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Sersli S, Gagné T, Shareck M. Social disparities in alcohol consumption among Canadian emerging adults. Health Promot Chronic Dis Prev Can 2023; 43:499-510. [PMID: 38117475 PMCID: PMC10824153 DOI: 10.24095/hpcdp.43.12.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Young adult drinking is a public health priority, but knowledge of socioeconomic status (SES) indicators and alcohol use among emerging adults (EAs; aged 18-29 years) is primarily informed by college samples, populations in their late teens and early twenties and non-Canadian data. We compared the association of three different SES indicators with monthly heavy episodic drinking (HED), less-than-monthly HED, no HED, and no drinking among Canadian EAs. METHODS We pooled the 2015 to 2019 waves of the Canadian Community Health Survey to include participants aged 18 to 29 years (n = 29 598). Using multinomial regression, we calculated weighted estimates of alcohol use by education, household income and area-level disadvantage, adjusting for adult roles and sociodemographic characteristics. RESULTS Approximately 30% of EAs engaged in monthly HED, whereas 16% did not drink at all in the past year. Compared to those in the lowest household incomes, being in the top income quintile was significantly associated with increased relative odds of monthly HED (e.g. in combined SES model, RRR = 1.21, 95% CI: 1.04-1.39). Higher levels of education, being in higher income quintiles and living in less disadvantaged areas were significantly associated with reduced relative odds of no HED and not drinking. Adjusting for adult roles did not substantially change the associations between SES and alcohol use. CONCLUSION Higher SES was associated with HED among EAs, although the magnitude of association was small. Universal prevention measures addressing the affordability, availability and marketing of alcohol could be complemented by interventions targeting EA populations at higher risk of HED.
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Affiliation(s)
- Stephanie Sersli
- Faculté de médecine et des sciences de la santé, Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke, Quebec, Canada
| | - Thierry Gagné
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
- International Centre for Lifecourse Studies in Society and Health, London, United Kingdom
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
| | - Martine Shareck
- Faculté de médecine et des sciences de la santé, Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke, Quebec, Canada
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Tolstrup JS, Kruckow S, Becker U, Andersen O, Sawyer SM, Katikireddi SV, Møller SP. Socioeconomic inequalities in alcohol-related harm in adolescents: a prospective cohort study of 68,299 Danish 15-19-year-olds. EClinicalMedicine 2023; 62:102129. [PMID: 37576460 PMCID: PMC10415833 DOI: 10.1016/j.eclinm.2023.102129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/27/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Abstract
Background Evidence shows that similar levels of alcohol consumption lead to greater harm in adults with low socioeconomic position (SEP) compared to high SEP. We investigated if SEP is associated with alcohol-related hospital contacts in adolescents, and whether differences in risk can be explained by differences in levels of alcohol consumption, drinking pattern, and substance use. Methods This is a prospective cohort study of 68,299 participants aged 15-19 years old from the Danish National Youth Cohort 2014. SEP was operationalised as parent educational level, family income and perceived financial strain in the family. Data were linked to national registers and participants were followed up for five years from 2014 to 2019. Outcomes were hospital contacts due to alcohol. Multilevel Poisson regression was used to estimate incidence rates (IR) and incidence rate ratios (IRR). Findings During 280,010 person years of follow-up, 872 participants had an alcohol-attributable hospital contact; intoxications (n = 778, 89%) were the most common diagnosis. Low as compared to high SEP was associated with higher IRR of alcohol-attributable hospital contacts for all three SEP measures. The adjusted IRR of harm was 1.73 (95% CI: 1.29-2.33) for elementary school as the highest parent education compared to longer parent education and 1.57 (95% CI: 1.30-1.89) for family financial strain compared to those without financial strain. Adjustment for weekly alcohol intake, drinking pattern and substance use did not substantially change results. Cubic spline analysis of the association between family income and alcohol-attributable hospital contacts revealed a dose-response relationship with decreasing risk of alcohol-related harm with higher income. Interpretation Our findings suggested that alcohol-related harm is more common in socioeconomically disadvantaged adolescents despite similar levels of alcohol consumption, regardless of differences in drinking pattern or substance use. Future preventive strategies should prioritise young adolescents, including those who are most disadvantaged. Funding Tryg Foundation (ID: 153539).
