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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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McKetta S, Morrison CN, Keyes KM. Trends in US Alcohol Consumption Frequency During the First Wave of the SARS-CoV-2 Pandemic. Alcohol Clin Exp Res 2021; 45:773-783. [PMID: 33587290 PMCID: PMC8014717 DOI: 10.1111/acer.14575] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/09/2021] [Indexed: 12/31/2022]
Abstract
Background The SARS‐CoV‐2 pandemic created disruptions and stressors which may have influenced alcohol consumption frequency trends. Varying COVID‐19 health burden and alcohol policies may have contributed to different consumption trends between states. The aim of this study is to assess trends in alcohol consumption and moderation by state of residence. Methods We examined trends in adult drinking days, during the first wave of the pandemic (March 10 to June 8) using longitudinal data from the Understanding America Study (N = 6,172 unique participants; N = 28,059 observations). Because state mandates were responsive to disease burden, we modeled the interaction of time by COVID‐19 burden, defined as whether the state had the median (or higher) daily incidence of COVID‐19 cases on the survey date, and state random effects. We controlled for individual sociodemographics, perceived personal/familial COVID‐19 burden, mental health symptomology, and risk avoidance. Results Drinking days increased throughout the duration (incidence risk ratio [IRR] for drinking per increase in one calendar day = 1.003, 95% CI 1.001, 1.004); trends were heterogeneous by disease burden, with individuals living in states with lower COVID‐19 burden increasing (IRR = 1.005, 95% CI 1.003, 1.007) faster than those living in states with higher COVID‐19 burden (IRR = 1.000, 95% CI 0.998, 1.002). Trends were heterogeneous between states, but there was no evidence of systematic geographic clustering of state trends. Conclusions Drinking days increased during the first months of the COVID‐19 pandemic, particularly among residents of states with lower disease burden.
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Affiliation(s)
- Sarah McKetta
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Christopher N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Abstract
OBJECTIVES In contrast with other developed nations, life expectancy is decreasing in the United States, in part due to increasing mortality from alcohol-associated liver disease (ALD). Up-to-date estimates of ALD mortality are necessary for setting public health priorities to reverse this concerning trend. We therefore aimed to assess current (2017) estimates of ALD mortality and temporal trends from 1999 to 2017. METHODS Using national data from the Centers for Disease Control and Prevention, we analyzed stratified ALD mortality rates between 1999 and 2017. We determined the age-adjusted death rates, stratified by sex and categorized by age, race/ethnicity, urbanization, and census region. We also identified statistically significant changes in the annual rate difference (ARD), annual percentage change (APC), and average APC in ALD mortality. RESULTS In 2017, mortality from ALD was higher than any other year since 1999 with age-adjusted rates of 13.1 per 100,000 (95% confidence interval [CI] 12.9-13.3) in men and 5.6 per 100,000 (95% CI 5.4-5.7) in women. Mortality was highest among men and women who were middle aged, Native American, and from rural areas. Since 2006, ALD mortality has increased in almost every age group and race with the exception of non-Hispanic black men. Absolute increases in mortality rates have been particularly pronounced in Native American women (2005-2017 ARD 0.8, 95% CI 0.6-0.9), non-Hispanic/white men (2006-2017 ARD 0.4, 95% CI 0.3-0.4), and non-Hispanic/white women (2013-2017 ARD 0.4, 95% CI 0.3-0.5). DISCUSSION Mortality from ALD is increasing over time in most demographic groups. Increased effort is needed to develop targeted public health strategies to address high and increasing ALD mortality.
