‘The opportunity to have their say’? Identifying mechanisms of community engagement in local alcohol decision-making

Background:Engaging the community in decisions-making is recognised as important for improving public health, and isrecommended in global alcohol strategies, and in national policies on controlling alcohol availability. Yetthere is little understanding of how to engage communities to influence decision-making to help reducealcohol-related harms. We sought to identify and understand mechanisms of community engagement indecision-making concerning the local alcohol environment in England.Methods:We conducted case studies in three local government areas in England in 2018, purposively selected forexamples of community engagement in decisions affecting the local alcohol environment. We conducted 20semi-structured interviews with residents, workers, local politicians and local government practitioners, andanalysed documents linked to engagement and alcohol decision-making.Results:Four rationales for engaging the community in decision-making affecting the alcohol environment wereidentified: i) as part of statutory decision-making processes; ii) to develop new policies; iii) as representationon committees; and iv) occurring through relationship building. Many of the examples related to alcohollicensing processes, but also local economy and community safety decision-making. The impact ofcommunity inputs on decisions was often not clear, but there were a few instances of engagementinfluencing the process and outcome of decision-making relating to the alcohol environment.Conclusions:While influencing statutory licensing decision-making is challenging, community experiences of alcoholrelated harms can be valuable ‘evidence’ to support new licensing policies. Informal relationship-buildingbetween communities and local government is also beneficial for sharing information about alcohol-related harms and to facilitate future engagement. However, care must be taken to balance the different interestsamong diverse community actors relating to the local alcohol environment, and extra support is needed forthose with least capacity to engage but who face more burden of alcohol-related harms, to avoidcompounding existing inequalities