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Andreacchi AT, Hobin E, Siddiqi A, Smith BT. Age, period and cohort effects of heavy episodic drinking by sex/gender and socioeconomic position in Canada, 2000-2021. Addiction 2024. [PMID: 39228260 DOI: 10.1111/add.16641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 07/10/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND AND AIMS Heavy episodic drinking (HED) trends have not been comprehensively examined in Canada. We measured age, period and birth cohort trends in HED in Canada by sex/gender and socioeconomic position. DESIGN AND SETTING We analyzed repeat cross-sectional data from the 10 provinces in the Canadian Community Health Surveys from 2000 to 2021 using hierarchical cross-classified random effects logistic regression. PARTICIPANTS 1 167 831 respondents aged 12+ . MEASUREMENTS HED was defined as 4+ standard drinks for women or 5+ for men at least monthly in the past 12 months. Socioeconomic position was measured using household income and education. FINDINGS We observed steeper HED decreases in young adult men (aged 18-29) than women (by 14.4% and 8.7%, respectively, from 2015 to 2021) and HED increases in middle adult women (ages 50-64) (by 8.0% from 2000 to 2014). Sex/gender-specific age-period-cohort models revealed strong age and birth cohort effects. In women and men, respectively, HED peaked in young adulthood (18.2% and 33.8%) and decreased with age, and HED was greatest in the 1980-1989 cohort (20.7% and 35.8%) and decreased in the most recent cohort born in 1990-2009 (15.6% and 19.8%), particularly in men. Higher household incomes had greater HED across age, periods and cohorts, while trends varied by education. Compared with lower education groups, people with a bachelor's degree or above had the lowest HED in middle adulthood. People with a bachelor's degree or above had low HED in earlier cohorts, which converged with other education groups in recent cohorts due to a pronounced HED increase, particularly in women. CONCLUSION The sex/gender gap in heavy episodic drinking (HED) appears to be converging in Canada: current young adult men are reducing HED, while high-risk cohorts of women are aging into middle adulthood with greater HED. Recent birth cohorts with a bachelor's degree or above experienced pronounced HED increases, which among women suggests greater educational attainment contributes to the converging gender gap in HED.
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Affiliation(s)
| | - Erin Hobin
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Edwin S.H. Long Centre for Health Children, Hospital for Sick Children, Toronto, ON, Canada
- Department of Social and Behavioural Sciences, Harvard School of Public Health, Boston, MA, USA
- Department of Health Behaviour, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Brendan T Smith
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
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Li G, Liu L, Liu DL, Yu ZZ, Golden AR, Yin XY, Cai L. Tobacco exposure and alcohol drinking prevalence and associations with hypertension in rural southwest China: A cross-sectional study. Tob Induc Dis 2024; 22:TID-22-101. [PMID: 38860152 PMCID: PMC11163415 DOI: 10.18332/tid/189222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/19/2024] [Accepted: 05/23/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION This study examined the prevalence of tobacco exposure and drinking and ascertained the relationships between tobacco exposure, alcohol drinking, concurrent smoking and drinking, and hypertension in rural southwestern China. METHODS Data were collected from a cross-sectional health interview and examination survey, which included 7572 adults aged ≥35 years, in rural China. Participant demographic characteristics, smoking habits, exposure to secondhand smoke (SHS), and alcohol drinking habits were obtained using a standard questionnaire. Blood pressure (BP), height, weight, and waist circumference were measured for each participant. RESULTS The overall prevalence of smoking, SHS exposure, drinking, concurrent smoking and drinking, concurrent exposure to SHS and drinking, and hypertension was 37.7%, 27.4%, 16.2%, 12.6%, 1.6%, and 41.3%, respectively. Males had a significantly higher prevalence of smoking (74.1% vs 2.2%, p<0.01), drinking (31.1% vs 1.7%, p<0.01), and concurrent smoking and drinking than females (25.3% vs 0.3%, p<0.01). However, females had a higher prevalence of SHS exposure than males (30.2% vs 20.6%, p<0.01). Ethnic minorities had a higher prevalence of SHS exposure, drinking, and concurrent smoking and drinking, than Han participants (p<0.01). Participants with a higher education level had a higher prevalence of smoking, drinking, and concurrent smoking and drinking than their counterparts (p<0.01). In contrast, participants with a lower education level had a higher prevalence of SHS exposure than their counterparts (p<0.01). Multivariate logistic regression analysis found that smokers (AOR=1.31; 95% CI: 1.13-1.51), individuals exposed to SHS (AOR=1.24; 95% CI: 1.11-1.43), drinkers (AOR=1.31; 95%: CI: 1.15-1.50), and concurrent smokers and drinkers (AOR=1.45; 95% CI: 1.25-1.67) all had a higher probability of having hypertension (p<0.01). Additionally, concurrent smoking and drinking had the strongest association with the prevalence of hypertension (AOR=1.45; 95% CI: 1.25-1.67; p<0.01). CONCLUSIONS Socioeconomic factors play an important role in influencing the prevalence of smoking, exposure to SHS, and drinking in rural southwest China. Interventions to prevent and reduce hypertension should, in particular, focus on smokers, individuals exposed to SHS, drinkers, and, in particular, concurrent smokers and drinkers.