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Wang Q, Xu W, Ren L, Wang W, Wang Y. The relationship between hope and post-traumatic stress disorder in Chinese shidu parents: The mediating role of perceived stress. J Affect Disord 2019; 251:23-30. [PMID: 30897529 DOI: 10.1016/j.jad.2019.03.049] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/02/2019] [Accepted: 03/07/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Parents who lost their only child and can not conceive another child, are known as shidu parents in China. This study aimed to estimate the prevalence of post-traumatic stress disorder (PTSD) and examine the mediating role of perceived stress between hope and PTSD symptoms in Chinese shidu parents. METHODS 295 shidu mothers and 197 shidu fathers were recruited in Shenyang city. Shidu parents were asked to complete a questionnaire including the PTSD Checklist for DSM-5 (PCL-5), the Herth hope index (HHI) and the Perceived Stress Scale-10 (PSS-10). Hierarchical linear regression was performed to assess the associations among hope, perceived stress and PTSD symptoms. Asymptotic and resampling strategies were used to explore the mediating role of perceived stress. RESULTS The prevalence of PTSD in Chinese shidu parents was 23.78%. Mothers were more likely to develop PTSD than fathers. For shidu fathers, the proportion of mediation of perceived stress was 39.48%. For shidu mothers, the proportion of mediation of perceived stress was 40.00%. LIMITATIONS Due to the cross-sectional design, the findings of the present study can not be used to establish formal causal relationships or to determine the direction of causality. Longitudinal studies are need to validate our findings. CONCLUSIONS Perceived stress partly mediated the relationship between hope and PTSD symptoms in Chinese shidu parents. The interventions of hope and perceived stress should be included in PTSD prevention. More assistance should be directed to improve the mental health of shidu mothers.
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Affiliation(s)
- Qiong Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122, PR China
| | - Weihua Xu
- Department of Family Development, Health and Family Planning Commission of Shenyang Municipality, No. 13 Beiqi Road, Heping District, Shenyang, Liaoning 110001, PR China
| | - Longfei Ren
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122, PR China
| | - Wenhao Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122, PR China
| | - Yang Wang
- Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New District, Shenyang, Liaoning 110122, PR China.
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Sattler S. Nonmedical use of prescription drugs for cognitive enhancement as response to chronic stress especially when social support is lacking. Stress Health 2019; 35:127-137. [PMID: 30378254 DOI: 10.1002/smi.2846] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/05/2018] [Accepted: 10/22/2018] [Indexed: 11/06/2022]
Abstract
The nonmedical use of prescription drugs to improve cognitive performance has gained attention due to concerns over its social and political implications as well as side effects and long-term health consequences. Some researchers expect a future trend of an instrumental use of drugs for cognitive enhancement (CE). Thus, getting insights about causes of CE-drug consumption is warranted before the prevalence increases. Because perceived stress is ubiquitous in universities and may decrease cognitive performance, one reaction to cope with stress and its consequences might be the instrumental use of drugs for CE, especially if other resources, such as social support, are lacking. With a prospective design, randomly selected students from four German universities were invited to a web-based survey and reinterviewed after 6 months (N = 2,203). Results show a 6-month prevalence rate of self-reported CE-drug use of about 2%. Higher reported chronic stress is positively associated with CE-drug use. Although social support has no main effect, stress-buffering effects were found. In men with low stress, more support is associated with a higher chance of self-reported CE-drug use. These findings can inform intervention and prevention strategies such as changes in drug regulation or sensitizing (potential) users to unwanted health consequences.
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Affiliation(s)
- Sebastian Sattler
- Institute for Sociology and Social Psychology, University of Cologne, Cologne, Germany.,Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, Québec, Canada
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Richman JA, Brown RL, Rospenda KM. Age Cohort Variation in Drinking among People with Physical Impairments: Politically-oriented Coping in the Wake of the Great Recession. JOURNAL OF DRUG ISSUES 2017; 47:467-478. [PMID: 29217868 DOI: 10.1177/0022042617701254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
People with physical impairments are at greater risk for economic hardship and more alcohol-related problems compared to the general population. We address age cohort differences in modes of coping with economic adversity and the extent to which modes of coping explain the relationships between age cohort membership and drinking outcomes among people with physical impairments. 176 respondents with physical impairments derived from a national sample completed a mail survey. Using SEM, we demonstrate that members of the Generation X age cohort manifest higher levels of alcohol consumption and problem-related drinking compared to baby boomers due to their lesser tendency to engage in politically-oriented coping to deal with economic adversity. Within the context of social movements contesting the disadvantaged social status of people with disabilities, the Generation X age cohort manifests both more limited political engagement and higher levels of alcohol consumption and problem-related drinking among people with physical impairments.
