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Tower S, Banaag A, Adams RS, Janvrin ML, Koehlmoos TP. Analysis of Alcohol Use and Alcohol Use Disorder Trends in U.S. Active-Duty Service Women. J Womens Health (Larchmt) 2024. [PMID: 38682265 DOI: 10.1089/jwh.2023.0497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Introduction: Alcohol use (AU) and disorders (AUDs) have been increasing among women over the past decade, with the largest increases among women of child-bearing age. Unprecedented stressors during the COVID-19 pandemic may have impacted AU for women with and without children. Little is known about how these trends are impacting women in the military. Methods: Cross-sectional study of active-duty service women (ADSW) in the U.S. Army, Air Force, Navy, and Marine Corps during fiscal years (FY) 2016-2021. We report the prevalence of AU and AUD diagnoses by FY, before/during the COVID-19 pandemic (2016-2019; 2020-2021, respectively), and by parental status. Log-binomial and logistic regressions examined associations of demographics, military, and family structure characteristics, with AU and AUD, during pre-COVID-19 and COVID-19 timeframes. Results: We identified 281,567 ADSW in the pre-COVID-19 period and 237,327 ADSW in the during COVID-19 period. The prevalence of AU was lower during the COVID-19 period (47.9%) than during the pre-COVID-19 period (63.0%); similarly, the prevalence of AUD was lower during the COVID-19 period (2.7%) than during the pre-COVID period (4.0%). ADSW with children had larger percentage decreases during the COVID-19 period. ADSW with children had a consistently lower prevalence and odds of AUD compared with ADSW without children in the pre- and during COVID-19 periods. Conclusion: Decreasing trends in AU and AUD among ADSW were unexpected. However, the prevalence of AU and AUD may not have been accurately captured during the COVID-19 period due to reductions in access to care. Continued postpandemic comparison of AU/AUD among women by parental status and demographic factors may guide targeted health efforts.
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Affiliation(s)
- Stephanie Tower
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Amanda Banaag
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
| | - Rachel Sayko Adams
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, USA
| | - Miranda Lynn Janvrin
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, USA
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Kerr WC, Lui CK, Ye Y, Li L, Greenfield T, Karriker-Jaffe KJ, Martinez P. Long-term trends in beverage-specific drinking in the National Alcohol Surveys: Differences by sex, age, and race and ethnicity. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 38658368 DOI: 10.1111/acer.15335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Despite substantial declines in underage drinking and binge drinking, alcohol consumption has increased in the past 30 years. This study examined how beverage-specific drinking patterns varied by sex, age, and race and ethnicity from 1979 to 2020. METHODS Secondary data analysis was conducted on pooled data from the National Alcohol Survey series from 1979 to 2020 of a sample of U.S. adults ages 18 years or older. Total and beverage-specific volume were calculated from graduated frequency questions on reported beverage type, which included beer, wine, and spirits. Sex-stratified analyses focused on descriptive trends of each alcohol measure over time and by age and race and ethnicity. Time-varying effect models were also conducted to identify subgroups at higher risk for increased consumption over time. RESULTS Women's drinking increased, with alcohol volume rising substantially from 2000 to 2020; the largest increase was among women 30 and older. Men's alcohol volume also rose over this period but remained below the levels of 1979 and 1984, with older adults increasing their consumption those 18-29 decreased their drinking. Beverage-specific trends showed some similarities by gender: in 2020, wine volume was at its highest level for both women and men, while spirits volume also was at its highest level for men and in women was tied with the 1979 peak in spirits consumption. Increases were also found among Black men and women and Latina women from 2000 to 2020. CONCLUSIONS Given the increases in alcohol volume, particularly among women and older age groups, alcohol policy, interventions, and education should consider ways to reduce harms associated with alcohol use among these groups. Continued monitoring of beverage-specific drinking patterns is needed to track policy-relevant changes.
