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SOCIAL
SCIENCE
-&-
MEDICINE
PGRGAMON Soci.~l Saence & Mcd~ane 55 (2002) 425-435
www eltievier cum/locate/tiocsumed
Secondhand effects of student alcohol use reported by
neighbors of colleges: the role of alcohol outlets
Henry Wechslera°*, Jae Eun Leea, John Hall~, Alexander C. Wagenaar°, Hang Leed
'`Hm unrd Schoal oJ Pub6c Henlth, Depqrtment oJ He~dth nnd Soc+n/ Behno~or, 677 Pfuntr~t~ton Avenue, lioaron, MA 02!/5, US~
^Mudiemnncu Pa6cy Research, 600 Alexaiider Pak, Princemn, NJ 08543, USif
°Depur[men! of Epidem~aloyy, Schon! of Pubhc Henlth, Uruue~sny of M~mreaotn, l300 SouUi 2nd Sneet, Suite 300, Mmnenpolm,
MN 55454-1015 OSA
`~CenterJo~ Vnccme Resea~ch & Depmfineiit of Pedmnics, UCLA SJioo! of Medicwe 1124 Weat Cn~snn Streel,
ResemeG «nd E~Gmunon Rmldrn9 E-6, Torrnnce, C~l 10502, USA
A6stract
Th~s is a shidy of the secondh.~nd eflects of student alcohol use expenen~ed by residents of ne~ghbodioods near
college campuses We exammed the relaGonsh~p of a college's level of 6mge drmkmg and Ihe mmiber of alcohol outlets
m lhe immed~a[e area, to lowered quahty of ne~gliborliood hfe throiigh such secondh.md effects Adults from 4661
houseliolds m the Umted States were mternewed through a stratified hs[-nss~sted random d~grt d~ahng [elephone
survey The mterview schedule mcluded queshons abont res~dents' expenences of secondhand effects of alcohol use such
as no~se, vand2lism or pubi~c d~sriirbances Reports abou[ the qiiahty of neighborhood I~fe provided by responJents
res~dmg near colleges were compared witli tliose of respondents who d~d no[ live near coileges, and reports of nc~ghbors
of colleges w~th Iugh rates of bmge dnnkmg were compared with [hose of ne~ghbors of colleges wrth lowe~ ra[es The
presence ot alcohol outlets m these ~reas wes also compared Res~den[s near colleges end partwularly near colleges wrth
heavy ep~sod~c drmkmg reported the presence of mora alcohol outlets withm a mde Those ne~gh6orhoods we~e
charactenzed by lower soc~oeconom~c s[atus Ne~ghbors I~vmg near college campuses were more hkely to report <<
lowered quahty of neighborhood life through sncli secondliand effects oC hcavy alcohol use as no~se and dtstnrbances,
vandalism, drunkenness, vomitmg and urm~[ion A patli analysis mdicated thut the number of nearby alcohol outlets
was an important fac[or med~ahng the relat~onship be[ween col(eges, espeaally those widi high rates of bmge drmkmg,
and such secondhand effects The results suggest that ne~ghborhood d~snip[~ons around colleges due to heavy ~tlcohol
use may be reduced by 6miUng the presence of alcohol outlets m those arcas, ~md the marketmg pracuces that this
engenders Qc 2002 Elsev~er Saence Ltd AII n~hts reserved
Keyiva~d~ Ne~ghborhood, College ltudents, Alcohol use, Environment, Alcohol-ielateJ d~sruption, Alcohol aude[ dens~ty,
Socioeconomw status, USA
Introduchon
In 1993, the Harvard School of Pubhc Health College
Alcoliol Shtdy (CAS) found that two ~u five US college
shidents werc bmge dnnkers (Weclisler, Davenport,
Dowd~ll, Moeykens, & Cnsl~llo, 1994) and this rate
'"Co[t'espondmg rmthoc Tel k1-617-43?-1137, fax +I-
617-432-3223
GmuJnddiesr hwechsle(n)hsphhaivardedu(H Wechsler)
remamed constlnt m[wo follow up surveys Q997 .md
1999) over ~i 6-year penod (Wcchsler, Dowdall, Maen-
iter, Gledhill-Hoyt, 8r. Lee, O98, 2000a) Among the
problems assoc~ated wrtli these high levels of alcoliol use
are what we liave termed "secondhand" etiects Weclis-
ler, Moeykens, Davenport, C~tstillo, and Hansen (19956)
fo~md that non-bmge drmkmg s[udents res~dmg on
campuses where more than half at students were bmge
drmkers were twice as likely to expenence secondhand
eCfects [han iion-bmge drmkers Irvmg on campuses wrtl~
0277-9536/02/$-see front mattcr [Q 200? Elsevwr Saence Ltd All r~glits ~escrved
PIT 50277-953b(O1)00259-3
426 H Wech~ler et al ~ Souu1 Smence & Medmrne 55 (2002J 425-435
fewer bmge dnnkers These secondhand effects mclude
(i~vmg sleep or sCUdy m[erruptcd, havmg to take care of
a drunken student, bemg msulted or assaulted, bemg the
victim of unwanted sexual advances, or liavmg personal
property v~~ndalized
Heary alcohol consumphon by college students and
othe~s may be encouraged by a"wet" environment, tlia[
~s, an env~ronment m whicli alcohol ~s promment and
easdy accessible (Edwards et al , 1995) Physicdl, social,
and econom~c ava~lability of alcohol is assoc~ated wrth
alcohol consumptron among the general population
(Parker, Wolz, & Harford, 1978, Rush, Stemberg, &
Brook, 1986, Abbey, Scott, Ohnsky, Qumn, & Andreski,
199Q Abbey, Scott, & Smrth, 1993, Gruenewald,
Madden, & 7anes, 1992, Gruenewa(d, Milter, & Treno,
1993) and among youny+ adolescents and older teenagers
(O'Mnlley & Wagenaar, 1991, Wagenaar, 1993, Wa~en-
