Spatially Varying Associations of Neighborhood Disadvantage with Alcohol and Tobacco Retail Outlet Rates.

dc.contributor.author

Wheeler, David C

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Boyle, Joseph

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Barsell, D Jeremy

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Glasgow, Trevin

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McClernon, F Joseph

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Oliver, Jason A

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Fuemmeler, Bernard F

dc.date.accessioned

2022-08-01T17:33:08Z

dc.date.available

2022-08-01T17:33:08Z

dc.date.issued

2022-04-26

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2022-08-01T17:33:06Z

dc.description.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.

dc.identifier

ijerph19095244

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1661-7827

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1660-4601

dc.identifier.uri

https://hdl.handle.net/10161/25552

dc.language

eng

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MDPI AG

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International journal of environmental research and public health

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10.3390/ijerph19095244

dc.subject

Tobacco

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Bayes Theorem

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Residence Characteristics

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Commerce

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Tobacco Products

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Neighborhood Characteristics

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Spatially Varying Associations of Neighborhood Disadvantage with Alcohol and Tobacco Retail Outlet Rates.

dc.type

Journal article

duke.contributor.orcid

McClernon, F Joseph|0000-0002-2846-980X

pubs.begin-page

5244

pubs.issue

9

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

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Institutes and Centers

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Psychiatry & Behavioral Sciences

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Duke Cancer Institute

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Institutes and Provost's Academic Units

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University Institutes and Centers

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Duke Institute for Brain Sciences

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Duke-UNC Center for Brain Imaging and Analysis

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Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

pubs.publication-status

Published

pubs.volume

19

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