Up for Debate: Regulating Alcohol Density in Madison

In my day job, I work to ensure every person in Wisconsin has the healthiest possible conditions in which to live, free from chronic disease. Cancer, in particular, is personal for me, having lost my father to pancreatic cancer two days before my 15th birthday. The causes of cancer are myriad; smoking is the top cause, but physical inactivity, poor diet, and alcohol use – yes alcohol – are also key risk factors. And as I continue to learn more about the impacts of alcohol on our community, I wanted to investigate opportunities to temper its negative effects.

A couple of years ago I was tasked with editing and compiling Wisconsin’s State Health Assessment. I was saddened to learn that Wisconsin leads the country in binge drinking, and found that alcohol density – the number of alcohol outlets per population – has a large impact on not only binge drinking, but also impaired driving, violence, and underage consumption. As a policy maker, one of the key elements of my charge is to work to protect the health, safety, and welfare of our community. Regulating alcohol density is an evidence-based approach to reducing harm, which is why I decided to investigate the possibility of a new alcohol density ordinance for Madison.

Regulating alcohol density in Madison isn’t new. In 2007, Madison implemented an alcohol license density ordinance for the downtown area, restricting any new licenses for bars, taverns, and liquor stores, but continuing to allow additional restaurants with alcohol licenses. The context of this was re-examined in 2014, and again in 2019, with a comprehensive report from Public Health Madison Dane County, which showed higher alcohol density results in higher calls for service for police, and for City building inspectors responding to concerns about the condition of buildings and grounds in these areas. This means that in areas with higher alcohol density, the city has to spend more on city services to those areas. How much more? In low alcohol density areas, the study team found police and building inspection services cost $13M, while in the highest density areas, costs were more than doubled, to $28M.

So, my colleagues and I decided to try to tackle the issue of alcohol density across all of Madison. The first attempt was to concentrate on Class A licenses (think of A=away, B=bar), as there is no control of who is consuming the alcohol off-site once it’s purchased, unlike in Class B establishments, where there are supposed to be trained servers identifying whether someone is underage or already inebriated, and therefore declining to serve them. But the Alcohol Licensing and Review Committee (ALRC) had concerns about the first version inhibiting too many future businesses, so we were willing to compromise, and developed a second, and then a third version of the ordinance. Of note, the third version was crafted in consultation with Alder Verveer, who has served on the ALRC for nearly his entire 30-year service on the Madison Common Council, and is therefore one of the most experienced in our community in regards to alcohol licensing issues.

This third version of the proposed ordinance represents a subtle, but important change from our current ordinance: Currently, new Class A and B licenses aren’t to be granted within 300 feet (the length of a football field) from schools, hospitals, places of worship, and libraries, unless they are a restaurant. The new proposal adds two additional sensitive sites--treatment centers and sites primarily serving people experiencing homelessness--and adds a license-to-license distance, meaning if there is an existing Class A or B license, there can’t be a new one placed within 300 feet, unless it is a restaurant. And, the ordinance adds an important caveat to the prohibition: as long as the Council explains why they wish to allow the license within 300 feet of one of these other uses, the prohibition can be waived. But the ALRC still raised concerns, which I will address point by point:

Argument 1) This is a solution in search of a problem.

Image credit: Public Health Madison Dane County

The map above shows the number of traffic incidents involving impaired driving just over the last 18 months. What’s important to recognize is that each of these dots represents a person. A person who was injured (orange, yellow, and blue dots) or killed (red dots) as a result of another person ingesting alcohol, and then deciding to drive afterwards. I do not understand how anyone could view this map and not recognize that Madison, we have a problem.

Recently, Public Health Madison Dane County (PHMDC) released a report on the burden of alcohol in Dane County. They showed the rate of deaths with alcohol as a contributing factor almost doubled in the last decade:

Image credit: Public Health Madison Dane County

PHMDC also showed nearly 1 in 5 deaths among adults aged 30-59 were alcohol related. But, these are just the data that are easier to compile. We don’t have great data on how many instances of domestic violence encountered by the Madison Police Department (MPD) involved alcohol. And while Focused Interruption, Madison’s leading violence prevention organization, explicitly called out the connection between alcohol use and firearm injury and death, we also don’t have robust local data on how many instances of gun violence involved alcohol. So, it’s clear the map and graph above are a gross underestimation of the harms caused by the abuse of alcohol in our community.

