Background: The spatial distribution of alcohol outlets is a key determinant of alcohol availability and related harms. Guided by the Social Determinants of Health framework, this study examines how area-level deprivation and alcohol availability interact to shape inequalities in alcohol-related harm, including within the context of the alcohol harm paradox, by exploring outlet density, distribution, and licence type in the Republic of Ireland.

Methods: Data on liquor licences issued or renewed in 2021–2022 were analysed, and geospatial mapping was conducted using ArcGIS Pro. Outlet density was calculated per 1,000 population based on 2022 Census data. Proximity analysis assessed the proportion of the population living within 300 m of a licensed premises. Negative binomial regression was used to model outlet density, and multinomial regression to examine licence type by area-level deprivation.

Results: Nationally, 75.3% of the population lives within 300 m of a licensed premises. Higher outlet densities were observed in ‘middle income’ areas (marginally above and below average deprivation). Licence type varied strongly by deprivation. Affluent areas had a higher concentration of on-licence premises (i.e. restaurants cafes, hotels), while more deprived areas had relatively more pubs and off-licences.

Conclusions: Alcohol availability in Ireland is widespread, with clear area-based socioeconomic differences. Both outlet density and outlet type are important components of alcohol availability. Availability varies by both volume and type across levels of deprivation, creating distinct alcohol environments. Higher outlet density in disadvantaged areas may contribute to alcohol-related harm and should inform targeted policy responses.