What do place and the built environment have to do with alcohol and drug addictions? According to Debra Furr-Holden, Ph.D., quite a bit. Behavioral and mental health studies have shown that environmental risk is a predictor of behavior in highly disordered environments. In fact, it may be a stronger predictor of risky behavior, including alcohol and drug use and violence, than individual-level risk factors.

What do place and the built environment have to do with addiction? According to @cdmholden quite a bit

Furr-Holden, a drug and alcohol dependence epidemiologist, studies how the environment shapes health and how interventions that address the built and social environment can promote health. She also studies the measurement of drug and alcohol use disorders; environmental approaches for the prevention of violence and alcohol and drug abuse; the social effects of incarceration; and behavioral health inequalities. She has worked with local and national policy makers to improve data driven decision-making. In her upcoming Office of Behavioral and Social Sciences Research (OBSSR) talk, “Using a Health Equity Model to Promote Environmental Approaches to Violence, Alcohol and Other Drug Prevention,” she will provide specific examples of how innovative methods and policy-relevant approaches can be used to minimize environmental risk. Additionally, she will speak about recent efforts to reduce the density of alcohol outlets and expand behavioral health services in Baltimore.

Innovative research and intervention methods and policy-relevant approaches can minimize environmental risk

The Environmental Influences on Violence

One of Furr-Holden’s recent papers, “Not in My Back Yard: A Comparative Analysis of Crime around Publicly Funded Drug Treatment Centers, Liquor Stores, Convenience Stores, and Corner Stores in One Mid-Atlantic City,” provides an example of how the built environment affects health and behavior.

The “Not in My Backyard” syndrome is characterized by neighborhoods’ resistance to having certain types of initiatives, such as group housing programs or drug treatment centers, in close proximity. Although many people may support such projects in theory, they are often against having them located in their own neighborhoods. They cite noise, traffic, violent crime, decreased property values, and decreased quality of life as reasons. However, there is little empirical evidence to back these claims, especially for drug treatment centers, and some researchers believe public fears are rooted in stigmatization of drug users.

Not in My Backyard syndrome: Neighborhood resistance to nearby group housing programs or drug treatment centers

To provide empirical evidence on whether drug treatment centers are actually associated with increased levels of violence, Furr-Holden and her team compared violent crime around publicly funded drug treatment centers to other commercial businesses, including liquor stores, convenience stores, and corner stores in Baltimore City. They examined quarter mile radiuses around each establishment and defined violent crime to include robbery, aggravated assault, rape, manslaughter, and homicide. The team found that violent crime was highest around liquor stores. According to the paper, crime levels near drug treatment centers were significantly lower than they were near liquor stores and were comparable to crime levels near convenience stores.

Furr-Holden hopes that this research will help communities make informed, data-driven decisions about whether to support such centers and help advocates mitigate strong opposition with evidence as opposed to moral arguments. Her findings on the relatively high levels of violent crime near liquor stores may also have important zoning implications, as strategic zoning could decrease violent crime. In fact, zoning as a method to promote and protect public health has started gaining increased acceptance.

@cdmholden found a one-unit increase in alcohol outlet density related to a 2.2% increase in number of violent crimes

The findings tying liquor stores with violent crimes were presented in another recent paper, “Neighborhood alcohol outlets and the association with violent crime in one mid-Atlantic City: the implications for zoning policy,” in which Furr-Holden specifically examined the relationship between the density of liquor stores and violent crime in Baltimore City. Although local leaders had been willing to support zoning policy aimed at decreasing alcohol outlets (both off- and on-premise outlets) as a measure to reduce violence, they wanted Baltimore-specific estimates for potential positive health impacts. Furr-Holden used historic crime, arrest, and neighborhood demographic data from Baltimore City to model the relationship between alcohol outlet density and violent crimes. She found that for each one-unit increase in alcohol outlet density, there was a 2.2 percent increase in the number of violent crimes.

Overall, Furr-Holden hopes that her research will continue to inform the general public, policymakers, and advocacy groups. Empirically based data will inform public discussion and can ultimately lead to policies to optimize the built environment for better health outcomes for all.

Additional Resources

OBSSR Lecture Series

Debra Furr-Holden Johns Hopkins faculty webpage

Neighborhood alcohol outlets and the association with violent crime in one mid-Atlantic City: the implications for zoning policy

Not in My Back Yard: A Comparative Analysis of Crime Around Publicly Funded Drug Treatment Centers, Liquor Stores, Convenience Stores, and Corner Stores in One Mid-Atlantic City

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