aar et al , 1996, 7ones-Webb et al , 1997) H~gh dens~ty
of alcohol outlets has been found to be associated wrth
h~gher rates of alcohol-related health and soc~al
problems such as honnc~de (Scnbner, Cohen, Kaplan,
& Allen, 1999), assaultrve molence (Alamz, Parker,
Gallegos, & Cartmdl, 1996, Alaniz, Cartmdl, & Plrker,
1998, Gorman, Speer, Labouv~e, & Subarya, 1998a,
Scnbner, MacKmnon, & Dweyer, (995, Speer, Labou-
v~e, & Ontkttsh, 1995), domestic vtolence (Gorman,
L~ibomie, Speer, & Suba~ya, 19986), [raffic safery
outcomes (Rabow & Wa[ts, I982, Jewell & Brown,
1995, Scribner e[ al , 1994), and mortalrty, morb~dity
and economro costs (Tatlow, Clapp, & Hohman, 2000,
Mann, Smart, Ang(m, & Adlaf, 1991, Rabow & Watts,
1982, Scnbner, Cohen, & Farley, 1998, Gorsky,
Schwar[z, & Denms, 1988, Smart, Mann, & Suurvali,
1998) Alcohol outlets and advert~smg appear to be
over-concen[rated m ethme mmonty commumties (Ala-
mz, 2000, Hackbartli, Sdvestr~, & Cosper, 1995, Altman,
Schooler, & Basil, 1991, LaVeist and Wallace, 2000),
~mplying tha[ ~[ is necessary to understnnd the socio-
demograph~c and economic background of a commumty
m copmg with dnnkmg problems
As Gruenewald and others (1995) have pom[ed out,
most of d~ese shidies find relat~onshtps be[ween outlets,
demograph~es, and drmkmg patterns, but most do not
provide a[heoretical basis for understandmg such
mterrelat~ons One such theoreGCal approach receiving
mereased attentiou recently is Yhe "routme actrvrt~es"
theory (Fox & Sobol, 2000) Most commonly appl~ed to
cnme victmuzat~on, routme act~vity Uieons[s find that
more frequent °~omg ouP' mcre~ses one's nsk of
vict~m~zat~on (Mustame & Tewksbury, 1998) In the
contex[ of college drmkmg, one nuyht ~rgue [ha[ h~gh
rates of heavy dnnkmg and alcohol-reldted probleme
among college students are "s~mply° the result of tlie~r
frequent and routme activ~ty of gomg ou[, part~cularly
to bars and ntghtcfubs Tltus, ~us[ as time spent walkmg
tlie stree[ mcrenses exposure Co nsk of (one type o~
assaull, tmie spenf m bars mereases exposure [o the nsk
of experiencmg sccondl~and etTects of heavy drmkmg
The pomt rema~ne, liowever, tha[ a high densiCy of bars
and clubs around campuses may encourage hcavier
dnnkmg among s[udents
Alcohol usc rates and related problems have been
reduced by strateg~es to restr~et alcohol availab~liCy
Coate and Grossman (1988) reported that as alcol~ol
excise taxes mereased, youth drmkmg [ates and deaths
resultmg from motor veh~cle acc~dents s~gmficantly
decreased O'Malley and Wagenaar Q991) found that
as sta[es mcreased nvmmum dnnktn~ age laws, alcohol
use and problems associated with ~t s~gmficantty
decreased Chiu, Perez, and Parker (1997) reported that
an alcohol ban, rts hf[mg, and its re-~mpos~hon had
stat~stical(y st~+mficant effects on the number of alcohol-
related outpatient visits m a geograph~cally isolated
eommumty Reshrouve alcoho( control pohcies sigmfi-
cantly affected m~ury death rates m a popu(at~on w~th
extremely high m~ury mortahty (Berman, Hull, & May,
2000)
Colleges with large numbers of bmge drmkers are ~
charactenzed by gre~[er v~s~b~hty and ava~lab~hty of ;
elcohol m the~r environment College sh~dents' bmge I
drmktng ~s assoc~ated w~[h the degree of ease of access to i
alcohol (Wechsle~, Kuo, Lee, & Dowdall, 20006), I
Iocahon of a bar wrthm a mdc from campus (Wechsicr
et aI , 1994), pr~ce (Chaloupk~i, Grossman, & Saffer,
1998, Wechsler et al , 20006), and state alcohol control
pohcies (Chalottpka et al , 1998)
Cleady, drmkmg levels and ra[es of alcohol-related
problems are assoc~ated with state and local pohc~es as
well as alcohol avadabdity, pnce, and marketmg
prachces For many dimensions of the poLcy and
markeUng env~ronment (eg, nlcohol taxes, drmkmg
age), we know that the causal mHuence runs &om pohcy
to drmkm~ For others (e ~, outlet densrty), the causal ~
mfluences mr~y be reciprocal, w~th the environment
encouragm~ drmking, and heavy drmkmg encouragm~
detenorahon of the commumty envuonn~ent Tlie
curren[ study exammes tl~e mterrelahonsh~ps be[ween
a commumty envvonment tl~at encourages drmkm~ and
a concentrat~on of heavy drmkerz (on college c~mpuses)
[I~at shape the commumty env~ronment Specifically, we
used surveys of commumty residents aronnd colleges,
along w~th surveys of student behavior on those
campuses to nnswer the followmg quesUOns
Are there more alcohol outlets m ne~ghborhoods near
colleges than m smt~lar neighborhoods wli~ch are not
nenr colleges~
Do residcn[s I~vm~ m commum[~es nea~ a college
expenence more secondhand e(fects of alcohol use
than residents of s~m~la~ areas no[ near a college~
Are the mcreased secondhand effects rela[ed to more
alcoliol oude[s near ~i college~
H Wedislcr el nl / Sacml Scmnce & MerLune 55 (2002J 425-435
