthler et al, 2007 Morton, 2013; Morton et al, 2014). Those studies, however, did not include individual-level drinking behavior.…”

“…A growing body of research suggests that areas with higher densities of some types of alcohol outlets also have higher rates of maltreatment (Freisthler, 2004; Freisthler et al, 2004; Freisthler et al, 2005; Freisthler et al, 2007; Freisthler, Gruenewald, Ring, & LaScala, 2008; Markowitz & Grossman, 1998; Morton, 2013; Morton, Simmel, & Peterson, 2014). In longitudinal studies, increases in off-premise alcohol outlets (i.e.…”

“…California-based studies have found that density of off-premise outlets per roadway mile are positively related to injuries due to child abuse (Freisthler et al, 2008) and higher rates of physical abuse (Freisthler et al, 2004). However, a recent study found that off-premise outlets were negatively related to rates of physical abuse in New Jersey (Morton, Simmel, & Peterson, 2014), suggesting the relationship might not be clear cut. Unfortunately, these ecological studies cannot control for individual alcohol use behaviors.…”

Are community level prescription opioid overdoses associated with child harm? A spatial analysis of California zip codes, 2001–2011

“…Both on-premise (e.g., bars or restaurants) and off-premise (e.g., liquor stores) alcohol outlets are associated with neighborhood child maltreatment rates (Freisthler et al, 2012; Freisthler and Weiss, 2008; Morton, 2013; Morton et al, 2014), although some of the literature is mixed (Morton et al, 2014). Neighborhood indicators of drug markets, such as drug sales (Freisthler et al, 2012), and drug arrests (Albert and Barth, 1996; Freisthler et al, 2005; Freisthler and Weiss, 2008), have also been associated with referrals to child protective services or maltreatment rates.…”