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Affiliation(s)
- Janne S. Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sofie Kruckow
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Susan M. Sawyer
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Srinivasa Vittal Katikireddi
- Medical Research Council (MRC)/Chief Scientist Office (CSO) Social & Public Health Sciences Unit, University of Glasgow, UK
| | - Sanne Pagh Møller
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Zhen-Duan J, Colombo D, Cruz-Gonzalez MA, Hoyos M, Alvarez K. Adverse childhood experiences and alcohol use and misuse: Testing the impact of traditional and expanded adverse childhood experiences among racially/ethnically diverse youth transitioning into adulthood. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:S55-S64. [PMID: 37476532 PMCID: PMC10356013 DOI: 10.1037/tra0001458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Objective Traditional Adverse Childhood Experiences (T-ACEs), such as abuse and neglect, have been associated with an increased risk of youth alcohol use and misuse. This study aims to compare associations of T-ACEs and Expanded ACEs (E-ACEs), an expanded set of ACEs that encompass community-level adversities, with alcohol use and misuse by race/ethnicity. Method Data came from a three-wave (1998-1999; 1999-2000; 2004-2005) community-based study in Houston, including youth transitioning into adulthood. We compared associations between ACEs at Wave 1 and past-year alcohol use, abuse, and dependence at Wave 3. Results Participants (n = 2,391) included White (n =908), Black (n = 898) and Latinx (n = 585) youth (M (SD) = 14.00 (2.04)) transitioning into young adulthood (M (SD) = 19.77 (2.34)). T-ACEs were associated with higher odds of alcohol use, abuse, and dependence (OR = 1.15, OR = 1.18, OR = 1.24, respectively) while E-ACEs increased the odds of alcohol dependence (OR = 1.23) in the total sample. No significant differences by race/ethnicity were found. Racial/ethnic differences in increased alcohol risk were observed for some ACE items, such as bullying and use for Latinx youth (OR = 2.13) and poverty and dependence for White youth (OR = 2.01). Conclusions T-ACES and E-ACEs increase the risk of alcohol use and misuse. Results highlight the importance of preventing ACEs exposure as a risk factor for youth alcohol use and misuse. Public policies must also focus on preventing ACEs through multi-level interventions aimed at reducing violence, bullying, and financial instability.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Mario A. Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mercedes Hoyos
- Department of Political Science, Boston College, Chestnut Hill, MA, USA
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Investigating the relationship between alcohol consumption and subjective poverty in Russia. J Public Health Policy 2023; 44:23-33. [PMID: 36624266 DOI: 10.1057/s41271-022-00386-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 01/11/2023]
Abstract
The Russian government has long struggled with the problem of excessive alcohol consumption. We examined the relationship between alcohol consumption and subjective poverty in Russia using the special survey of the Levada Analytical Center conducted in 2017. Subjective poverty represents an individual's perception of personal well-being when an individual's income is lower than the required not to feel poor. We found that the status of being subjectively poor was associated with the increased probability of consuming vodka for women and the probability of consuming beer for men. Results inform decision-makers about the importance of subjective poverty issues for understanding alcohol consumption.
