Risky Business: An Exploration Of Alcohol Risk Environments Surrounding Military Installations in the United States

Statement of the Problem: Approximately 33% of U.S. military personnel (defined here as active duty members in any service of the military) across the four services of the Department of Defense (DoD) (Navy, Army, Marines and Air Force) are heavy drinkers (defined as consumption of more than 14 drinks per week for men, and more than 7 drinks per week for women in the past twelve months). Increased alcohol misuse in the military negatively affects readiness and safety, thereby posing both a public health problem and a threat to national security. The goal of this dissertation is to build on experiences with interventions in drinking environments surrounding college campuses to analyze and suggest interventions in alcohol environments surrounding military installations. Methods: Literature review of articles on alcohol use and related harms in colleges and the military, using Goffman’s theory of total institutions as a conceptual framework; analysis of the alcohol outlet density per 1,000 individuals within five miles of military installations in eight U.S. states using ArcGIS; and environmental scans of on- and off-sale alcohol establishments near 12 military installations using scoring of environmental risk based on three of the four P’s of marketing: promotion, product, and price. Results: Alcohol environments surrounding military installations have sufficient similarities to those surrounding college campuses, and patterns of drinking in the two populations are of sufficient high risk to warrant exploration of environmental interventions that have been effective in college settings in military settings as well. Alcohol outlet densities for some installations increase with proximity to the installation, and may occur at higher rates than densities around college campuses. Environmental scans suggest that level of risk in commercial establishments near military installations varies, and risk scoring can point to specific interventions. Conclusions: Military drinking occurs at high levels and is likely to be affected by drinking environments near military installations. This dissertation sheds new light on these previously under-studied environments, and points to the need for further research into outcomes of high levels of outlet density as well as effective interventions in these environments