Firearm Violence and Off-Premises Alcohol Outlets: The Role of Outlet Characteristics and Distance

Firearm violence is a leading cause of morbidity and mortality among young men in the US. While an association of alcohol availability with violence is well established, the mechanisms through which it operates are unclear, and the role of alcohol availability in firearm violence specifically is less often studied. In this study we examined the effects of off-premises alcohol outlet characteristics on firearm violence in their immediate environs in Milwaukee, Wisconsin. Firearm violence was 1.5-3 times higher in areas near off-premises retail alcohol outlets, with levels on the higher end of the range when outlets possessed certain characteristics, specifically graffiti, greater foot traffic, loitering, or younger clientele. Examining alcohol outlet characteristics provides insight into mechanisms driving the alcohol-violence association and may aid in harm reduction.