• Do res~dents of areas near colleges widi h~gh levels of
bmge dnnking expenence more secondhand e(i'ects
Ih2n residents of areas near colleges wrth low levels of
bmge dunkmg~
Methods
Shady procedure
We conducted a telephone survey oF ndult residents of
tlie cont~guous Umted Stntes plus the Distnct of
Columb~a usmg a strat~fied Lst-nssisted random d~git
dtalmg (2DD) sample purchased from Genesys Sam-
pl~ng Systems ~ The hsbass~sted method used covers an
estimated 96 5% of all households wrth telephones
(Brick, Waksberg, & Starer, 1995) Ach~al coverage
may be higher because [he sample wus selected at
multiple points m timc, so some households excluded
carly m[he survey could have been ~ncluded latcr on
Bnck et al (1995) concluded that hst-ass~sred RDD
samplmg ~s "effic~ent and no[ suU~ect to unportant
coverage bias"
The survey was conduc[ed by M1[hemet~ca Policy
Rescarch of Pnnceton, NJ The mterv~ew schedule
mcluded qneshons about residents' expenences of
secondhand effects of heavy alcoliol use siich as noise,
vandal~sm or public d~sturbances Questwns were
p~.tterned nfter [4ose mclnded m[he Hatvard School
of Publro Healtli College Alcohol Study s[udent ques-
t~onnave (Wedisler, Dowdall, Davenport, & Castillo,
1995a, Wechsler, Kelly, Wertzman, G~ovanm, & Seibr-
mg, 2000a) Respondents were nlso asked about thev
views on alcohol control pohcies, as well as personal
backgronnd charactensncs. The schedule was pre-tested
on a small sample of respondents res~dmg near colleges
diat were not part of tlie samplmg frame Mmor
revis~ons were done as a result of the pretest
Survey m[erviews were conducted between Marcli and
August 1999 Up to IS callz were attempted to obtam a
completed mterview for each sampled [elephone num-
ber Enghsh-speakm~ adults (age 18 and above) Lvmg m
a household setfmg who were not full-time college
students were eLgible for the sncvey In honseholde wrth
more than one eli~~ble adult, one was randonily selected
for the mterview Intervtews were condncted by tramed
mterv~ewecs uemg convent~ottal Camputer Ass~sted
Telephone [nterv~ewmg (CATI) me[hods
A total of 9248 telephone numbera were called, w~th
4661 households ident~Ged Of these, 2621 were study
elig~ble and 2300 were successfully mterviewed, yieldmg
~i completion rate of 86% and 2n es[im<<ted over2ll
response rate of 50% nsmg methods recommended by
~ L~s[ ass~sted RDD snmp6ng me[imds aro descnbcd m
Lepkowsk~ (1988)
427
the Counci] of Amer~can Survey Research orgamzations
(CASRO, Frankel, 1983) Desp~ta tlie level of response,
a comparison of selected demograph~c char~ic[eristics of
the respondents w~th US census data mdtcated no
signdicant d~fferences, prov~dmg no s[rong evidencc of
selection b~as on [he basis of these var~ables
Sampltn~ desi~n
We defined 7 strata for sampla selechon Strata 1-4
mcluded areas near h~gli and low binge sdiools A h~gh
bin~e schoo( is one of tlie 30 schools wrth the lughest
prevalencc of bmge dnnkmg amon~ the 116 colleges
par[ic~patmg m the 1997 H~.rva~d School of Pubhc
Healtli College Alcohol Study (CAS) Similarty, s low
bmge school ~s one of the 30 schools that were lowest m
[he prevalence of bmge drmking (Wechsler et al , 1998)
The h~gh bmge areas ~nchide strata 1(pubhshed
numbers) and 2(unpubhshed) The Iow bmge areas are
covered by strata 3(pubhshed) and 4(Linpnbhshed)
More prec~sely, strata 1 and 2 mcluded [elepltonc
numbers assoc~ated w~th census tracts [hat were
eshmated to be wrthm a 1 m~le rad~us of colleges that
had been clnss~fied as h~gh bmge drinking schools Strata
3 nnd 4 were s~milarly near colleges tl~at had been
class~fied as low bmge drmkmg sclzools Pubhshed and
unpubhshed refer to whether a household's telephone
number appeared m the telephone directory Pubhshed
nnmbers were ass~gned to stratum 1 or 3 based on tlie~r
street addresses Unpubl~shed mimbers were assigned to
stratum 2 or 4 if they belonged to a telephone exchange
where at least 30% of the publ~slied numbers were
assigned to stratnm 1 or 3, respecGvely
Strata 5 und 6 included households m count~es [liat
have colleges on ti~e sample frante used m selecnng the
sample for [he earlier s[udent snrvey Stratum 7 is [he
balance of the US More spec~fically, stratum S mcluded
otlier counhes wrth colleges prov~ded the coimty had ~
large enougli population to be selected with eertam[y
when usmg proba6~Lty proportional to size (PPS)
metliods Strahim 6 mcluded any other counties wrth
one or more colleges on t6e sample frame Stratum 7
compnsed court~es wrth no college on frame
Telephone numbers m strata l-4 also could have been
sampled m crther stratum S or 6 Tliese multiple chances
of selectwn were lccounted for ~n sample we~gh[mg Tlie
sample ~s a nmlt~s[age design W~thm strat~ l, 2, 3, and 4
