Aims: This paper summarizes several theoretical perspectives that serve to explain observed associations between concentrations of alcohol outlets and alcohol-related problems. A critique of each perspective discusses how each addresses the social etiology of these problems; that is, how, where and why these problems arise in association with alcohol outlets?
Methods: This theoretical work is based upon mathematical and computational models of the ecology of alcohol-related problems developed in the 'Ecosystems Modeling Project', an advanced research project of the National Institute on Alcohol Abuse and Alcoholism, United States.
Results: Associations between outlets and problems are thought to arise from the concentration of individuals in drinking places ('flow models'), the attraction of some places for people at risk for problems ('gravity models'), or because outlets are located in high-risk neighborhoods and have negative social normative effects ('social contextual models'). None of these approaches explain how some outlets come to have more problems than others (e.g. violent outlets). An alternative social ecological model is introduced which asserts that the complementary processes of niche marketing and assortative drinking form the social dynamic that explains these relationships. Alcohol sellers 'niche market' to select social strata, drinkers return to establishments at which they find people like themselves, and consequent social stratification of the market-place increases the levels of related problems in some outlets.
Conclusions: The proposed mechanism is very general, and suggests that over-concentrations of outlets will lead to stratification of drinking groups and intensification of problems related to those outlets.