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Affiliation(s)
- Judith A Richman
- Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor Street, Chicago, IL 60612, U.S.A
| | - Robyn Lewis Brown
- Department of Sociology, University of Kentucky, 1529 Patterson Office Tower, Lexington, KY 40506, U.S.A
| | - Kathleen M Rospenda
- Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor Street, Chicago, IL 60612, U.S.A
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Dobson KG, Ibrahim S, Gilbert-Ouimet M, Mustard CA, Smith PM. Association between psychosocial work conditions and latent alcohol consumption trajectories among men and women over a 16-year period in a national Canadian sample. J Epidemiol Community Health 2017; 72:113-120. [PMID: 29183955 DOI: 10.1136/jech-2017-209691] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/19/2017] [Accepted: 11/07/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND It is unclear how psychosocial working conditions influence future alcohol consumption. Using group-based trajectory modelling, this study aimed to determine: the number of latent alcohol consumption trajectories over 16 years in a representative sample of the Canadian workforce; the association between psychosocial working conditions and longitudinal alcohol consumption; and if the association between psychosocial work factors and longitudinal alcohol consumption differed among men and women. METHODS We included 5458 employed adults from the longitudinal Canadian National Population Health Survey. Average daily alcohol consumption was measured every 2 years from 1994 to 2010. Psychosocial work factors were measured in 1994 using the Job Content Questionnaire. Group-based trajectory modelling was used to derive the appropriate number of alcohol behaviour trajectories. The association between psychosocial work factors and alcohol trajectory membership was estimated using multinomial logistic regression. Models were stratified by sex to determine if these associations differed among men and women. RESULTS Three alcohol consumption trajectories were present: non-drinkers, light drinkers (0.5-1 drinks/day) and moderate drinkers (2-3 drinks/day). Higher workplace physical exertion and lower social support levels were associated with membership in the moderate drinking trajectory. Among men, lower psychological demands and higher physical exertion levels were associated with membership in the moderate drinking trajectory. Among women, lower levels of physical exertion were associated with membership in the light drinking trajectory, and higher psychological demand levels were associated with membership in the moderate drinking trajectory. CONCLUSIONS Our study suggests that workplace physical exertion and psychological demands may be associated with different alcohol consumption trajectories among men and women.
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Affiliation(s)
- Kathleen G Dobson
- Institute for Work and Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Mahée Gilbert-Ouimet
- Institute for Work and Health, Toronto, Ontario, Canada.,Centre de Recherche du CHU de Québec, Quebec City, Quebec, Canada
| | - Cameron A Mustard
- Institute for Work and Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Peter M Smith
- Institute for Work and Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Gender differences in the use of alcohol and prescription drugs in relation to job insecurity. Testing a model of mediating factors. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 37:21-30. [PMID: 27561136 DOI: 10.1016/j.drugpo.2016.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/17/2016] [Accepted: 07/01/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND The results of several studies suggest that economy-related stressors are less distressing for women compared with men. This study proposed to examine the relationship of perceived job insecurity with the use of licit drugs using a theoretical model that considered antecedents and mediators of this association, in order to identify differences between working men and women. METHODS Using information from the Catalan Health Survey (2010-2014), we selected working individuals aged 16-64 who were primary providers of household income (N=5315). The outcomes were two measures of alcohol consumption (heavy drinking and binge drinking) and the use of hypnotics/sedatives. As antecedents of the exposure to job insecurity we considered the type of contractual relationship and occupational class. The mediating factors were poor mental health, household structure and the hours of housework per week. The theoretical model was assessed using path analysis where the moderating effect of gender was considered in all the associations. RESULTS No differences in the prevalence of job insecurity were found between men and women (17%). Job insecurity (Odds ratio [OR]=1.35, 95% confidence interval [CI]=1.23-1.48) and house workload (OR=1.01, 95% CI=1.00-1.02) were positively associated with poor mental health, with no significant interactions with gender. Poor mental health was significantly associated with binge drinking (OR=1.23, 95% CI=1.13-1.33) and with the use of hypnotics/sedatives (OR=1.71, 95% CI=1.53-1.91). House workload showed a direct negative association with binge drinking (OR=0.99, 95% CI=0.98-1.00), while those in households with no children were more likely to be binge drinkers, with no significant interactions with gender. An alternative model had better fitting results for heavy drinking. CONCLUSION No gender differences were found in the association of job insecurity with mental health nor with the use of substances among primary providers of household income, emphasising the importance of social roles when assessing differences in mental health among men and women.