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Affiliation(s)
- Guohui Li
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Lan Liu
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Du-li Liu
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Zi-zi Yu
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Allison R. Golden
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Xiang-yang Yin
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Le Cai
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
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Druffner N, Egan D, Ramamurthy S, O'Brien J, Davis AF, Jack J, Symester D, Thomas K, Palka JM, Thakkar VJ, Brown ES. IQ in high school as a predictor of midlife alcohol drinking patterns. Alcohol Alcohol 2024; 59:agae035. [PMID: 38804536 DOI: 10.1093/alcalc/agae035] [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] [Received: 06/28/2023] [Revised: 04/27/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
AIMS The aim of the present study was to assess the relationship between adolescent IQ and midlife alcohol use and to explore possible mediators of this relationship. METHODS Study data were from 6300 men and women who participated in the Wisconsin Longitudinal Study of high-school students graduating in 1957. IQ scores were collected during the participants' junior year of high school. In 2004, participants reported the number of alcoholic beverages consumed (past 30 days) and the number of binge-drinking episodes. A multinomial logistic regression was conducted to determine the relationship between adolescent IQ and future drinking pattern (abstainer, moderate drinker, or heavy drinker), and Poisson regression was used to examine the number of binge-drinking episodes. Two mediators-income and education-were also explored. RESULTS Every one-point increase in IQ score was associated with a 1.6% increase in the likelihood of reporting moderate or heavy drinking as compared to abstinence. Those with higher IQ scores also had significantly fewer binge-drinking episodes. Household income, but not education, partially mediated the relationship between IQ and drinking pattern. CONCLUSIONS The present study suggests that higher adolescent IQ may predict a higher likelihood of moderate or heavy drinking in midlife, but fewer binge-drinking episodes. The study also suggests that this relationship is mediated by other psychosocial factors, specifically income, prompting future exploration of mediators in subsequent studies.
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Affiliation(s)
- Natalie Druffner
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Donald Egan
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Swetha Ramamurthy
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Justin O'Brien
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Allyson Folsom Davis
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Jasmine Jack
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Diona Symester
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Kelston Thomas
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Jayme M Palka
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Vishal J Thakkar
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
| | - Edson Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390-8849, United States
- The Altshuler Center for Education & Research, Metrocare Services, 1345 River Bend Dr, Suite 200, Dallas, Texas, 75247, United States
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Netzer J, Jarchow M. Comparative analysis of diets in Sioux Falls: Influence of sociodemographic characteristics, alignment to US national diet and healthy diet. Heliyon 2024; 10:e28853. [PMID: 38601515 PMCID: PMC11004753 DOI: 10.1016/j.heliyon.2024.e28853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/19/2024] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
Continuous examination of diets and factors that influence dietary patterns is vital to improve diet quality. The objectives of this study are to evaluate the average diet of adults in the Sioux Falls Metropolitan Statistical Area (SFMSA), USA, examining sociodemographic differences in dietary intake and compare the average diet in the SFMSA (SF Diet) to the U.S. national average and USDA healthy dietary guidelines. A cross-sectional population-based study was conducted and 127 individuals were surveyed from August 2020 to August 2021. Dietary intake was assessed using the self-reported single 24-h dietary recall method and sociodemographic questions. Main effects and first order interactions of participant sociodemographic characteristics were considered. Main findings show that men had higher intake of meat, poultry, and eggs (p < 0.05) and alcohol, particularly older men (p < 0.05), than women. Higher alcohol intake was found for participants with lower levels of income and education (p < 0.01). The intake of fish and seafood was higher for older adults with a high level of income (p < 0.01). Differences were found between the SF diet and the national average but both followed a similar trend (e.g., low in fruits and vegetables and high in solid fats) and did not meet dietary guidelines, particularly for nutrient-dense foods. The intake of total vegetables (p < 0.001) and dark green vegetables (p < 0.001) was higher in the SF Diet and the national average was higher in total grains (p < 0.05), refined grains (p < 0.01), oils and fats (p < 0.001), solid fats (p < 0.001), and added sugar (p < 0.001). By not meeting the dietary guidelines, the findings of this study raise public health concerns.
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Affiliation(s)
- Jacinda Netzer
- Department of Sustainability and Environment, University of South Dakota, 414 E Clark St., Vermillion, SD 57069, United States
| | - Meghann Jarchow
- Department of Sustainability and Environment, University of South Dakota, 414 E Clark St., Vermillion, SD 57069, United States
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Kose J, Duquenne P, Hercberg S, Galan P, Touvier M, Fezeu LK, Andreeva VA. Co-occurrence of habit-forming risk behaviors and their socio-demographic, health status and lifestyle determinants: a population-based cross-sectional study. Arch Public Health 2024; 82:26. [PMID: 38419088 PMCID: PMC10900606 DOI: 10.1186/s13690-024-01251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Although habit-forming risk behaviors frequently co-occur, determinants of concurrent risk behaviors have rarely been investigated. The aim of the present study was to investigate socio-demographic, health status, and lifestyle determinants of single versus concurrent risk behaviors in general-population adults. METHODS We analyzed data from 32,622 participants (74.5% female; mean age = 57.9 ± 14.2 years) of the NutriNet-Santé cohort who completed the Alcohol Use Disorders Identification Test, the 12-item Cigarette Dependence Scale, the modified Yale Food Addiction Scale 2.0, and the Internet Addiction Test in 2021-2022. Using established cutoffs, participants were first split into 2 groups (presence versus absence) for each risk variable (alcohol use disorders, nicotine dependence, food addiction, Internet addiction) and were then divided into 3 groups (no risk behavior, 1 risk behavior (reference), and ≥ 2 risk behaviors). The association between socio-demographic, health status, and lifestyle exposures and individual/concurrent risk behaviors were investigated with polytomous logistic regression. RESULTS Younger age (Odds Ratio (OR) = 2.04; 95% Confidence Interval (CI: 1.62-2.56), current financial difficulties (OR = 1.29; CI: 1.08-1.54), self-perceived poor health (OR = 1.70; CI: 1.32-2.20), overall poor dietary quality (OR = 2.88; CI: 2.06-4.02), being underweight (OR = 1.46; CI: 1.05-2.04), having obesity (OR = 1.62; CI: 1.31-1.99), lack of affection during childhood (OR = 1.41; CI: 1.18-1.69), and a lifetime prevalence or medication use for a mental disorder (OR = 1.46; CI: 1.24-1.73) were positively associated with having ≥ 2 versus 1 risk behavior (all p < 0.05). The comparison of none versus 1 risk behavior revealed the same determinants in addition to having a higher education, being physically active at work, and being overweight. CONCLUSIONS We investigated determinants of concurrent habit-forming risk behaviors among adults in a large, population-based study. The findings could serve as impetus for future research in this domain and ultimately help guide addiction prevention efforts.
