Report: As Off-Premises Alcohol Sales Spike During Pandemic, Safer Alcohol Sales Policies Can Improve Health and Reduce Violence

Limiting Alcohol Outlet Density Can Help Reduce Violent Crime in Cities

March 2, 2021

Report: As Off-Premises Alcohol Sales Spike During Pandemic, Safer Alcohol Sales Policies Can Improve Health and Reduce Violence

WASHINGTON, D.C. — March 2, 2021 — Since the onset of the COVID-19 pandemic, sales from off-premises alcohol outlets — such as from liquor and convenience stores — have risen dramatically across the country. A new report by CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, analyzes the relationship between alcohol outlet density and violent crime, and provides safer alcohol sales policy options to help cities reduce violent crime while improving the health and well-being of residents.

“There is strong evidence that violent crime increases with higher alcohol outlet density in cities across the country,” said CityHealth Co-Executive Director Catherine D. Patterson. “With both takeaway sales and violent crime on the rise during the pandemic, the need for local action to adopt safer alcohol sales policies is more urgent than ever.”

Multiple studies have found that areas with greater alcohol outlet density have more homicides, aggravated assaults, sexual assaults, and aspects of neighborhood disadvantage. While cities have varying degrees of authority to regulate alcohol sales, many have the power to regulate alcohol outlets through zoning regulations, licensing, and nuisance laws, which can be powerful tools in limiting alcohol use and reducing violent crime.

“Regulating alcohol sales not only improves public safety, but also creates a space to engage residents in decisions about how their neighborhoods are developed and shaped,” said CityHealth Co-Executive Director Katrina Forrest. “Many cities can regulate alcohol outlets through zoning and licensing policies, which can lead to a broad spectrum of health and economic benefits for residents.”

The report found that the spacing and placement of alcohol outlets also has significant racial and economic implications and consequences. In some cities, the concentration of alcohol outlets in low-income communities and communities of color underscores the continuing harms and impact of structural racism in urban planning. By adopting policies that regulate where, when, and how alcohol may be sold, city leaders have an opportunity to engage their residents on issues including economic development and neighborhood investment, while also ensuring that health outcomes are shared equitably.

Each year, CityHealth awards gold, silver, bronze, or no medals to cities based on the strength and number of the policies that they have in place. A total of 16 out of the 40 largest U.S. cities earned medals for safer alcohol sales in 2020. Cities earning gold medals include Atlanta, Boston, Chicago, Denver, Kansas City, Las Vegas, Milwaukee, and Washington, D.C. Cities earning silver include Fresno, Long Beach, Memphis, Nashville, Sacramento, San Diego, San Francisco and San Jose.


CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, works to advance a package of proven policy solutions that will help millions of people live longer, better lives in vibrant, prosperous communities. CityHealth regularly evaluates cities on the number and strength of their policies. Find out more at

The de Beaumont Foundation advances policy, builds partnerships, and strengthens public health to create communities where people can achieve their best possible health. Learn more at

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 12.4 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, visit