the pnmary samplmg unrt (PSU) ~s [lie college and the
surroundmg area For stratum 6 the PSU is the county
In each case [he secondary sampl~ng umt ~s the house-
hold The s~tmples of households tn sV.it~i 5 1nd 7 are
not I~kely to be clustered
Data were weiglited to reflect d~fferences m prob-
~ib~hty of selecuon and response rates across s[rn[a
Otlier components of the we~glits mcluded ad~us[men[s
for mulhplc telephone Imes and for mterniptions m
428 K Wechsler et u! / Somu! Science & Med~cme 55 (2002J 425-435
telephone service,z and posbstrat~fication ad~ustments to
n~it~onal esGm~~tes of the populaUOn distr~bution by sex,
~ige, race and home ownersh~p 3 All analyses were
conducted usmg weighted data
Measures
Almost all of [lie measures m the stndy were obt~med
from responses to the comple[ed mterv~ews Respon-
dents we~e asked ~f they I~ave seen or witnessed negative
consequences of others' drinkmg (li[ter, noise or
d~shirbance, vandal~sm, people who are drunk, figlitmg
or assault to otliers, vonut or unuatton, and antomob~le
acc~dents) one or more t~mes m their ne~gliborhood m
the p~ist year (secondtiand effects) The number of
neighbors exper~encm~ four or more of these second-
hand effects was exammed The secondhand effects were
broken down mto the mc~dents attnbu[ed to c,ollege
students by askmg ~f the college students were pr~mar~ly
responsible for the mcident
Commimrty problems were measured by askmg
respondents ~f tliey thought ne~ghborhood concerns
and ~ssues were a ma~or problem or a problem ~n [lie~r
ne~ghborhood Neigltborhood concerns <<nd issues m-
cluded homelessness, cnme, pubhc drunkenness, drug
use, vandahsm, drunk drrvm~, underage drmkmg, anJ
loitermg
Respondents were asked [o esGmate the d~stance of
the nearest college from the~r home "How many miles
f~om your home is the c(osest college or umversity
(Plcase exelude commumty college m your answer)~"
They were also asked to esdma[e how many alwhol
outlets (on-prem~se and off-prem~se, sep~ra[ely) were
located withm 1 mile of Cheir home
(n addit~on to survey data, we also nsed some
var~ables from census data Of the commumty back-
ground vanables, eshmates of mcome, racial composo-
[ion, home ownersh~p and a~e distribution were
estimates a[ the [elephone exchange level provided by
Genesys Samplmg Systems (Marketmg Systems Group)
or the US Census Bureau
zAd~ustments for mterrupnon m telephone service allow the
survey to compens<<te for Ihe omission ot non-telephone
households Very few honseholds wrthout telephone serv~ce
on a given d.~y never have [elephone servwe Mos[ fall mto wha[
Keeter (1995) calls Ihe "trans~en[" oategory-havmg serv~ce
tome 4mes and bemg wrthout at othen By usmg n we~ght
acl~ustment factor thn[ ~s proporhonal to Ilte number of monthti
w~fhout telephone servwe, Ihe tranment telephone household
populn[~on can be appropn~~[ely ~epresented m sample es[~-
m.i[es
~AdJtts(ments for Itome ownersh~p were b,tsed on eshmates
prov~ded by die s~tmple vendor, Genesys SAmp6ng Systems
(Markenng Systems G~oup) Ad~usunents for age, race ~md sex
were baaed on Census Bureau pro~ectiona (Bure.iu of the
Census, ?000)
Analysrs
SUDAAN V 7 5(Shah, Barnwell, & B~eler, I997) was
used for all Chi-square tests and multtple log~stic
regression analyses, SUDAAN empioys a Taylor senes
Imear~zahon to approximate corxecf standard errors for
sample eshmates grven [he mult~stage samphng dcsign of
the survey and the effects of sample we~glitmg 2 x Z Cho-
square tests were used to examme the difference m
socioecononve backgrounds between commumt~es de-
fined by the d~stancc (w~tlim and Farther dian 1 m~le)
from t0e closest college Multtple log~stic regress~ons
were conducted to test tf repor[ed secondhand effects of
dnnkmg attnbutable to college students diftered among
residents of h~gh and fow heavy-ep~sod~c dnnkmg school
areas, and whether secondhand eftects vaned dependmg
on [he d~stance from the closest colle~e The logist~c
regress~ons controlled for soc~oeconom~c background
variables est~mated at the telephone exchange level
(racial composi[ion, % meome 0-lOk, °/a owner
occnp~ed, °/a age 18-24, and rural/urban)
We used structnral equation models to examme how
the d~stance From the closest college or the college bmge
dnnktng rate is rela[ed to numbers of Hlcohol outlets
and Yhe number of secondhand efTec[s (controllmg
commum[y's socioeconom~c characterishcs) We created
an mdex of soc~oeconom~c status reflechng race, mcome,
home ownerslup, and popnlat~on age distribnt~on to
s~mphfy the model and avo~d potential multroollmeanty
When we conducted the path analys~s, we assumed a
nmdirechonal causal relat~onslup between alcohol out-
lets and the environment even though there was the
pose~bd~Cy of a bi-dvechonal relaGOnsh~p between the
