32 33 However, overall evidence remains mixed, 34 35 with several calls in the literature for increased conceptual and theoretical clarity on how availability of food outlets, and within-outlet food options influence diet behaviour.
This paper aims to measure the association between alcohol consumption among adolescents (aged 15) and the availability of alcohol outlets, measured by both proximity, density, and type of outlet, while adjusting for social background (social class and family structure) and investigating gender interactions.
Although underage drinkers more frequently source alcohol from social contacts rather than directly through retail outlets (Hearst et al., 2007; Information Services Division, 2010), both routes may be influenced by the physical availability of alcohol outlets.
Because urban areas are correlated with neighborhood availability of food outlets and individual eating behavior [ 30], population density is taken into account by dividing the number of food outlets per 1000 county residents.
Greater availability of liquor outlets is associated with higher rates of suicide, alcohol-related crash, and alcohol-related crash fatality.
Achieving change requires the availability of suitable outlets for publishing research and information (UNISDR 2015b) and the participation of the full range of stakeholders, including developing countries and in languages other than English.
Therefore, the availability of recreational outlets may be particularly important for African Americans.
A number of rigorous epidemiological studies, however, have found direct associations between neighborhood availability of recreational outlets and overweight.
For African American girls, but not girls from other ethnic groups, neighborhood availability of recreational outlets was associated with onset of breast and pubic hair.
It may also be important to consider whether availability of recreational outlets and physical activity levels interact with African American girls' overweight to influence pubertal onset (e.g., are effects greater for overweight girls?).
