Project 460181

Alcohol is a leading cause of disease and death in Canada, and its impact on Canadians' health and the health care system is increasing. In December 2015, the Government of Ontario began relaxing rules regarding the sale of alcohol by allowing select grocery stores to sell beer, wine, and cider. This policy decision resulted in 450 more stores selling alcohol in Ontario over 5 years (an increase in alcohol stores by 30%). Previous studies have found that individuals in regions with more alcohol stores drink more alcohol and experience greater alcohol-related harms. However, we don't fully understand the direction of this relationship (e.g., do more stores promote higher alcohol consumption or does heavier alcohol consumption attract more stores?). Further, no study has examined if the relationship between more alcohol stores and health outcomes differs for specific populations such as between men and women and younger and older adults. In this study, we will determine how adding alcohol sales in grocery stores impacted the health of Ontarians. We will link detailed data on Ontario's alcohol retail landscape over 8 years to Ontario's health records which capture health care visits due to alcohol (emergency department, hospitalizations, primary care). The sequential roll-out of grocery store alcohol sales allows us to observe the effect of this experiment at multiple time points, reducing the likelihood that any observed impacts are due to chance. Also, since not all grocery stores began selling alcohol, we can compare changes in health outcomes for individuals living close to grocery stores that began selling alcohol to those living close to grocery stores that did not sell alcohol. Our research fills a critical knowledge gap concerning alcohol policies in Canada and internationally. We will collaborate with health care providers, communities and officials at all government levels to develop evidence-informed policy recommendations to reduce alcohol harm.