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Affiliation(s)
- Junko Kose
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Pauline Duquenne
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
- Department of Public Health, AP-HP Paris Seine-Saint-Denis Hospital System, Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Léopold K Fezeu
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Valentina A Andreeva
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France.
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Rasouli MA, Zareie B, Gouya MM, Hadavandsiri F, Mahboobi M, Moradi Y, Moradi R, Moradi G. Lifetime and past-month alcohol use and related factors among female sex workers in Iran. Brain Behav 2023; 13:e3288. [PMID: 37872677 PMCID: PMC10726872 DOI: 10.1002/brb3.3288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/07/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE Alcohol use is more common among female sex workers (FSWs). This study assessed the prevalence of lifetime and past-month alcohol use and related factors among FSWs in Iran. METHODS We conducted a cross-sectional survey among 1464 women from 8 major cities in Iran. Behavioral data were collected by trained interviewers and conducted face-to-face in a private room. Weighted analysis was used to determine the lifetime and past-month alcohol use prevalence. Univariate and multivariate logistic regression was used to investigate the association between alcohol use and independent variables. RESULTS The most alcohol used in lifetime and past-month (weekly, less than once a week, and daily) in FSWs was 52.7% (12.25%, 12.94%, and 1.83%), respectively. In the final model, factors that were independently associated with alcohol use included the 31-40 years (AOR = 2.41, 95% CI: 1.13-5.15), education level of diploma (AOR = 2.43, 95% CI: 1.31-4.51), history of lifetime drug use (AOR = 2.79, 95% CI: 2.01-3.89), history of lifetime group sex (AOR = 2.07, 95% CI: 1.41-3.03), history of intentional abortion (AOR = 1.42, 95% CI: 1.06-1.92), six or more sexual clients in the last month (AOR = 3.25, 95% CI: 1.80-5.87), history of lifetime anal sex (AOR = 2.47, 95% CI: 1.82-3.35), and FSWs the married, temporarily married, and living with partner were positively associated with lifetime alcohol use. CONCLUSION Alcohol use is prevalent among FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with alcohol use among this vulnerable population in Iran. Designing intervention programs, it is suggested to consider other variables affecting alcohol use in FSWs.
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Affiliation(s)
- Mohammad Aziz Rasouli
- Department of Epidemiology and BiostatisticsFaculty of Medicine, Kurdistan University of Medical SciencesSanandajIran
| | - Bushra Zareie
- Department of Epidemiology, School of Public HealthHamadan University of Medical SciencesHamadanIran
| | - Mohammad Mehdi Gouya
- Iranian Center for Communicable Disease ControlMinistry of Health and Medical EducationTehranIran
| | - Fatemeh Hadavandsiri
- School of Public Health and SafteyShahid Beheshti University of Medical SciencesTehranIran
| | - Marzieh Mahboobi
- Iranian Center for Communicable Disease ControlMinistry of Health and Medical EducationTehranIran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Rozhin Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
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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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Liu C, He L, Li Y, Yang A, Zhang K, Luo B. Diabetes risk among US adults with different socioeconomic status and behavioral lifestyles: evidence from the National Health and Nutrition Examination Survey. Front Public Health 2023; 11:1197947. [PMID: 37674682 PMCID: PMC10477368 DOI: 10.3389/fpubh.2023.1197947] [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] [Received: 03/31/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023] Open
Abstract
Background Diabetes disproportionately affects minorities and those with low socioeconomic status (SES) in the United States, and differences in behavioral lifestyles are largely responsible for the unequal distribution of diabetes among different groups. Methods With data of 9,969 participants collected in the 2007-2008 and 2009-2010 cycles of the US National Health and Nutrition Examination Survey (NHANES), this study examined several mediators and their mediating effects in the connection between SES and the risk of diabetes. The SES is assessed by the income-to-poverty ratio (IPR), education level, and employment status. For the mediation analysis, we used health-related behaviors as mediators (smoking, alcohol use, consumption of green vegetables and fruits, physical activity and sedentary time, health insurance, and healthcare). In this study, the structural equation model was utilized to evaluate the mediating effects of behavioral lifestyle as a mediator in the relationship between SES and diabetes. Results A total of 9,969 participants were included in this study. We found a negative nonlinear association between IPR and diabetes risk (Poverall < 0.001; Pnon-linear = 0.46), which was independent of the majority of known or suspected risk factors and confounding variables (gender, age, race). Participants with lower SES had higher risk of diabetes compared with those with higher SES. In mediating analysis, we found alcohol intake (OR = 0.996), physical activity (OR = 0.993), health insurance (OR = 0.998), and healthcare (OR = 1.002) mediated the IPR-diabetes association. But in the relationship between education status and diabetes, the mediation effect of alcohol intake (OR = 0.995), physical activity (OR = 0.991), and health care (OR = 1.008) were obvious. Likewise, alcohol intake (OR = 0.996), fruit intake (OR = 0.998), and health care (OR = 0.975) were important mediators in the association between employment status and diabetes. Conclusion This study provides critical insights on the link between SES and diabetes. Our results highlight that poor health-related behaviors and limited access to healthcare are important pathways for increased diabetes risk related to those with low SES, particularly among Mexican Americans and males. They should be top priorities for agencies and healthcare providers to develop behavior-related interventions to reduce inequalities in diabetes risk.
