Environmental characteristics of hotspots of alcohol-related health incidents outside of the entertainment districts of Amsterdam

While hotspots of alcohol-related incidents have been associated with alcohol outlet density, few studies have considered other environmental factors. We aimed to characterise the environment of hotspots outside of outlet density areas in Amsterdam. Using geographical information systems, we identified hotspots of alcohol-related health incidents outside of outlet density areas based on the registry of alcohol related ambulance attendances. While quantitative data and methods were used to analyse victim profiles (including age, sex and home address) and temporal profiles (time of incident), we combined quantitative and qualitative information to develop environmental profiles of these hotspots. We identified 11 hotspots with 242 incidents outside outlet density areas. Results indicate substantial differences between incidents in these hotspots and incidents in high outlet density areas. Victims in these hotspots are older, more often male and live closer to the incident location compared to victims in high outlet density hotspots. Incidents are less likely to take place during the night and at weekends. In-depth analysis of four hotspots showed different combinations of contributing environmental factors, including (a) public parks bordering deprived neighbourhoods, (b) dance event facilities close to a traffic black spot, and (c) residential services for disadvantaged groups near ‘hang-outs’. The study shows that hotspots of alcohol-related incidents can arise outside outlet density areas at locations where several other environmental factors cluster, particularly in more deprived areas. Such hotspots can be addressed in urban planning and urban design.