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Boyd J, Sexton O, Angus C, Meier P, Purshouse RC, Holmes J. Causal mechanisms proposed for the alcohol harm paradox-a systematic review. Addiction 2022; 117:33-56. [PMID: 33999487 PMCID: PMC8595457 DOI: 10.1111/add.15567] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/17/2020] [Accepted: 04/28/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS The alcohol harm paradox (AHP) posits that disadvantaged groups suffer from higher rates of alcohol-related harm compared with advantaged groups, despite reporting similar or lower levels of consumption on average. The causes of this relationship remain unclear. This study aimed to identify explanations proposed for the AHP. Secondary aims were to review the existing evidence for those explanations and investigate whether authors linked explanations to one another. METHODS This was a systematic review. We searched MEDLINE (1946-January 2021), EMBASE (1974-January 2021) and PsycINFO (1967-January 2021), supplemented with manual searching of grey literature. Included papers either explored the causes of the AHP or investigated the relationship between alcohol consumption, alcohol-related harm and socio-economic position. Papers were set in Organization for Economic Cooperation and Development high-income countries. Explanations extracted for analysis could be evidenced in the empirical results or suggested by researchers in their narrative. Inductive thematic analysis was applied to group explanations. RESULTS Seventy-nine papers met the inclusion criteria and initial coding revealed that these papers contained 41 distinct explanations for the AHP. Following inductive thematic analysis, these explanations were grouped into 16 themes within six broad domains: individual, life-style, contextual, disadvantage, upstream and artefactual. Explanations related to risk behaviours, which fitted within the life-style domain, were the most frequently proposed (n = 51) and analysed (n = 21). CONCLUSIONS While there are many potential explanations for the alcohol harm paradox, most research focuses on risk behaviours while other explanations lack empirical testing.
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Affiliation(s)
- Jennifer Boyd
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Olivia Sexton
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Robin C. Purshouse
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Oliveira LM, Cerezer DM, Casarin M, Moreira CHC, Zanatta FB. Alcohol use disorders are associated with higher prevalence of periodontitis in a rural area of Brazil. J Periodontal Res 2021; 56:940-950. [PMID: 34057233 DOI: 10.1111/jre.12890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The aim of the present cross-sectional study was to determine whether alcohol use disorders (AUD) are independently associated with severe and extent cases of periodontitis in individuals living in a rural area of Brazil. METHODS A representative probability sample (N = 585) was evaluated using six-site full-mouth periodontal examination. AUD was assessed using the alcohol use disorders identification test (AUDIT) and considered in its unidimensional and bidimensional factor structures. The first address hazardous alcohol consumption [HAC (overall scores ≥8)], and the second deals with two distinct constructs, harmful use [HU (items 1-3 scores ≥4 for men or ≥3 for women)], and alcohol-related consequences [ARC (items 4-10 scores ≥1)]. Periodontal outcomes were defined based on the criteria proposed by the CDC-AAP (2012) and an adaptation of the EFP-AAP (2018) definition of generalized stages III or IV periodontitis (GP). Adjusted multilevel multinomial and binary logistic regression analysis were used with a conceptual hierarchical approach to calculate the odds ratios (OR) of periodontal outcomes. RESULTS In the adjusted model, HU (OR = 2.69; 95% CI: 1.29-5.58) and ARC (OR = 3.79; 95% CI: 1.51-9.51) were significantly associated with higher prevalence of severe periodontitis (SP). Higher occurrence of GP was detected in individuals presenting HAC (OR = 1.88; 95% CI: 1.05-3.37) and ARC (OR = 2.90; 95% CI: 1.61-5.24). CONCLUSION AUD was independently associated with higher prevalence of SP and GP in individuals living in a rural area.
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Affiliation(s)
- Leandro Machado Oliveira
- Department of Stomatology, Postgraduate Program in Dentistry, Universidade Federal de Santa Maria (UFSM, Santa Maria, Rio Grande do Sul, Brazil
| | - Débora Martins Cerezer
- Department of Stomatology, Postgraduate Program in Dentistry, Universidade Federal de Santa Maria (UFSM, Santa Maria, Rio Grande do Sul, Brazil
| | - Maísa Casarin
- Department of Semiology and Clinic, Postgraduate Program in Dentistry, Universidade Federal de Pelotas (UFPel, Pelotas, Rio Grande do Sul, Brazil
| | - Carlos Heitor Cunha Moreira
- Department of Stomatology, Postgraduate Program in Dentistry, Universidade Federal de Santa Maria (UFSM, Santa Maria, Rio Grande do Sul, Brazil
| | - Fabrício Batistin Zanatta
- Department of Stomatology, Postgraduate Program in Dentistry, Universidade Federal de Santa Maria (UFSM, Santa Maria, Rio Grande do Sul, Brazil
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