Liquor outlet density, deprivation and implications for foetal alcohol syndrome prevention in the Bergriver municipality in the Western Cape, South Africa

Foetal alcohol syndrome (FAS) is the most common preventable birth defect in the world, and some South African communities have amongst the highest reported rates. In August 2008, global positioning systems and geographic information systems (GIS) were used to collect data on legal and illegal alcohol outlets in the Bergriver municipality. A total of 112 outlets were recorded and towns with the densest distributions (outlet/km2) were Piketberg and Eendekuil. Spearman coefficients were used to estimate the relationship between alcohol outlet distributions within the study area and the South African Index of Multiple Deprivation. Although not statistically significant, the data are suggestive of an inverse relationship between legal alcohol outlets and deprivation less deprived areas had higher density of legal alcohol outlets while the opposite relationship applied for illegal alcohol outlets. GIS provides spatial documentation of determinants of FAS risks amenable to geographically based prevention strategies, as well as providing baseline data to evaluate the effectiveness of liquor legislation aimed at controlling access to alcohol. Results are being repurposed into health education materials that encourage community action to address the social determinants of health outcomes such as FAS.