An Observational Cross-Sectional Study of Alcohol Outlets and Associated Alcohol and Cocaine/Crack Use Among African American Adults in Atlanta, Georgia Open Access

Abstract

Cocaine/crack use has been widely recognized as a public health concern that has negative social and health consequences. On average, African Americans in inner-city neighborhoods have higher rates of cocaine/crack use, with which concurrent alcohol use is commonly reported. This group also experiences high alcohol outlet density, which is associated with increased alcohol consumption. The authors used cross-sectional data from the People and Places study to examine concurrent alcohol and cocaine/crack use with the number of alcohol outlets within one mile of African American adult residences in disadvantaged neighborhoods of Atlanta, Georgia. Logistic regression models were used to estimate the association between alcohol outlet density and 30-day concurrent cocaine/crack and alcohol use, exclusive cocaine/crack only use, exclusive alcohol use, and use of neither, while controlling for socio-demographic factors and perception of neighborhood drug/alcohol problems. Off-site alcohol outlets such as liquor stores were statistically significantly associated with 9% higher odds of 30-day exclusive use of cocaine/crack (95% CI: 1.03, 1.15) and 2% higher odds of concurrent cocaine/crack and alcohol use (95% CI: 1.00, 1.04). Conversely, on-site alcohol outlets such as bars had an inverse association with both exclusive cocaine/crack use (OR: 0.97, 95% CI: 0.95, 0.99) and concurrent cocaine/crack and alcohol use (OR: 0.99, 95% CI: 0.98, 0.997). There was no apparent association between off-site or on-site alcohol outlet density and exclusive alcohol use. Increased negative perception of neighborhood drug and alcohol problems was associated with 18% higher reported use of concurrent cocaine/crack and alcohol use (p<0.0001). This study supports the possible association between off-site alcohol outlet density and cocaine/crack use, both exclusively and concurrently with alcohol among African American adults in disadvantaged neighborhoods of Atlanta, Georgia.

Table of Contents

Chapter I: Background/Literature Review 1

Chapter II: Manuscript 14

Title, Author(s), Abstract 14

Introduction 15

Methods 17

Results 23

Discussion 31

References 36

Tables 50

Appendices 59

Supplemental Tables 60

Figures/Figure Legends 79

Literature Review Tables 81

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	cocaine African American alcohol alcohol outlet crack cocaine alcohol outlets
Committee Chair / Thesis Advisor	Spaulding, Anne C, Emory University Elifson, Kirk, Emory University Nehl, Eric J., Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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