Investigating the impacts of alcohol outlet zoning policy on alcohol consumption and access to non-alcoholic services: A spatial agent-based simulation.

Debates continue over the effectiveness of limiting alcohol outlet density in reducing alcohol consumption, and its broader impacts on access to non-alcoholic services in low-income urban communities remain underexplored. This study addresses this gap by investigating the impacts of alcohol outlet zoning policies on alcohol consumption and walkable access to non-alcoholic services in low-income urban communities with different baseline densities of liquor and grocery stores. We developed a spatial agent-based model of Baltimore City neighborhoods, simulating the closure of non-conforming liquor stores following the city's zoning code rewrite. The model was calibrated using national survey data and empirical research on alcohol consumption and walkable access to alcohol, food, lottery, and ATM outlets by subgroups. We observed non-linear relationships and differences by gender and employment status in the effects of liquor store closures on heavy drinking, with policies showing limited effectiveness in neighborhoods with high baseline liquor store density. While the policies had minimal impact on access to food and ATMs due to high prevalence of grocery stores, they reduced access to lottery services. Our modeling approach serves as a valuable decision-making tool for policymakers to explore hypothetical scenarios, identify tipping points of policy impacts, and provide actionable insights into the complex interactions between zoning policies and neighborhood dynamics concerning alcohol consumption and access to essential goods and services.