two Smce our ma~or concem through the path model
was to determme the med~atmg role of alcohol outlets
between college bmge drmkmg and secondhand el~'ec[s,
we used a recursrve rather [han non-recursrve model
The imtial path model was based on our hypotheses F~t
of the model was eval~iated by comparahve fit mdex
(CFI), Bender and BonetPs (1980) non-normed fit mdex
(NNFI), Bentler and Bonett's (1980) normed fit mdex
(NFI), and tlle Chi-square goodness of fit The statlstical
vi~tb~hty of Ihe restnchons m[he model wns determmed
by i.agrange MulGpher test The SAS CALIS procedure
was used for structuial equation modelmg (Hatcher,
1994)
Resulte
Communtty Background
Income was sigmficantty lower antong ~espondents
hvmg witlun a nule than those hmng mare than 1 nule
from ~i college (Table 1) More A&ioan Amencans, fewer
whites, and, ~is expected, more young people aged 18-24
H Weclnle~ e! u! ~ Soa~ul Suertce & Mvdame 55 (2002) 425-435
Table l
Socioeconom~c charac[erm[~cs of commum[y by dtstance from college
Prevalence m (%)
To[al More [hun Withm a m~le`
I mde° (n = 1692) (n = 526)
429
Chrsquare p-value
More Ihan 10% of households huve annual mcome less
[h,~n $1Q000
Yes 56 2
No 43 8
More than 12% of md~vidualy are African Amerman
(non-Hispamc)
Yes 31 0
No 69 0
More than 1l% of md~viduels arc H~spemc
Yes 28 4
No 71 G
More than 71"/0 of mdrviduals nce White
(non-Htspamc)
Yes 61 8
No 38 2
More than 50% of housmg unrts arc awnei
occupied
Yea 84 9
No 15 I
Mo~e than 10'% of mdrnduals are age 18-24
Yes 20 9
No 79 I
53 8 72 7 0 0005
46 2 27 3
28 8 46 6 0 0028
71 2 53 4
27 7 33 1 0 3095
72 3 66 9
64 3 43 9 0 0009
35 7 56 1
87 7 65 4 0 0001
I23 346
17 4 38 8 <0 0001
826 61?
' Respottdent's est~m~[e of chstunce oC home &om college
n = vnhd snmple s~ze
hved w~thm a mile from the college Are2s wrthm a mile
of a college had a lower prevalence of homeowners
On-premise (bars/mghtclubs) and off-prem~se (Itqttor
stores) alcohol outle[s were more often loca[ed withm a
mile from a college Nmety-Iwo percent of res~den[s
Irvmg w~tltm a mile from the closes[ college reported one
or more alcoliol ouUets w~thm a mile from the¢ house
compared to 75% of those who hved more than 1 m~le
away After controlLng for mcome, race, urbamsm, and
home ownersh~p, respondents who I~ved w~thtn a mile
from the nearest college were sigmficantly more likely to
report the presence of alcol~ol outlets nearby (nd~us[ed
OR= 2 83, 95% CI I 47-5 47, p<0 001, Tablc 2)
Commumty problems repor[ed by respondents are
presented m Tab~e 3 Commumty problems reported
most &equently were underage dnnkmg (60 8%), cnme
(55 6%), vandalism (52 3'%), and drunk dnvmg (47.9%)
Ne~ghbors who Irved wrthin a mde from a college more
otten repor[ed liontelessness, crime, pubhc drunkenness,
dn~g use, undernge dnnkmg, and lo~teung than those
hvmg one or more m~les from a colle~c (Table 3)
d~cturbances, v~inda6sm, dnmkenness, and vom~t and
unnnhon than those lrvmg tnore than a mile from the
school They ware s~gmficantly more hkely to report fottr
or more sucli e11'ects (Table 4)
College shidents were not v~ewed as primardy
respons~ble for most of these secondhand effects Only
about one-fourteenth of tl~e respondents v~ewed coilege
students to be responsible for vom~t/unnation (7 8%),
no~se/d~s[urbance (6 9%), fi~hhng/assault (6 3%), and
litter (6 1%) Coilege students were more often v~ewed
to be responsible for I~tter, noise/d~s[urbance, vandal-
ism, and dnmkenness by respondents hvmg wrthm 1
m~le from a college, than by tliose hvmg more than a
mile from the school One m five (19 5°/n) respondents
who Irved w~tltm a mile from a college mewed college
students to be respons~ble for 2t leas[ one such effect,
wh~le one m twelve (8 3%) Irvmg more than a m~le away
d~d Those who lived wrthm a mile were sigmficantly
more hkely to report at le.ist one of these effects
Secondhnnd eJJects m/mv and /tt~h bm~e dr ~n/c~n~ colle~e
s~tes
D~stance /rom colleye nnd secondhnnd efJ'ects
Respondents who Irved w~thm I mile from a college
were sigmficantly more likcly to report no~se and
Wh~le more respondents m Ivgh bmge drmkmg school
areav than w low bmge drmkmg ~ireati ~eported the
p~esence of alcohol outlets wrthm a mile of the~r homes
430 H Wechs[er e! al / Sonul Suence & Med~une SS (2002) q25-435
Table 2
Presenca of alcohol ontle[s by d~s[ance of cesponAent's home from college
Mo~e [han I m~le" (n = I692) W~[hm a mile' (n = 526)
~"~o) (%) Ad~us[ed ORs (95%CI)n
PreSence of 6ar/mgh[clttb` 49 8 73 9 2 17 (1 32-3 57)***
Presence of hquor s[are 52 4 77 3 2 33 (I 32-4 17)***
Presence oF other store that sells ,~Icohol 63 9 74 2 I 20 (0 75-I 92)
Presene,e of any one of above alwhol outlets 74 9 92 I 2 83 (I 47-5 47)***
"Respondent's eshmate oF d~sWnce of home &om closest college