Argument 2) This ordinance is inherently discriminatory based on:

• Race. Some Alders have suggested that this ordinance could disenfranchise BIPOC businesses. By implementing the ordinance city-wide, it is inherently equitable across the entire city, which is confirmed by the Race, Equity, and Social Justice (RESJ) analysis of a previous version of this proposed ordinance. This argument also discounts the historical practices of tobacco and alcohol retailers specifically targeting BIPOC communities to hook them on their products so they would be long-term consumers.
• Disability. There have been arguments that 300 feet between alcohol licensees, and between licensees and the sensitive sites defined in the proposed ordinance (which an able-bodied person can walk in a minute and a half), disenfranchises the people who need assistance to traverse our city. Since this proposed ordinance only applies to new alcohol licenses, it cannot increase the distance anyone, regardless of ability, must travel to access alcohol from today’s existing licensed establishments.
• People experiencing homelessness. Part of the proposed ordinance calls for adding sites that primarily serve people experiencing homelessness as a sensitive site to keep a license 300 feet away from. Why were these sites added? Because data show that approximately 2 in 5 people experiencing homelessness has an alcohol use disorder. That’s compared to about 1 in 10 in the general population. Therefore, trying to reduce easy access to alcohol use in this population is a logical approach to harm reduction. When people live in “food swamps” – areas with high density of fast food, ice cream, etc. – do we blame the people who live there for higher than average rates of diabetes and hypertension? Or do we work to change zoning, and bring in healthy retail to provide alternative options in their environment? The latter is the evidence-based public health approach. It should be the same for alcohol.

Argument 3) We don’t want to inhibit individual use of a legal product.

In general, we want people to be able to make choices for themselves. But for products that carry harm, like alcohol and tobacco, we have higher levels of restrictions, including the age of ability to purchase the product, higher taxes, and restrictions on place of use (no smoking indoors, where others can be harmed by secondhand smoke; no open alcohol containers in public spaces). It’s important that we recognize alcohol is a product whose use creates negative consequences for the user and those who choose not to drink, including through impaired driving and violence. This proposed ordinance is a small step towards reducing the negative impacts of alcohol use.

Argument 4) The Alcohol Licensing and Review Committee (ALRC) is already an effective vehicle to review each license.

The ALRC does review each license that comes forward in the city. But we have to recognize the limitations of a non-expert panel of individuals making decisions, often with incomplete information. ALRC relies on the expertise of the MPD, which does background checks on the person applying for a license and provides general information about calls for service to the area. But that information is necessarily subjective, as the information relies on calls being made in the first place. And the neighborhood association, if one exists, can weigh in on an application, as can the Alder for the district, but these too are subjective, and dependent on the amount of public engagement in the area. When a new license is proposed, the Clerk’s office provides a cursory map of the surrounding few blocks showing only other license sites – it doesn’t differentiate between Class A and B licenses, doesn’t show other sites, like libraries, schools, hospitals, and houses of worship -- which are already supposed to be 300 feet from any license -- and doesn’t even show the names of the other licensed establishments on the map. This is an issue that can be fixed, and I will work with my colleagues to do so. But this is the context in which the ALRC has made decisions in the past and forwarded its resulting recommendations to the Common Council.

In general, the ALRC seeks to safeguard business interests. There is currently no seat on the ALRC for a representative of the Board of Health, and no guarantee that an Alder or resident member will have any knowledge of or interest in alcohol policy. The committee often asks questions in relation to hours of operation, amount of food served, security, etc. But there are not generally questions related to how they will prevent youth access to alcohol off premises, or how they will ensure people are not overserved. Recently, the Council faced a situation in which the ALRC recommended non-renewal, as opposed to revocation, of an establishment six months after an unlicensed bartender overserved that establishment’s unlicensed bar manager and then allowed said bar manager to get into a car. The bar manager crashed, and the crash killed a passenger in another car. The Council voted unanimously not to renew the license, but the licensee has the right to come back to the ALRC to request a new license without a time limit.

Real lives, real stories

Because I know that stories drive people more than data and statistics, I’ll share one of my own. We had a family living a few doors down from us: a mom, dad, and their son. The mom was a professor at the UW. The family seemed happy, with the son often playing outside with other neighbor kids. But at some point, we realized the dad and son had moved out. Seeing the dad elsewhere, we asked what was happening. He relayed that the mom had recently lost her father, and had turned to alcohol for solace. He had left her and gained custody of their son. Not long after that, I saw the mom walking down the sidewalk, weaving, in the middle of the day. Was she coming back from the bar that’s four blocks away? Or did she just pick up additional alcohol at the liquor store three blocks away, or the gas station that’s two blocks in the other direction? Would she have imbibed that much if we didn’t have such easy access to alcohol within just a few blocks? After losing her job, she did get treatment, and stayed sober. But she had done so much damage to her liver, she died. She was 53.

I can’t say an ordinance like this would have saved my neighbor, but I can say it’s a first step. My hope is that by sharing my thoughts and goals on alcohol density more people will understand the needs of our community and call on other elected officials to ensure the safety and well-being for all of us. If not this, then what? If not now, then when?