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Affiliation(s)
- Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Li He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yuanfei Li
- Department of Sociology, University at Albany, State University of New York, Albany, CA, United States
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, United States
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, China
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Long D, Mackenbach JP, Klokgieters S, Kalėdienė R, Deboosere P, Martikainen P, Heggebø K, Leinsalu M, Bopp M, Brønnum-Hansen H, Costa G, Eikemo T, Nusselder WJ. Widening educational inequalities in mortality in more recent birth cohorts: a study of 14 European countries. J Epidemiol Community Health 2023; 77:400-408. [PMID: 37094941 PMCID: PMC10176379 DOI: 10.1136/jech-2023-220342] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/01/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Studies of period changes in educational inequalities in mortality have shown important changes over time. It is unknown whether a birth cohort perspective paints the same picture. We compared changes in inequalities in mortality between a period and cohort perspective and explored mortality trends among low-educated and high-educated birth cohorts. DATA AND METHODS In 14 European countries, we collected and harmonised all-cause and cause-specific mortality data by education for adults aged 30-79 years in the period 1971-2015. Data reordered by birth cohort cover persons born between 1902 and 1976. Using direct standardisation, we calculated comparative mortality figures and resulting absolute and relative inequalities in mortality between low educated and high educated by birth cohort, sex and period. RESULTS Using a period perspective, absolute educational inequalities in mortality were generally stable or declining, and relative inequalities were mostly increasing. Using a cohort perspective, both absolute and relative inequalities increased in recent birth cohorts in several countries, especially among women. Mortality generally decreased across successive birth cohorts among the high educated, driven by mortality decreases from all causes, with the strongest reductions for cardiovascular disease mortality. Among the low educated, mortality stabilised or increased in cohorts born since the 1930s in particular for mortality from cardiovascular diseases, lung cancer, chronic obstructive pulmonary disease and alcohol-related causes. CONCLUSIONS Trends in mortality inequalities by birth cohort are less favourable than by calendar period. In many European countries, trends among more recently born generations are worrying. If current trends among younger birth cohorts persist, educational inequalities in mortality may further widen.
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Affiliation(s)
- Di Long
- Department of Public Health, Erasmus MC, Rotterdam, Netherlands
| | | | - Silvia Klokgieters
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ramunė Kalėdienė
- Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Patrick Deboosere
- Department of Sociology, Vrije Universiteit Brussel, Brussel, Belgium
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Kristian Heggebø
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
- NOVA, Oslo Metropolitan University, Oslo, Norway
| | - Mall Leinsalu
- Stockholm Centre for Health and Social Change, Södertörn University, Huddinge, Sweden
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Matthias Bopp
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | | | - Giuseppe Costa
- Department of Clinical Medicine and Biology, University of Turin, Torino, Italy
| | - Terje Eikemo
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
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10
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Smith BT, Schoer N, Sherk A, Thielman J, McKnight A, Hobin E. Trends in alcohol-attributable hospitalisations and emergency department visits by age, sex, drinking group and health condition in Ontario, Canada. Drug Alcohol Rev 2023; 42:926-937. [PMID: 36843065 DOI: 10.1111/dar.13629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/20/2022] [Accepted: 01/26/2023] [Indexed: 02/28/2023]
Abstract
INTRODUCTION Alcohol-attributable harms are increasing in Canada. We described trends in alcohol-attributable hospitalisations and emergency department (ED) visits by age, sex, drinking group, attribution and health condition. METHODS Hospitalisation and ED visits for partially or wholly alcohol-attributable health conditions by age and sex were obtained from population-based health administrative data for individuals aged 15+ in Ontario, Canada. Population-level alcohol exposure was estimated using per capita alcohol sales and alcohol use data. We estimated the number and rate of alcohol-attributable hospitalisations (2008-2018) and ED visits (2008-2019) using the International Model of Alcohol Harms and Policies (InterMAHP). RESULTS Over the study period, the modelled rates of alcohol-attributable health-care encounters were higher in males, but increased faster in females. Specifically, rates of alcohol-attributable hospitalisations and ED visits increased by 300% (19-76 per 100,000) and 37% (774-1,064 per 100,000) in females, compared to 20% (322-386 per 100,000) and 2% (2563-2626 per 100,000) in males, respectively. Alcohol-attributable ED visit rates were highest among individuals aged 15-34, however, increased faster among individuals aged 65+ (females: 266%; males: 44%) than 15-34 years (females:+17%; males: -16%). High-volume drinkers had the highest rates of alcohol-attributable health-care encounters; yet, low-/medium-volume drinkers contributed substantial hospitalisations (11%) and ED visits (36%), with increasing rates of ED visits in females drinking low/medium volumes. DISCUSSION AND CONCLUSIONS Alcohol-attributable health-care encounters increased overall, and faster among females, adults aged 65+ and low-/medium-volume drinkers. Monitoring trends across subpopulations is imperative to inform equitable interventions to mitigate alcohol-attributable harms.