~ORs ~~e ad~usted for % mcome, % rnce, rural/urban and % owner occupied OR = odds rat~o 95% CI = 95% confidence mterval
`One or more self-repor[ed alcohol ou[leta wrthm 1 mile Cmm house
°**p <0 001, n =vaLd sample s¢e
Table 3
Reported commumty problems by dts[ance ot responden['s home from college
More thun I mde` (n = 1692) W~thin n m~le~ (n = 526)
~ ~o) (%) Ad~usted ORs (95%CI)~
Commumty problemt`
Homelessness 19 I 35 1 1 82 (I I I-3 03)*
Cnme 53 7 68 4 t 75 (1 12-2 78)**
Publ~c Dru~~kenness 30 3 43 1 1 61 Q OI-? 56)*
Drug use 44 7 58 8 1 67 (1 04-2 70)*
Va~daham 51 4 58 5 I 33 (0 87-2 04)
Drunk dr~vmg 48 0 47 2 1 09 (0 72-I 64)
Underage d~mkmg 59 5 69 9 I 64 (I OS-2 50)•
Lo~term6 346 541 192 (123-294)^"*
Four or more pro6lems reported 44 0 59 7 1 89 (I 22-2 94)*"""
"Respondent's es[~ma[e of dislance of liome from closes[ college
~'ORs are ad~usted fo~ '% mcome, % race, "/o age 18-24, rural/urban, .ind % owner occup~ed OR°odds ra[~o 95% CI=95%
wnfidence ~nterval
°% repor[mg lh~s ns a problem
*p <0 05, **p <0 01, *"*p <0 001, n= vahd sample size
(903% vs 82 1%, ad~usted OR=233, 95% CI 1 45-
370, p<0001), no s~~ntficant d~fference m soc~ceco-
nomic status was found between the two school areas ~
Respondents who hved m h~gli-bm~e school areas j
more often reported htter and no~se/disturbance by ~
college students than [hose m low-bmge dnnkmg school
are~s (Table 5) One m five (18 6%) respondents m high-
bmge drmkmg school srtes reported at least one such
secondhand e1~eU, compared [o only one m ten
respondents m low-bmge school areas
Rale of a(coho! outlets as medtahny fnctor
We conducted a path analys~s to explore the degree to
wh~ch alcohol outlets med~a[e the relat~onship between
wllege factors (distance from college and college bmge
dnnkmg levels) and the secondhand effects (F~~ 1) Tlie
Chi-square statishc was not sigmfichnt and tlie CFI,
NNFI, and NFI nll exceeded 0 98, md~ca[mg the model
fits the observed data well All path coefficients shown
were sigmficant at p<005 Distance from [he closest
college and college bmge drmkmg level had an md~rec[
effect on rates of sewndhand problems through the
number of alcohol outle[s m the area No direct effect of
distance from a college on secondhand problems was
found Soc~oeconom~c s[atus had both dtrect ~md
mdirect effects on secondhnnd problems The md~rect
or med~ated effects of college, student dnnkmg, and
soc~oeconom~c steh~s on secondhand problems is ~~
stronger tlian duect effects, mdicatmg thaY the presence
of atcoliol ontlets appears to be essenCial for colleges ~Lnd
theu bmge drmkmg students to have a s~gmficant effect
on neighborhood d~srupt~on
Discussion
A survey of a nat~onal sample of households revealed
s~gmficant correla[wns be[ween tlie dwtance from the
uearest coilege and such secondhand efTects of heavy
H GVechsle~ e~ ul ~ Somal Sc~ance & Medreme 55 (2002) 425-435
Table 4
Repor[ed sewndliand efTee.ts of dlcoliol by d~stance af respondenPs hame from college 431
More thon 1 m~le° (n = 1692) Wrthm a mde° (n = 526)
(%)0 ('%) ORs (95%CI)e
Secondhnnd effects`
Lrt[er 72 8 79 3 I 22 (0 76-2 00)
No~se or d~shvbance 53 4 70 8 l 72 (1 10-2 70)*
VandaLsm 31 7 48 7 2 00 Q 27-3 23)*"'"
People who ~~re d~ unk 35 6 58 5 2 00 (1 22-3 33)*'"
Figh[mg or nssnult m others 17 8 28 5 I 41 (0 85-2 38)
Vom~t or unna[~on 10 5 32 2 2 70 (1 54-4 76)***
Automobde acrndent o~ others 40 2 46 1 1 19 (0 78-1 79)
('our or mare problems observed 30 8 53 2 2 00 (1 25-3 23)***
College student-at[nbuCed secondhand effects`~
Littcr 5 2 11 9 2 27 (1 09-4 76)*
Noine or d~sturbnnae 6 0 11 S 2 63 (1 20-5 88)*
V~mdalism I 7 8 9 5 00 (1 39-16 fi7)**
People who are d~ unk 4 3 12 5 2 94 Q 19-7 14)•
F~ghtmg or nstiault to others 4 9 12 2 3 45 (0 81-14 29)
Vomit or urma[ion 5 I 13 8 3 23 (075-14 29)
Automobile .tcctden[ or o[hers 3 2 5 4 2 27 (0 54-10 00)
Any one of above problems 8 3 19 5 2 78 (l 54-50 00)*'""
°RespondenPti est~m~tte of d~stunce of home fmm collebe
nORs are ~d~us[ed for % mcome, % raae, and % owner occup~ed OR=odds rat~o 9$% CI= 95 % oonfidence m[erval
`% repordny observmg even[ one or more dmes
°'% who abserved event nnd .ittnbu[ed rt to college students
'p <0 O5, *'"p <0 Ol, ***p <0 001, n= val~d sample s~ze
Ta61e 5
Secondhend efi'ects a[tnbu[ed to colle~;e s[udents by respondents near h~gh nnd low bmge level co lleges
Low bmge dnnkmg achool s~[e (n = 817) H~gh bmge dnnking school s~te (n = 490)
(%) (%) Ad~us[ad ORs (95%aC])"
Colle6e student-nt[r~bu[ed secondliand efiectse
Lrtter 4 7 15 8 3 36 (1 77-6 40)*"*
Noise or d~sturbance 8 3 13 9 1 97 (1 12-3 44)*
Vandahsm 2 S 7 4 2 70 (0 76-9 68)
People who are drmik 7 9 I S 8 ? 3? (0 98-5 83)
~igh4ng or ~ssault [o o[hers 4 0 5 8 I 60 (0 46-6 34)
Vom~[ or urm~~don I l 8 7 3 93 (0 85-18 10)
