It is no secret that for decades, tobacco companies have filled disadvantaged communities with advertising and marketing attracting generations of young people of color to the products they peddle. A new report from the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health finds that alcohol companies are taking a page from the tobacco industry's playbook.
Specifically, we found African-American youths ages 12-20 are seeing more advertisements for alcohol in magazines and on TV, compared with all youths ages 12-20. In fact, over the study period, African-American youths saw 32 percent more alcohol advertising than all youths in national magazines, and 17 percent more television advertising, including 20 percent more exposure to distilled spirits advertising. On radio, while black youths heard less alcohol advertising overall, they were exposed to 32 percent more ads for distilled spirits products.
Here in Baltimore, from 2009 through 2011, alcohol advertisers placed an average of 11,000 radio commercials and 1,000 TV commercials per year, at an annual average cost of about $1 million. That's on top of the national TV advertising that surrounds Baltimore's youths — including many ads for hard liquor on cable TV.
The overexposure is a result of two key phenomena. First, many brands are specifically targeting African-American audiences; and second, African-American media habits make that population more vulnerable to alcohol advertising in general because of greater exposure to media.
This increased exposure comes with a huge cost: At least 14 long-term studies have found that the more young people are exposed to alcohol advertising and marketing, the more likely they are to drink, or if they are already drinking, to drink more. Alcohol is already the most widely used drug among African-American youths, and it is associated with violence, motor vehicle crashes and the spread of sexually transmitted diseases. Some factors in the black community are protective against drinking problems, such as generally lower incomes and higher levels of religiosity. However, alcohol advertising exposure is a risk factor pointing in the wrong direction for African-American youths.
The influence of the alcohol industry on young people of color is not limited to ads on television and in magazines they are more likely to watch and read. A study conducted by colleagues at the Bloomberg School found that in Baltimore, liquor stores are disproportionately located in predominantly black census tracts, even after controlling for census tract socioeconomic status. Census tracts that are both low income and predominantly African-American have substantially more liquor stores per capita than other census tracts and have the worst health outcomes and highest mortality rates from homicide.
And as we see with media exposure, the prevalence of liquor stores produces serious consequences. Published data about Baltimore show not only an inequitable distribution of liquor stores in predominantly African-American and low-income communities, but also significant associations between the presence of liquor stores and the risk of health-related problems. Specifically, communities with a greater density of liquor stores have higher levels of drinking, unintentional injuries, crime and violence. And while it's difficult to prove causality because many risk factors overlap, a 2010 study conducted in Washington, D.C., found that community-level liquor outlet density is significantly associated with assaultive violence, independent of other neighborhood factors including violent crime, and the prevalence of weapons and illicit drugs.
The association between alcohol outlet density and the health of underserved communities was front and center earlier this year when Baltimore Health Commissioner Dr. Oxiris Barbot sought to address alcohol outlet location and density by reducing the number of liquor stores in predominantly poor Baltimore neighborhoods. As a result of the city's efforts, dozens of alcohol stores may need to close, move to a location with proper zoning, or stop selling alcohol if they choose to remain in their current location.
Every day in the United States, more than 4,500 kids under age 16 have their first full drink of alcohol. African-Americans who drink report higher levels of alcohol-related social problems — and higher prevalence of alcohol-related deaths and disease, including hypertension and heart disease — compared to the rest of the population.
The alcohol industry is systematically targeting disadvantaged communities through advertising and access, creating an extraordinary public health problem. Despite the well-known negative health consequences, alcohol products and imagery continue to pervade African-American youth culture and communities. Alcohol companies have self-regulatory codes that they claim protect young people from exposure to their advertising. Staff from the Federal Trade Commission, the Institute of Medicine and 24 state attorneys general agree that these codes are not strong enough.
Establishing no-buy lists for consistently youth-oriented programming and requiring a higher percentage of adults in programming where alcohol advertising is placed are two steps the alcohol industry could take today. These initiatives would help us all do a better job of protecting young people — and of safeguarding African-American youths in particular.
David Jernigan (djerniga@jhsph.edu) is director of the Center on Alcohol Marketing and Youth and an associate professor at the Johns Hopkins Bloomberg School of Public Health. Alicia Samuels (alsamuel@jhsph.edu) is director of communications for the Center on Alcohol Marketing and Youth.