and summarized for application to the measurement of alcohol outlet density by CDC. Three approaches have been reviewed by Zhang et al. Quantifying spatial accessibility in public health practice is essential for evaluating population exposure to local environments (e.g., alcohol and tobacco outlets or public parks) and population access to health care resources (e.g., primary care clinics or trauma hospitals). This study demonstrates a flexible and robust method that can be applied or modified to quantify spatial accessibility to public resources such as healthy food stores, medical care providers, and parks and greenspaces, as well as, quantify spatial exposure to local adverse environments such as tobacco stores and fast food restaurants. These results can be used to assess the relationship between geographic access to on-premise alcohol outlets and health outcomes. Sensitivity analysis demonstrated that population weighted accessibility measures were more sensitive to excessive drinking outcomes than were population weighted distance measures. The population-weighted spatial accessibility indexes were highly correlated to respective population-weighted distance measures. At the county level, population-weighted driving times and distances exhibited significant geographic variations, and averages for both measures increased by the degree of county rurality. Population-weighted driving distances ranged from 0.67 miles (DC) to 7.91 miles (Arkansas). At the state level, population-weighted driving times ranged from 1.67 min (DC) to 15.29 min (Arizona). The national average population-weighted driving time to the nearest 7 on-premise alcohol outlets was 5.89 min, and the average population-weighted driving distance was 2.63 miles. A multilevel model-based sensitivity analysis was conducted to evaluate the associations between different on-premise alcohol outlet accessibility measures and excessive drinking outcomes. We then calculated spatial access-based measures, specifically a population-weighted spatial accessibility index and population-weighted distances (Euclidean distance, driving distance, and driving time) to alcohol outlets at the census tract, county, and state levels. Using network analysis in a geographic information system, we computed distance-based measures (Euclidean distance, driving distance, and driving time) to on-premise alcohol outlets for the entire U.S.

To assess spatial accessibility measures to on-premise alcohol outlets at census block, census tract, county, and state levels for the United States.

Sas geodist function