Automobde ace~dent or others 2 5 2 4 1 OS (0 32-3 44)
Any one of above problems 10 3 IS 6 2 I I (1 21-3 68)'"*
"ORs nre ~~d7ttsted for'% mcome, "/o r.ice, and "/o owner occup~ed OR=odds mho 95'% CI= 95% ~onfidence mterval
°i% who observed event and attn6u[ed ~[ [o caliege titudents
*p<005, **p<001, *'"'p<OOOI, n=vnl~d sample size
alcohol use as noise, ht[er, and vandahsm 2espondents
residmg near a college werc a[ h~gher i~sk of cxpcnen-
c~ng such secondhand effects They were ~ilso more hkely
to liave alcohol oL~tlets Iocated near them Path analys~s
md~clted that residing near a college does not appear to
be suffic~ent for experiencmg high r~t[es of secondhand
problems Tlie colleges' contnbuLOn to ne~gliborhood
pioblems appears Co operatc [hrough the presence of
alcohol outlets Our findings suggeat tliat alcohol outlets
are more often located m areas near colleges, pardctt-
larly those w~[h h~gh rates of bmge dnnkmg Commu-
mty iesidents m these areas aie I~kely to expe~ience
lugher iates of neigh6orhood disniphon Such an
mte~pretaLOn ~s cons~stent wrth the hteratu~e on alcohol
~
432 H Wechale~ ct af / Sounl Scrence & Med~cme 55 (2002J 425-435
DISTANCE from
Colle e Cam us
- ll+*• R'=29 R
'= I8
/~ 1
•
ALWIIOL SECONDHAND
OUTLETS Number EPFECTS
BINGEDRINKING 08*** ofalcoholoutlets 33*** Numberof
33 *• LEVEL at collegc w~thm a mile from -~ secondhand etfects
+~• responAent abserved
_ qq
SCS Commumty's
SomoeCOnomw Stafus _ ~ q+++
*** p<0001
%Z (2) =4 966I, p=0 O8, CFI=O 9964, NNFI= 0 9822, and NFI= 0,9941
Valid samples=2,206
Fig 1 Reduced path model of secondhand elfec[s
oudet density m general, which finds that h~gher outlet
dens~hes mcrease percerved availabihty of alcohol, lower
reta~l price through mcreased compehhon, lower total
eoet to tlie dnnker (mcludmg C~avel t~me), mareases
consumptton of alcohol, aud mcreases violence and
other cnme and disrupt~on assoctated with drm_ k~n~
(Abbey ct at , l99Q Alamz et al , 1998, Scrtbner, Cohen,
& F~sher, 200Q Berman et al, 2000) Gyvep t cro s-
swhonel des~~n of the current study, we cannot answer
the queshon of which came first Does [he presence of a
college, espec~ally w~th a li~gh ra[e of heavy drmkmg,
encourage more alcohol outlets7 Or does the presence of
meny compepng alcohol outlets encourage h~gh rates of
heavy drmkmg by the students of the nearby college~
Our resul[s sugges[ however, [ltat ra[es of nei~hborhood
disruption around colleges may be si~mficantty reduced
by ImnGng the presence of alcohol outlets m those areae
- tier ac[ors contnbute to the presence of elcoio
outlets .~round many colleges Onr resnlts md~cate
neighborhoods near colleges are more hkely to be lower
soc~oeconomic arcas These cond~twns might tncrease
Lhe ease of obtammg alcoho] hcenses, and produce a
lugher presence of outlets Others have reported
panc~ularly h~gh ra[es of alcohol outlet density m poor
urban lreas (Goiman & Speer, 1997, LaVeisr &
Wallace, 2000), and res~dents of tliese ne~ghborhoods
are more likely to report a range of social problems such
as homelessness, crime, pubhc drunkenness <md lorter-
~ng
Current attemp[s ro change studenr behavior througli
educddon and bnef motrvat~onal techmques are ~imong
the mam mtervenhons colleges are usmg to reduce he.~vy
drtnkmg Results of Ph~s stndy suggest that deahng w~Cl1
tlre h~gh density of alcohol outlets and [he marketing~
prachces th~s engenders ~n ne~ghborhoods ~mmediately
surroundmg campuses may also be an ~mportant
strategy Str~cGy Imvnng hcenses for new outlets and
pliasing out Iicenses of establishments tl~at ~epeaCedly
violate servin~ and marketmg regnlahons are means to
ieducmg aleohol ouCle[s In many comnmmGes, half of
all alcohol outlets regularty v~olate laws aglmst sellmg
or servmg alcohol [o those under tlie legal dnnkmg age
(Forster, Murray, Wolfson, & Wagenaar, t995), and a
recent study revealed three-quarters of outlets v~olate
laws proh~bitmg sales [o patrons who already show s~gns
of obv~ous mtoxicatton (Toomey et al ,(999) Aetive
enforcement of these laws is needed throu~h regular
comphance checks of all alcohol outlets, espec~ally m
colle~e areas wliere sales to nunors and sales to
mtoxicated mfrachons may be panc~ularly pievalent
Sucli enforcement has ~mmediate benefits m reducmg
risky sales pract~ces (Jeffs & Saunders, 1983, Preusser,
Wilhams, & Wemstem, 1994), and may have furtlier
benefits via the revocaC~on of Che hcenaees of particulaely
problem-prone ontlets, and a gradual reduchon m
alcohol outlets m college ne~ghborhoods Res~dents
who suffer the secondhand etCects of lteavy drmkmg
can be enhsted m tli~s eftbrt, nsmg a type of `ne~ghbor-
(iood watch' operation Raismg licensmg fees and
alcohol [~~xes to pay for the preventmn and cle~nup ot
ne~ghborhood disntp[~on should be constdered, espe-