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Affiliation(s)
- Brendan T Smith
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Nicole Schoer
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Technology Enterprise Facility, Victoria, Canada
| | - Justin Thielman
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Anthony McKnight
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Canadian Institute for Substance Use Research, University of Victoria, Technology Enterprise Facility, Victoria, Canada
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11
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Barros MBDA, Medina LDPB, Lima MG, Sousa NFDS, Malta DC. Changes in prevalence and in educational inequalities in Brazilian health behaviors between 2013 and 2019. CAD SAUDE PUBLICA 2022; 38Suppl 1:e00122221. [PMID: 35857955 DOI: 10.1590/0102-311x00122221] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 04/28/2022] [Indexed: 11/22/2022] Open
Abstract
Considering the relevance of health behaviors for chronic diseases prevalence and mortality and the increase in income concentration observed in the world and in Brazil, this study aimed to evaluate the changes in the prevalence and in the educational inequalities of Brazilian adult health behaviors between 2013 and 2019. We analyzed data of 49,025 and 65,803 adults (18-59 years of age) from the Brazilian National Health Survey (PNS), 2013 and 2019. Prevalence of health behaviors (smoking, alcohol intake, diet, physical activity and sedentarism) were estimated for three educational strata, for both surveys. Prevalence ratios (PR) between year of survey and between educational strata were estimated by Poisson regression models. Significant reductions were found in the prevalence of smoking, physical inactivity, sedentarism, insufficient consumption of fruits, and the excessive consumption of sweetened beverages. However, an increase was observed in alcohol consumption and binge drinking; vegetable consumption remained stable. Contrasting the favorable change in some behaviors, inequalities among schooling strata remained very high in 2019, specially for smoking (PR = 2.82; 95%CI: 2.49-3.20), passive smoking (PR = 2.88; 95%CI: 2.56-3.23) and physical inactivity (PR = 2.02; 95%CI: 1.92-2.13). There was a significant increase in the educational inequality regarding physical inactivity (21%), insufficient intake of fruit (8%) and in the frequent consumption of sweetened beverages (32%). The persistence and enlargement of inequalities highlight the behaviors and social segments that should be special targets for policies and programs focused in promoting healthy lifestyles.
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12
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Miller M, Mojica-Perez Y, Livingston M, Kuntsche E, Wright CJC, Kuntsche S. The who and what of women's drinking: Examining risky drinking and associated socio-demographic factors among women aged 40-65 years in Australia. Drug Alcohol Rev 2022; 41:724-731. [PMID: 35081266 DOI: 10.1111/dar.13428] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Recent trends in Australian national survey data show an increase in alcohol use among middle-aged people, amidst declines in alcohol use among other population groups. There is limited research, however, on middle-aged women's alcohol use. This study aimed to examine patterns in alcohol use among Australian women aged 40-65 and the associated sociodemographic and contextual factors. METHODS Cross-sectional data from six waves of the National Drug Strategy Household Survey (2001-2019). We estimated the prevalence of long-term risky drinking (>2 Australian standard drinks per day) and risky-single occasion drinking (>5 Australian standard drinks on one occasion) among middle-aged women. Logistic regression models were estimated using 2019 data to examine demographic characteristics and contextual factors associated with alcohol use. RESULTS Since 2001, there has been a statistically significant increase in long-term risky drinking and risky-single occasion drinking amongst middle-aged women in Australia. Educational attainment, marital status and employment status were negatively associated with risky drinking, whereas rurality, age and location of use were positively associated with risky drinking. Beverage type was both positively and negatively associated with risky drinking. DISCUSSION AND CONCLUSIONS Given the significant increase in alcohol use amongst middle-aged women in Australia, prevention efforts are needed for this group, which may focus in particular on home drinking and the impact of rurality on alcohol use.
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Affiliation(s)
- Mia Miller
- The George Institute for Global Health, Sydney, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Yvette Mojica-Perez
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Cassandra J C Wright
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
| | - Sandra Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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13
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Educational Gradients in Drinking Amount and Heavy Episodic Drinking among Working-Age Men and Women in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074371. [PMID: 35410052 PMCID: PMC8998990 DOI: 10.3390/ijerph19074371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 02/04/2023]
Abstract
Alcohol-related harm decreases as socioeconomic position increases, although sometimes the opposite happens with alcohol intake. The objective was to know the educational gradient in monthly measures of drinking amount and heavy episodic drinking (HED) among people aged 25−64 years in Spain from 1997−2017. Such gradient was characterized with the relative percent change (PC) in drinking measures per year of education from generalized linear regression models after adjusting for age, year, region, marital status and immigration status. Among men, the PCs were significantly positive (p < 0.05) for prevalence of <21 g alcohol/day (2.9%) and 1−3 HED days (1.4%), and they were negative for prevalences of 21−40 g/day (−1.1%), >40 g/day (−6.0%) and ≥4 HED days (−3.2%), while among women they ranged from 3.6% to 5.7%. The gradient in prevalences of >40 g/day (men) and >20 g/day (women) was greatly attenuated after additionally adjusting for HED, while that of ≥4 HED days was only slightly attenuated after additionally adjusting for drinking amount. Among women, the gradients, especially in HED measures, seem steeper in 2009−2017 than in 1997−2007. Educational inequality remained after additional adjustment for income and occupation, although it decreased among women. These results can guide preventive interventions and help explain socioeconomic inequalities in alcohol-related harm.
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14
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Schmengler H, Peeters M, Kunst AE, Oldehinkel AJ, Vollebergh WAM. Educational level and alcohol use in adolescence and early adulthood-The role of social causation and health-related selection-The TRAILS Study. PLoS One 2022; 17:e0261606. [PMID: 35045096 PMCID: PMC8769339 DOI: 10.1371/journal.pone.0261606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022] Open
Abstract
Both social causation and health-related selection may influence educational gradients in alcohol use in adolescence and young adulthood. The social causation theory implies that the social environment (e.g. at school) influences adolescents' drinking behaviour. Conversely, the health-related selection hypothesis posits that alcohol use (along other health-related characteristics) predicts lower educational attainment. From past studies it is unclear which of these mechanisms predominates, as drinking may be both a cause and consequence of low educational attainment. Furthermore, educational gradients in alcohol use may reflect the impact of 'third variables' already present in childhood, such as parental socioeconomic status (SES), effortful control, and IQ. We investigated social causation and health-related selection in the development of educational gradients in alcohol use from adolescence to young adulthood in a selective educational system. We used data from a Dutch population-based cohort (TRAILS Study; n = 2,229), including measurements of educational level and drinking at ages around 14, 16, 19, 22, and 26 years (waves 2 to 6). First, we evaluated the directionality in longitudinal associations between education and drinking with cross-lagged panel models, with and without adjusting for pre-existing individual differences using fixed effects. Second, we assessed the role of childhood characteristics around age 11 (wave 1), i.e. IQ, effortful control, and parental SES, both as confounders in these associations, and as predictors of educational level and drinking around age 14 (wave 2). In fixed effects models, lower education around age 14 predicted increases in drinking around 16. From age 19 onward, we found a tendency towards opposite associations, with higher education predicting increases in alcohol use. Alcohol use was not associated with subsequent changes in education. Childhood characteristics strongly predicted education around age 14 and, to a lesser extent, early drinking. We mainly found evidence for the social causation theory in early adolescence, when lower education predicted increases in subsequent alcohol use. We found no evidence in support of the health-related selection hypothesis with respect to alcohol use. By determining initial educational level, childhood characteristics also predict subsequent trajectories in alcohol use.