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Camillia K Lui
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Thomas Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | | | - Priscilla Martinez
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
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Adams RS, McKetta SC, Jager J, Stewart MT, Keyes KM. Cohort effects of women's mid-life binge drinking and alcohol use disorder symptoms in the United States: Impacts of changes in timing of parenthood. Addiction 2023; 118:1932-1941. [PMID: 37338343 PMCID: PMC10527386 DOI: 10.1111/add.16262] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/02/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND AND AIMS Alcohol use is increasing among women in mid-life concurrently with societal changes in timing of parenthood and changing cultural norms, which may influence alcohol use. The aim of this study was to determine if age of first parenting was associated with excessive drinking [i.e. past 2-week binge drinking and past 5-year alcohol use disorder (AUD) symptoms] among women during mid-life in the United States and to determine if there were pronounced cohort effects influencing these relationships. DESIGN This was a retrospective cohort, longitudinal study. SETTING, PARTICIPANTS AND MEASUREMENTS Data were drawn from the Monitoring the Future survey, an annual ongoing survey of high school students' substance use behaviors in the United States. Participants were women who completed the age 35 survey between 1993 and 2019, corresponding to high school senior years 1976-2002 (n = 9988). Past 2-week binge drinking and past 5-year AUD symptoms were self-reported. Age of first parenting was self-reported. FINDINGS Binge drinking and AUD symptoms were higher among women in recent than in older cohorts. Women from the 2018-19 cohort had increased odds of binge drinking [odds ratio (OR) = 1.73, 95% confidence interval (CI) = 1.41-2.12] and AUD symptoms (OR = 1.51, CI = 1.27-1.80) relative to women from the 1993-97 cohort. Throughout cohorts, there was an inverse association between transition to parenthood and excessive drinking outcomes (e.g. range for ORs for binge drinking among those without children compared with those who had had children between the ages of 18 and 24: 1.22-1.55). Simultaneously, there was a population shift towards delaying parenting in recent cohorts (i.e. 54% of women in the 1993-97 cohort had children before age 30 compared with 39% in the two recent cohorts), increasing the size of the group at highest risk for excessive drinking. CONCLUSIONS In the United States, subgroups of women at highest risk of excessive drinking appear to be expanding, probably supported in part by a trend towards delayed parenting.
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Affiliation(s)
- Rachel Sayko Adams
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Veterans Health Administration, Aurora, CO, USA
| | - Sarah C McKetta
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Maureen T Stewart
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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Wallace LA, Paul R, Gholizadeh S, Zadrozny W, Webster C, Mayfield M, Racine EF. Neighborhood disadvantage and the sales of unhealthy products: alcohol, tobacco and unhealthy snack food. BMC Public Health 2021; 21:1361. [PMID: 34243730 PMCID: PMC8272253 DOI: 10.1186/s12889-021-11442-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 07/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals may use unhealthy coping mechanisms such as alcohol, tobacco, and unhealthy snack consumption. The purpose of this study was to assess how neighborhood disadvantage is associated with sales of alcohol, tobacco, and unhealthy snacks at stores of a discount variety store chain. METHODS Alcohol, tobacco, and unhealthy snack sales were measured monthly for 20 months, 2017-2018, in 16 discount variety stores in the United States. Mixed effects linear regressions adjusted for population size, with store-specific random effects, to examine the relationship of weekly unit sales with three outcome variables and neighborhood disadvantage, measured using the Area Deprivation Index (ADI). RESULTS The discount variety stores were located in neighborhoods where the median ADI percentile was 87 [interquartile range 83,89], compared to the median ADI percentile of 50 for all US communities, indicating that the stores were located in substantially disadvantaged neighborhoods. For every 1% increase in ADI, weekly unit sales of unhealthy snack food increased by 43 [95% confidence interval, CI 28-57], and weekly unit sales of tobacco products increased by 11.5 [95% CI 5-18] per store. No significant relationship between neighborhood disadvantage and the weekly unit sales of alcohol products was identified. CONCLUSIONS The positive relationship between neighborhood disadvantage and the sale of tobacco and snack foods may help explain the pathway between neighborhood disadvantage and poor health outcomes. It would be useful for future research to examine how neighborhood disadvantage influences resident health-related behaviors.
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Affiliation(s)
- Lauren A Wallace
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA.
| | - Rajib Paul
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Shafie Gholizadeh
- College of Computing and Informatics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Wlodek Zadrozny
- College of Computing and Informatics, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Caitlan Webster
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Melanie Mayfield
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
| | - Elizabeth F Racine
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA
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