More than 100 years ago, alcohol problems were salient enough to lead to national prohibition of alcohol sales. When the U.S. repealed the national prohibition in 1933, it placed primary responsibility for the regulation of alcohol in the hands of the states. Many states in turn passed at least some of that responsibility — and the powers that come with it — on to the cities and towns within their borders.
Since the turn of this century — and particularly since the onset of the COVID-19 pandemic — rising alcohol consumption and related harms make these powers even more important to the health and safety of our cities.
In recent decades, cities across the country have experimented with innovative approaches to regulate alcohol outlets by using licensing, land use, and nuisance powers to give communities a greater voice in the placement and practices of alcohol outlets in their neighborhoods. These “safer alcohol sales” policy solutions have been shown to be effective in addressing alcohol-related harms by enabling cities to have input into the number, density, and sales and service practices of alcohol outlets in a given neighborhood.
In 1977, Oakland, California, became the first city to pass safer alcohol sales policies to address significant increases in violent crime, including homicides. The city pioneered a type of a zoning ordinance that enabled the city to grant or deny permits for new alcohol outlets based on the city’s land use powers. By 1993, approximately half of California’s 475 cities had zoning ordinances in place to govern location and operation of alcohol outlets. These ordinances have helped cities reduce crime through steps such as restricting the sale of high alcohol content beverages.
In Georgia, beginning in 2003, the City of Atlanta used its powers over alcohol outlets to address crime in the Buckhead neighborhood. When Buckhead intentionally reduced alcohol outlet density by 3%, a multi-year study by researchers from the Centers for Disease Control and Prevention and Georgia’s Department of Public Health compared it with two similar neighborhoods in the city, and documented a drop in crime that was twice as large as what happened in the other neighborhoods over the same time period.
Today, the COVID-19 pandemic has brought a new urgency to safer alcohol sales efforts as the country is experiencing a rise in both alcohol sales and violent crime. Despite the economic hardships experienced by many during the pandemic, federal alcohol tax revenues for 2020 were nearly the same (after accounting for inflation) as those for 2019, and sales of distilled spirits — the strongest form of alcohol — actually increased by nearly 8%. Survey data suggest that many people — especially women — are drinking heavily more frequently during the pandemic and are also reporting more alcohol-related problems.
Because of pandemic-related closures, people are doing more of their drinking away from supervised settings such as bars and restaurants. Research has found that this kind of drinking — off-premises consumption — is twice as likely to be associated with violence. Moreover, violence including homicides and domestic violence incidents has risen significantly: An analysis of 18 studies by the National Commission on COVID-19 and Criminal Justice found an 8.1% increase in domestic violence after the issuance of stay-at-home orders.
Alcohol’s role in violence is both physiological and psychological. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol use can weaken mechanisms in the brain that normally keep impulsive and aggressive behaviors in check. At the same time, alcohol expectancies — what people think will happen when they drink — include being more aggressive.
A new report out this week from CityHealth, Preventing Violence in American Cities with Safer Alcohol Sales, examines alcohol outlet density and violent crime in the nation’s largest cities and provides a menu of policy options for cities. The report overlays crime and alcohol outlet data for several cities with varying degrees of local control. While there are many factors that influence the relationship between alcohol outlet density and crime, the maps illustrate that high-crime areas often coincide with areas of high alcohol outlet density, although high outlet density areas do not always coincide with areas of high crime.
Atlanta and Baltimore are cases in point for the importance of city powers and local control. Both have both been the sites of peer-reviewed studies of alcohol outlets and violence. Atlanta, which received a CityHealth gold medal for its safer alcohol sales policies, has significant local control over its alcohol outlets. Baltimore, in contrast, received no medal because it has very limited local control over outlets selling and serving within its borders. Research in Baltimore has found associations between the alcohol outlets and violent crime, pedestrian safety, and life expectancy.
Research has also found repeatedly that alcohol outlets tend to cluster more in low-income communities and communities of color. This has come about both as part of the legacy of redlining — lending practices that discriminated against other businesses in these neighborhoods — and as a manifestation of the historical disfranchisement of these communities from political decisions that affect their lives.
The maps point to the potential for cities to use their regulatory powers to influence both the concentration and the practices of alcohol outlets. Taking meaningful action on safer alcohol sales policies has the potential to improve both health equity and the health and safety of all city residents.
In 2021, the attention of public health and policymakers is rightfully focused on the pandemic itself. However, there is good reason to believe that the rise in violence during the pandemic is related at least in part to the changes in how and where alcohol is sold and consumed. For this reason, there is an urgent need for cities to take action.
One of the lessons of national prohibition was that local communities need to be able to determine how, when and where alcohol will be sold. Nearly a century later, as both chronic alcohol problems such as liver disease, and acute problems like violence, are on the rise, cities have an opportunity to remember, revive, and improve their ability to bring about safer alcohol sales. Doing so could save lives, protect communities, and help the nation come back stronger from the trauma and tragedy of the COVID-19 pandemic.