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Affiliation(s)
- Heiko Schmengler
- Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
| | - Margot Peeters
- Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
| | - Anton E. Kunst
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Albertine J. Oldehinkel
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center of Groningen, University of Groningen, Groningen, the Netherlands
| | - Wilma A. M. Vollebergh
- Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
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15
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Keyes KM. Age, Period, and Cohort Effects in Alcohol Use in the United States in the 20th and 21st Centuries: Implications for the Coming Decades. Alcohol Res 2022; 42:02. [PMID: 35083099 PMCID: PMC8772964 DOI: 10.35946/arcr.v42.1.02] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This article is part of a Festschrift commemorating the 50th anniversary of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Established in 1970, first as part of the National Institute of Mental Health and later as an independent institute of the National Institutes of Health, NIAAA today is the world's largest funding agency for alcohol research. In addition to its own intramural research program, NIAAA supports the entire spectrum of innovative basic, translational, and clinical research to advance the diagnosis, prevention, and treatment of alcohol use disorder and alcohol-related problems. To celebrate the anniversary, NIAAA hosted a 2-day symposium, "Alcohol Across the Lifespan: 50 Years of Evidence-Based Diagnosis, Prevention, and Treatment Research," devoted to key topics within the field of alcohol research. This article is based on Dr. Keyes' presentation at the event. NIAAA Director George F. Koob, Ph.D., serves as editor of the Festschrift.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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16
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Klokgieters SS, Kok AAL, Visser M, van Groenou MIB, Huisman M. Changes in the role of explanatory factors for socioeconomic inequalities in physical performance: a comparative study of three birth cohorts. Int J Equity Health 2021; 20:252. [PMID: 34895239 PMCID: PMC8665629 DOI: 10.1186/s12939-021-01592-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to societal changes and changes in the availability of health promoting factors, explanatory factors of socioeconomic inequalities in health (SIH) may change with time. We investigate differences in the relative importance of behavioural, social and psychological factors for explaining inequalities in physical performance between three birth cohorts. METHODS Data came from N = 988, N = 1002, and N = 1023 adults aged 55-64 years, collected in 1992, 2002 and 2012 as part of the Longitudinal Aging Study Amsterdam. Physical performance was measured by three performance tests. We included lifestyle factors (physical activity, smoking, alcohol use and Body Mass Index (BMI)); social factors (network size, network complexity, divorce, social support); and psychological factors (mastery, self-efficacy and neuroticism). In multi-group mediation models, we tested whether the strength of indirect effects from socioeconomic position (SEP) via the explanatory factors to health differed between birth cohorts. Stronger indirect effects indicate an increase in the importance; weaker indirect effects indicate a decrease in importance. RESULTS Absolute SIH were present and similar across cohorts. The strength of indirect effects of SEP on physical performance through smoking, binge alcohol use, emotional support and mastery increased across cohorts. The indirect effects of BMI, network size, self-efficacy and neuroticism were similar across cohorts. CONCLUSIONS Inequalities in smoking, binge alcohol use, emotional support and mastery may have become more important for explaining SIH in recent cohorts of middle-aged adults. Policies that aim to reduce socioeconomic inequalities may need to adapt their targets of intervention to changing mechanisms in order to reduce SIH.
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Affiliation(s)
- Silvia S Klokgieters
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Uniersiteit Amsterdam, Amsterdam Public Health, de Boelelaan 1117, Amsterdam, Netherlands.
| | - Almar A L Kok
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Uniersiteit Amsterdam, Amsterdam Public Health, de Boelelaan 1117, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science and Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - Martijn Huisman
- Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Uniersiteit Amsterdam, Amsterdam Public Health, de Boelelaan 1117, Amsterdam, Netherlands
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit, Amsterdam, The Netherlands
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17
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Platt JM, Jager J, Patrick ME, Kloska D, Schulenberg J, Rutherford C, Keyes KM. Forecasting future prevalence and gender differences in binge drinking among young adults through 2040. Alcohol Clin Exp Res 2021; 45:2069-2079. [PMID: 34741556 DOI: 10.1111/acer.14690] [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: 02/22/2021] [Revised: 06/21/2021] [Accepted: 07/29/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Binge drinking among adolescents and young adults has changed over time, but patterns differ by age and gender. Identifying high-risk groups to target future efforts at reducing drinking in this population remains a public health priority. Forecasting methods can provide a better understanding of variation and determinants of future binge drinking prevalence. METHODS We implemented regression-based forecasting models to estimate the prevalence and gender differences in binge drinking among cohort groups of U.S. young adults, ages 18, 23-24, and 29-30 through 2040. Forecasting models were adjusted for covariates accounting for changes in demographic, Big-5 social roles (e.g., residential independence), and drinking norms and related substance use, to understand the drivers of forecasted binge drinking estimates. RESULTS From the last observed cohort group (years varied by age) through 2040, unadjusted binge drinking prevalence was forecasted to decrease from 26% (95% CI: 20, 33%) (2011-15) to 11% (95% CI: 4, 27%) at age 18, decrease from 38% (95% CI: 30, 45%) (2006-2010) to 34% (95% CI: 18, 55%) at ages 23/24, and increase from 32% (95% CI: 25, 40%) (2001-2005) to 35% (95% CI: 16, 59%) at ages 29/30. Gender-stratified forecasts show a continuation in the narrowing of binge drinking prevalence between young men and women, though the magnitude of narrowing differs by age. Estimated trends were partially explained by changing norms regarding drinking and other substance use, though these indirect effects explained less of the total trend as age increased. CONCLUSIONS Understanding how covariates influence binge drinking trends can guide public health policies to leverage the most important determinants of future binge drinking to reduce the harm caused by binge drinking from adolescence to adulthood.