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Margerison-Zilko C, Goldman-Mellor S, Falconi A, Downing J. Health Impacts of the Great Recession: A Critical Review. CURR EPIDEMIOL REP 2016; 3:81-91. [PMID: 27239427 DOI: 10.1007/s40471-016-0068-6] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The severity, sudden onset, and multipronged nature of the Great Recession (2007-2009) provided a unique opportunity to examine the health impacts of macroeconomic downturn. We comprehensively review empirical literature examining the relationship between the Recession and mental and physical health outcomes in developed nations. Overall, studies reported detrimental impacts of the Recession on health, particularly mental health. Macro- and individual-level employment- and housing-related sequelae of the Recession were associated with declining fertility and self-rated health, and increasing morbidity, psychological distress, and suicide, although traffic fatalities and population-level alcohol consumption declined. Health impacts were stronger among men and racial/ethnic minorities. Importantly, strong social safety nets in some European countries appear to have buffered those populations from negative health effects. This literature, however, still faces multiple methodological challenges, and more time may be needed to observe the Recession's full health impact. We conclude with suggestions for future work in this field.
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Affiliation(s)
- Claire Margerison-Zilko
- Department of Epidemiology and Biostatistics, Michigan State University, 909 Fee Rd., Rm 601, East Lansing, MI 48824, Ph: 517-353-8623
| | - Sidra Goldman-Mellor
- Department of Public Health, University of California, Merced, 5200 N. Lake Rd., Merced, CA 95342, Ph: (209) 228-2498
| | - April Falconi
- General Internal Medicine, Stanford University, Palo Alto, CA 94305, Ph: (703) 328-4851
| | - Janelle Downing
- School of Public Health, University of California, Berkeley, 545 University Hall, University of California, Berkeley, CA 94720-7360, Ph: (510) 643-8571
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Brown RL. Functional Limitation, Pain, and Alcohol Use: Exploring Gender Differences in the Mediating Role of Depressive Symptoms. J Stud Alcohol Drugs 2015; 76:809-17. [PMID: 26402362 PMCID: PMC4714831 DOI: 10.15288/jsad.2015.76.809] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/28/2015] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE This study considered the processes linking functional limitation and pain with depressive symptoms and two alcohol-related outcomes (past-month drinking and problematic drinking) over a 3-year period. METHOD Data were drawn from a two-wave Miami-Dade County community study of people with physical disabilities (N = 559). Structural equation modeling was used to assess whether depressive symptoms mediated the associations among functional limitation, bodily pain, and the alcohol-related outcomes considered, and whether these associations were moderated by gender. RESULTS When the effects of the sociodemographic control variables were controlled for, depressive symptoms partly explained the effects of Wave 1 functional limitation and bodily pain on problematic drinking at Wave 2. The mediating effects of depressive symptoms on problematic drinking were significantly greater for men than for women. CONCLUSIONS The findings demonstrate clear linkages between two physical health indicators, depressive symptoms and drinking, and highlight the circumstances in which gender matters most for understanding these associations.
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Affiliation(s)
- Robyn Lewis Brown
- Department of Sociology, University of Kentucky, Lexington, Kentucky
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