Spatially Varying Associations of Neighborhood Disadvantage with Alcohol and Tobacco Retail Outlet Rates.
Abstract
More than 30% of cancer related deaths are related to tobacco or alcohol use. Controlling
and restricting access to these cancer-causing products, especially in communities
where there is a high prevalence of other cancer risk factors, has the potential to
improve population health and reduce the risk of specific cancers associated with
these substances in more vulnerable population subgroups. One policy-driven method
of reducing access to these cancer-causing substances is to regulate where these products
are sold through the placement and density of businesses selling tobacco and alcohol.
Previous work has found significant positive associations between tobacco, alcohol,
and tobacco and alcohol retail outlets (TRO, ARO, TARO) and a neighborhood disadvantage
index (NDI) using Bayesian shared component index modeling, where NDI associations
differed across outlet types and relative risks varied by population density (e.g.,
rural, suburban, urban). In this paper, we used a novel Bayesian index model with
spatially varying effects to explore spatial nonstationarity in NDI effects for TROs,
AROs, and TAROs across census tracts in North Carolina. The results revealed substantial
variation in NDI effects that varied by outlet type. However, all outlet types had
strong positive effects in one coastal area. The most important variables in the NDI
were percent renters, Black racial segregation, and the percentage of homes built
before 1940. Overall, more disadvantaged areas experienced a greater neighborhood
burden of outlets selling one or both of alcohol and tobacco.
Type
Journal articleSubject
TobaccoBayes Theorem
Residence Characteristics
Commerce
Tobacco Products
Neighborhood Characteristics
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https://hdl.handle.net/10161/25552Published Version (Please cite this version)
10.3390/ijerph19095244Publication Info
Wheeler, David C; Boyle, Joseph; Barsell, D Jeremy; Glasgow, Trevin; McClernon, F
Joseph; Oliver, Jason A; & Fuemmeler, Bernard F (2022). Spatially Varying Associations of Neighborhood Disadvantage with Alcohol and Tobacco
Retail Outlet Rates. International journal of environmental research and public health, 19(9). pp. 5244. 10.3390/ijerph19095244. Retrieved from https://hdl.handle.net/10161/25552.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
F Joseph McClernon
Professor in Psychiatry and Behavioral Sciences
Joseph McClernon, Ph.D., is a professor in the Department of Psychiatry and Behavioral
Sciences and founder/director of the Center for Addiction Science and Technology (CfAST).
In his four years with the Duke Clinical and Translational Science Institute (CTSI)
he has served as director of the Evaluation and Strategic Planning core, interim co-director
of the Team Science core, and director of the Integration and Strategic Partnerships
pillar. During his tenure with CTSI, his leadership has be

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