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18
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Martínez-Cao C, de la Fuente-Tomás L, Menéndez-Miranda I, Velasco Á, Zurrón-Madera P, García-Álvarez L, Sáiz PA, Garcia-Portilla MP, Bobes J. Factors associated with alcohol and tobacco consumption as a coping strategy to deal with the coronavirus disease (COVID-19) pandemic and lockdown in Spain. Addict Behav 2021; 121:107003. [PMID: 34111653 PMCID: PMC8172276 DOI: 10.1016/j.addbeh.2021.107003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/20/2021] [Accepted: 05/31/2021] [Indexed: 12/21/2022]
Abstract
Aim To provide a population-based characterization of sociodemographic and clinical risk and protective factors associated with consumption of alcohol, tobacco, or both as a coping strategy in a sample of the Spanish general population during the early phase of the COVID-19 pandemic. Methods Cross-sectional study based on an online snowball recruiting questionnaire. The survey consisted of an ad hoc questionnaire comprising clinical and sociodemographic information and the Spanish versions of the Depression, Anxiety, and Stress Scale (DASS-21) and the Impact of Event Scale (IES). Results The final sample included 21,207 individuals [mean age (SD) = 39.7 (14.0); females: 14,768 (69.6%)]. Up to 2867 (13.5%) of participants reported using alcohol, 2545 (12%) tobacco and 1384 (6.5%) both substances as a strategy to cope with the pandemic. Sex-related factors were associated with alcohol consumption as a coping strategy [female, OR = 0.600, p < 0.001]. However, education level, work status, and income played different roles depending on the substance used to cope. Having a current mental disorder was associated only with tobacco consumption as a coping strategy [OR = 1.391, p < 0.001]. Finally, sex differences were also identified. Conclusions Sociodemographic, clinical, and psychological factors were associated with consumption of alcohol, tobacco, or both as a coping method for the COVID-19 pandemic and lockdown. Our findings may help develop specific intervention programs reflecting sex differences, which could minimize negative long-term outcomes of substance use after this pandemic.
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19
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Miller ER, Olver IN, Wilson CJ, Lunnay B, Meyer SB, Foley K, Thomas JA, Toson B, Ward PR. COVID-19, Alcohol Consumption and Stockpiling Practises in Midlife Women: Repeat Surveys During Lockdown in Australia and the United Kingdom. Front Public Health 2021; 9:642950. [PMID: 34277533 PMCID: PMC8278199 DOI: 10.3389/fpubh.2021.642950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/03/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: This project examined the impact of COVID-19 and associated restrictions on alcohol practises (consumption and stockpiling), and perceptions of health risk among women in midlife (those aged 45–64 years). Methods: We collected online survey data from 2,437 midlife women in the United Kingdom (UK) and Australia in May 2020, recruited using a commercial panel, in the early days of mandated COVID-19 related restrictions in both countries. Participants were surveyed again (N = 1,377) in July 2020, at a time when COVID-19 restrictions were beginning to ease. The surveys included the Alcohol Use Disorder Identification Test—Consumption (AUDIT-C) and questions alcohol stockpiling. Analysis involved a range of univariate and multivariate techniques examining the impact of demographic variables and negative affect on consumption and acquisition outcomes. Results: In both surveys (May and July), UK women scored higher than Australian women on the AUDIT-C, and residence in the UK was found to independently predict stockpiling of alcohol (RR: 1.51; 95% CI: 1.20, 1.91). Developing depression between surveys (RR: 1.53; 95% CI: 1.14, 2.04) and reporting pessimism (RR: 1.42; 95% CI: 1.11, 1.81), and fear/anxiety (RR: 1.33; 95% CI: 1.05, 1.70) at the beginning of the study period also predicted stockpiling by the end of the lockdown. Having a tertiary education was protective for alcohol stockpiling at each time point (RR: 0.69; 95% CI: 0.54, 0.87). Conclusions: COVID-19 was associated with increases in risky alcohol practises that were predicted by negative emotional responses to the pandemic. Anxiety, pessimism and depression predicted stockpiling behaviour in UK and Australian women despite the many demographic and contextual differences between the two cohorts. Given our findings and the findings of others that mental health issues developed or were exacerbated during lockdown and may continue long after that time, urgent action is required to address a potential future pandemic of alcohol-related harms.
