Researchers at the University of Sheffield examined data on more than 1m alcohol-linked hospital admissions from the past 12 years.
Localities with the most pubs, bars and nightclubs had a 13% higher hospital admission rate for short-term conditions caused by alcohol, in comparison to places with a lower density.
The admissions rate for alcohol-related chronic conditions such as liver disease was 22% higher in areas saturated with drinking outlets.
On and off-trade outlets
In addition to on-trade outlets, the study analysed outlets where alcohol is bought to drink elsewhere.
A high density of shops selling alcohol was paired with 10% higher admission rates for acute conditions and 7% for chronic conditions, compared to areas with the lowest density of convenience stores.
Density was measured as the number of alcohol retail outlets within a 1km limit of the centre of every residential postcode in England, and divided into four categories of density.
Researchers adjusted their analysis for other factors that could have influenced associations, including differences in age, socio-economic deprivation and hospital admission policies in different areas.
The study from the University’s School of Health and Related Research (ScHARR) is the largest of its kind in the world.
University of Sheffield professor of epidemiology and public health Ravi Maheswaran said: “The strongest link was between pubs, bars and nightclubs and admissions for alcoholic liver disease.
“We also observed an association between restaurants licensed to sell alcohol and hospital admissions, which we had not expected. This needs further investigation to establish if there is a causal link.
“While convenience stores were clearly associated with hospital admissions, the association for supermarkets was modest, as we had expected. Supermarkets account for a significant proportion of alcohol sales, however, they tend to serve large catchment areas while our study was set up to examine the effects of outlet density in small local areas.”
“Although we have observed clear associations between alcohol outlet densities and hospital admissions, our study cannot confirm if these associations are causally linked,” he said.
The Portman Group, an advocacy organisation for responsible drinking, said local partnerships have helped to tackle harm.
John Timothy, chief executive for the Portman Group, said: "The study indicates that the relationship between licensing density and alcohol harm isn’t simple and requires more research, particularly into changes in density over time.
"Official Government statistics clearly demonstrate significant regional variations of alcohol harm, amidst an improving national picture.
"Based on this, the industry has developed strong local partnerships to tackle these harms at local levels and promote vibrant, diverse night-time economies."
The research was funded by Alcohol Research UK, a charity aiming to reduce alcohol-related harm.
Alcohol Research UK director of research and policy development Dr James Nicholls urged local licensing authorities to factor the findings into decisions about the availability of alcohol in an area.
He said: “We often hear that no individual outlet can be held responsible for increased hospital admissions and, because of this, licensing teams can’t plan on that basis. However, this study adds weight to the argument that licensing needs to also think about the overall level of availability in a given area.
“As the evidence on the relationship between availability and harm becomes stronger, those tasked with regulating the market need to respond."