Not Everyone Benefits Equally from Sunday Alcohol Sales Bans: Socioeconomic Differences in Alcohol Consumption and Alcohol-Attributable Mortality

Abstract

We examined socioeconomic variations in the association of off-premises Sunday alcohol sales bans and alcohol consumption and alcohol-attributable mortality in the United States. We analyzed associations between Sunday sales ban presence and alcohol consumption patterns, allowing for a differential effect by education in fixed-effects regression models using data from the 2000–2019 Behavioral Risk Factor Surveillance System. Mortality data from the National Vital Statistics System (2000–2019) were analyzed in interrupted time-series analysis to test the effect of lifting the Sunday sales ban in Minnesota (07/01/2017) on alcohol-attributable mortality. Regression analysis indicated lower alcohol consumption when Sunday sales bans were in place, with an overall stronger effect on those with high education. The repeal of the Minnesota ban resulted in a significant mortality increase, especially among individuals with high education. While overall effective, off-premises Sunday alcohol sales bans appear inadequate to address socioeconomic inequalities in the alcohol-attributable health burden.