Abstract PR003: An examination of tobacco and alcohol outlet density in Boston to identify priority areas for cancer prevention efforts using environmental justice mapping
Authors: Kephart Lindsay 
Published: December 2023

Abstract
Background. Inequitable access to health-harming substances in the built environment can create and exacerbate race and SES-based disparities in cancer incidence and mortality. Availability and density of tobacco and alcohol outlets is associated with increased experimentation, initiation, and regular use of alcohol and tobacco products. Prior studies examining the sale of tobacco and alcohol indicate that these outlets tend to be concentrated in communities of color and low-income areas. Massachusetts has highlighted environmental justice (EJ), one’s right to be protected from hazards and live in clean, health-promoting environments, as a priority issue and identified block group populations who are at most risk of environmental burdens. The objective of this study was to (a) examine the distribution of tobacco and alcohol outlets in environmental justice block groups in Boston, and (b) compare outlet density in more deprived neighborhoods to more privileged neighborhoods. Methods. Publicly available licensing lists for tobacco and alcohol retailers with geocoded data were obtained from the City of Boston’s open data hub. Lists were de-duplicated so that retailers that sell both tobacco and alcohol products were only represented once. The environmental justice block group layer (2020) was downloaded from Mass.gov. EJ block groups meet one or more of the following criteria: ‘high minority’ (&gt;40% non-white population), ‘low-income’, or ‘high English isolation.’ ArcGIS Pro software was used to spatially join retailer data to Boston block groups and calculate tobacco and alcohol outlet density (the number of retailers per 1,000 people). Sociodemographic and cancer mortality data from the Health of Boston Report was used to classify neighborhoods as ‘more privileged’ (Back Bay, Beacon Hill, North End, West End) or ‘more deprived’ (Dorchester, Hyde Park, Mattapan, Roslindale, Roxbury). Results. Of the 560 Boston block groups analyzed, 458 (81.8%) were considered environmental justice block groups with 60% of EJ block groups classified as ‘high minority’. There were 931 retailers that sell tobacco or alcohol products for off-premises consumption in Boston, with 86% of these retailers (n=811) located in EJ block groups. On average, tobacco and alcohol outlet density was greater in EJ block groups compared to non-EJ block groups (2.09 vs 1.25 retailers per 1,000 residents). Nearly half (48%) of environmental justice block groups in Boston are located in the most deprived neighborhoods compared to only 3.7% in the most privileged neighborhoods. Tobacco outlet density is significantly higher in deprived neighborhoods compared to privileged neighborhoods (1.25 vs 0.98, p &lt; 0.01). However, alcohol density is lower in more deprived block groups compared to more privileged ones (0.35 vs 0.74, p &lt; 0.01). Conclusion. Environmental justice mapping can be used as a tool to identify areas where cancer prevention efforts may be enhanced by modifying the built environment to reduce clusters of alcohol and tobacco outlets.
Citation Format: Lindsay Kephart. An examination of tobacco and alcohol outlet density in Boston to identify priority areas for cancer prevention efforts using environmental justice mapping [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR003.