cially smce substanual ma~onties of the US general
populat~on support such poi~cies (Wagenaar, Harwood,
Toomey, Denk, & Z~inder, 2000)
Another noteworthy findmg suggests that (ower
soc~oeconomic conditions around college campuses
H GVech~ler el a! / Socra/ Scrence & Med~mne 55 (2002) 425-435
may contribute to the presenec of aleohol outlets
D~sadvan[aged neighbors may be less able to preven[
[he grantmg of hcenses to sell alcohol Th~s may be part
of a v~c~ous c~rcle Iowe~ soc~oecononuc s[atus near
colleges may result m more alcohol outlets, more alwhol
outlets may lead to more secondliand effects, and more
secondhand cffects may contrtbu[e to decreased real
estate values and st~ll lower SES Eff'orts shonld be
focused on how to d~sconnect tlie v~cious c~rcle
A few cau[~ons are important to cons~der when
mterpretmg data from th~s s[udy Tlie results are based
on a[elephone stirvey, and are sub~ect to the I~m~tations
~nherent m such metliods Persons w~thout telephones
canno[ be pazt of [lie sumple However, m a large sc21e
general population survey w~th adequale coverage <<nd
response rate the results for those who have phones werc
found to no[ ddfer sigmf~cantly from those of [he
popul.itwn ~is .i whole (Aday, 1989) Sample atlnhon
also oecurs hecduse of fadure to obtam and oomplete
mterv~ews with the setected telephone numbers Tlie
response r~tte of 50% may have mlrodnced s~impLng
b~ns However, a comparison of selected demograpliic
char~ctens[ics of the responden[s w~th US census data
mdicated no s~gmficant dilTerences Whde other sources
of 6~as may ex~st, the sample of responden[s mdtches the
charactenshcs of the general populahon
In addition to poss~ble samplmg b~as, selt-reports m1y
mtroduce a whole set oF measurement error components
(Det Boca 3c Noll, 2000) However, such errors are Iikely
to be random, and should not alter the nahire of [lie
relaLOnslups Smce we exammed relat~onships at the
aggregate or ne~ghborhood level, est~mates of 2 college's
heuvy dnnkmg rate or a neighborhood's alcol~ol out(e[s
and level of alcohol-related disruption represent an
avera~e for overall responden[s at that s~te, by which the
potenti~~l measurement errors may be averaged out
In onr study, d~stance from [he nearest college, and
number of alcohol outlets w~thm a ntile of home were
based on respondents' estimates r2ther than phys~cal
measures, and may not exactly re(lect real d~stances and
actu<<I mmiber of outlets However, usmg an admims-
tr~tor survcy developed to obtam mformaGOn on
campus alcoliol poliaes from denns of students or otlier
adm~mstrators, Wechsler, Lee, Kuo and Lee (2000c) also
found a stanstwally sigmficant associat~on of campus
dnnkmg levels w~th adm~mstrators' report of ~tlcohol
outle[s located wrthm a mile of their college These
consistent results usmg reports of d~sYance from nearest
alcoliol ouUet obtamed trom [wo d~fferent types of
respondents seive to valida[e tlie measure Fur[hermoie,
wh~le not re8echng actual miles, respondents may be
repoctmg the number of elcohol outlets wrthm the area
[hat [liey perceived as °Iheir ne~gli6orhood"
One poss~ble source of error tha[ muy no[ be random,
relates to the dnnktng 6eltavror ot respondents It is
poss~ble that respondents who drank more frequently
433
were more aware of the outlets m the~r envvonmenl, and
conld provide morc accurate, and prob~tbly fuller counts
of them Allhongh we mchided quest~ons about
respondents' dnnkmg behavioi, we could no[ wntrol
for th~s factor because of the large nnmber of no answers
[o tlus question (45%) Smce most analyses werc
condncted wrth d~chotomous vanables (no outlet vs
some outlets), the potent~al confoundmg effect of this
fnctor may be mm~mized, thougli not fully discounted
Another I~m~tat~on m mterpretmg tlie resnlts of the
study ~s tlie cross-secUonal des~gn Whde complex and
expens~ve, future studies arc needed to examme thc role
of alcohol outlets m heavy drmkmg on college c~mpuses
wli~ch track changes over tmze m botlt drmkmg rntes
and [he density and prachces of alcohol outle[s The best
opportnmt~es for such stud~es are mos[ Itkcly s~hiahons
m wlucli there aic ma~or changes m law, regulation or
economic condrtions [ltat result m substanhal changes m
alcoliol onUe[s over a rel<ttively short penod of t~me
Contiolled [~me-ser~es shidies (B~glan, Ary, & W2gen-
aaq 2000) of such na[ttral expenments m selec[ wllege
commumties may help furthei our understandmg of the
apparen[ly important role alcohol outlets play m
encouragmg heavy drmkm~; on college c~impuses
Acknowledgements
We gratefully acknowledge the assistance of Ehssa R
We~[~m2n m[he development of [he survey qnestwn-
naire Th~s shidy was supported by the Rober[ Wood
Johnson Founda[ion
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