Geographical variation in alcohol access, risk and harms in selected Australian states

Future analyses and data sources

In this report, the measures on access are presented for SA2 by Capital city areas and Non-capital city areas to address some of the differences in how close and how many alcohol outlets there are in cities compared with other areas.

However, it is well established that some population groups (such as people living in rural and remote areas) are more likely to drink at risky levels (AIHW 2024). While this work did not compare across different population groups, future work could expand upon this analysis to better understand the impact of alcohol outlet locations on different population groups, by age, sex, remoteness areas and Socio-Economic Index For Areas (SEIFA) (ABS 2021).

This work was based off a method developed by the Centres for Disease Control and Prevention (CDC 2017) which uses road network analysis to a population weighted centroid, rather than individual addresses, to approximate the distance to closest alcohol outlet. Australia is a less densely populated country than the United States of America, and therefore this method may not be as applicable in more remote parts of Australia when a small number of people are spread widely across hundreds of kilometres. Future work could be done to further understand the use population weighted centroids in Australian research, particularly in the non-urban areas of Australia.

This report has considered local context, where possible. When looking at or comparing specific areas, it is important to establish whether there are factors specific to both the location (for example, is it a tourist destination or a remote area) and the population (for example, age structure) in areas and the specific alcohol-related risks and harms being considered (CDC 2017).

To help to answer important policy relevant questions, there are many other data sources on alcohol-related risks and harms that could be considered for future work using a similar methodology.

As demonstrated in the use-case with the NDSHS 2019, measures of access can be analysed in conjunction with other data sources to explore alcohol outlet locations and risky drinking or other harms like alcohol-related injuries from hospital and emergency department data.

Similar analyses could also be used to assess the relationship between other outlet types and health harms such as gambling outlets and mental health, or tobacco/e-cigarette outlets and smoking or vaping behaviours.

Data availability

The data used in this report were not all available for the same time period. Data on alcohol outlet locations were for the end of 2018 for all states except SA, which was only able to provide data for 2021. Historical data was not available for the ACT or NT. In future work it would be ideal to have data for all jurisdictions and for the same year.

Estimates of population

This work uses population data from the 2016 ABS Census, while data for alcohol outlets are for 2018 (or 2021 for SA) and the data on risk and harms are for 2019. This may result in some underestimates of the population being serviced by the alcohol outlets in areas with high population growth, such as new housing estates.

People do not stay in the same place all the time; they also travel to places of work and leisure. Relating alcohol outlets to areas where people live may be a poor indicator of individual access to alcohol and subsequent harms, as a person may visit licensed liquor outlets near their places of work or leisure (Holmes et al. 2014; Raza et al. 2023). These individual level exposures are not accounted for in this analysis.

Delivery alcohol services

The way Australians access alcohol is changing with the rise of online purchasing and delivery services. These platforms make it easier access to alcohol for many Australians (Colbert et al. 2020a; Holmes et al. 2014).

Delivery services challenge existing legislation that was written for traditional licensed alcohol outlets. For example, by offering 24-hour shopping, same day delivery and limited checks at point of delivery for age and intoxication levels (Duthie et al. 2023). In NSW, since 1 July 2021, there have been new measures to address same day alcohol delivery services to limit the hours in which they can operate, include the same identity, age and intoxication checks on delivery and also require providers to report to Liquor & Gaming NSW every six months, the volume of packaged alcohol delivered as same day deliveries by postcode (Liquor & Gaming NSW 2021).

This report has not accounted for access to alcohol through these platforms and services as it is a different way to access alcohol than the licensed alcohol outlets with physical addresses described in this study. As the more widespread use of delivery services did not occur until 2020 (Colbert et al. 2020b) and this report focuses on licensed alcohol outlets in 2018 (except for SA which is for 2021), this will have had a limited impact on the findings of this report.

COVID-19

During the COVID-19 pandemic liquor licensing restrictions were relaxed in many Australian states and territories (Colbert et al. 2020b). Licensing conditions changed variably around Australia, for instance, in New South Wales and South Australia licensed premises that under normal conditions were unable to supply alcohol for consumption off-site were permitted to provide alcoholic products for take away and delivery (Colbert et al. 2020b). While the data used in this study predate the COVID-19 pandemic, these changes could affect future research similar to what has been presented in this report looking at alcohol outlet locations and alcohol-related risks and harms.