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Affiliation(s)
- Emma R Miller
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Ian N Olver
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Carlene J Wilson
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.,Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, VIC, Australia
| | - Belinda Lunnay
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Samantha B Meyer
- School of Public Health and Health Systems, University of Waterloo, Ontario, ON, Canada
| | - Kristen Foley
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jessica A Thomas
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Barbara Toson
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Paul R Ward
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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20
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Baburin A, Reile R, Veideman T, Leinsalu M. Age, Period and Cohort Effects On Alcohol Consumption In Estonia, 1996-2018. Alcohol Alcohol 2021; 56:451-459. [PMID: 33164062 DOI: 10.1093/alcalc/agaa115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/17/2020] [Accepted: 10/03/2020] [Indexed: 11/14/2022] Open
Abstract
AIMS To analyse the independent effects of age, period and cohort on estimated daily alcohol consumption in Estonia. METHODS This study used data from nationally representative repeated cross-sectional surveys from 1996 to 2018 and included 11,717 men and 16,513 women aged 16-64 years in total. The dependent variables were consumption of total alcohol and consumption by types of beverages (beer, wine and strong liquor) presented as average daily consumption in grams of absolute alcohol. Mixed-effects negative binomial models stratified by sex were used for age-period-cohort analysis. RESULTS Alcohol consumption was highest at ages 20-29 years for both men and women and declined in older ages. Significant period effects were found indicating that total alcohol consumption and consumption of different types of beverages had increased significantly since the 1990s for both men and women. Cohort trends differed for men and women. Men born in the 1990-2000s had significantly lower daily consumption compared to earlier cohorts, whereas the opposite was found for women. CONCLUSION While age-related patterns of alcohol consumption are aligned with life course stages, alcohol use has increased over the study period. Although the total daily consumption among men is nearly four times higher than among women, the cohort trends suggest convergence of alcohol consumption patterns for men and women.
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Affiliation(s)
- Aleksei Baburin
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn 11619, Estonia
| | - Rainer Reile
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn 11619, Estonia.,Institute of Family Medicine and Public Health, University of Tartu, Tartu 50411, Estonia
| | - Tatjana Veideman
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn 11619, Estonia
| | - Mall Leinsalu
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn 11619, Estonia.,Stockholm Centre for Health and Social Change, Södertörn University, Huddinge 141 89, Sweden
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21
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Malta DC, Silva AGD, Prates EJS, Alves FTA, Cristo EB, Machado ÍE. Convergence in alcohol abuse in Brazilian capitals between genders, 2006 to 2019: what population surveys show. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210022. [PMID: 33886895 DOI: 10.1590/1980-549720210022.supl.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/10/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the temporal trend of the prevalence of alcohol abuse among adults in Brazilian capitals, between 2006 and 2019. METHODS Time series study, based on data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel), between 2006 and 2019. The population consisted of adults (≥ 18 years old) with landline telephone residing in Brazilian capitals. The trend analysis was performed by linear regression. RESULTS Between 2006 and 2019 there was a significant increase (p = 0.03) in the abusive consumption of alcoholic beverages in the total adult population, from 15.6 to 18.8%. Among men, there was a stability trend (p = 0.96), and among women, there was an increase from 7.7 to 13.3% (p < 0.001; β = 0.295). In the male gender stratified by capitals, from 2006 to 2019 there was a reduction in Belém, Fortaleza, João Pessoa, Macapá, Manaus, Natal, Recife, São Luis, and Teresina. On the other hand, there was growth in the Federal District. Among women, the trend was upward in: Aracaju, Belo Horizonte, Cuiabá, Curitiba, Florianópolis, Goiânia, Palmas, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, Vitória, and the Federal District. CONCLUSION The results indicate that more adult women are currently drinking in excess compared to previous years, suggesting an increased risk of alcohol-related harm in this portion of the population in Brazilian capitals, bringing about a convergence effect with the prevalence among men and women.
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Affiliation(s)
- Deborah Carvalho Malta
- Maternal-Child and Public Health Nursing Department, Nursing School, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Alanna Gomes da Silva
- Post-graduate Nursing School, Nursing School, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | | | - Elier Broche Cristo
- Secretariat of Health Surveillance, Ministry of Health - Brasília (DF), Brazil
| | - Ísis Eloah Machado
- Department of Family Medicine, Mental and Collective Health, Medical School, Universidade Federal de Ouro Preto - Ouro Preto (MG), Brasil
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22
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Klare DL, McCabe SE, Ford JA, Schepis TS. Prescription drug misuse, other substance use, and sexual identity: The significance of educational status and psychological distress in US young adults. Subst Abus 2020; 42:377-387. [PMID: 32692942 DOI: 10.1080/08897077.2020.1784358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim was to examine the effects of sexual identity, educational status, and their interaction on the past-year prevalence of controlled prescription use and prescription drug misuse (PDM) in U.S. young adults, 18-25 years. Methods: Data were from the 2015-2017 National Survey on Drug Use and Health (young adult N = 38,298). Past-year prescription opioid, stimulant and benzodiazepine use and PDM were outcomes, with PDM defined as use without a prescription or in ways not intended by the prescriber. Separate regressions by sex evaluated the relationship between prescription medication use or PDM prevalence and sexual identity, educational status/attainment (college student/graduate versus non-college), their interaction and past-year psychological distress. Results: Sexual identity minority young adults had higher rates of prescription use and PDM than heterosexual young adults. After accounting for educational status, though, bisexual men rarely differed from heterosexual men; after including psychological distress, gay men rarely differed from heterosexual men. Versus heterosexual women, lesbian (adjusted odds ratio [AOR] = 2.33, 95% confidence interval [95% CI] = 1.47-2.30) and bisexual (AOR= 1.78, 95% CI = 1.27-2.50) young adult women had higher rates of prescription opioid misuse, after adjusting for educational status, psychological distress and sociodemographics. Versus heterosexual men, benzodiazepine PDM was elevated in gay men (AOR = 1.91, 95% CI= 1.02-3.58). Educational status was generally associated with lower rates of prescription use and PDM, except for stimulant PDM. Conclusions: Screening for psychological distress and PDM is needed in sexual identity minority young adults, especially for prescription opioid misuse among sexual identity minority women. Culturally-sensitive intervention should be considered for those with elevated psychological distress or signs of PDM. Further research on the sex differences found in the link between psychological distress and sexual identity minority opioid and stimulant PDM is warranted.
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Affiliation(s)
- Dalton L Klare
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Jason A Ford
- Department of Sociology, University of Central Florida, Orlando, Florida, USA
| | - Ty S Schepis
- Department of Psychology, Texas State University, San Marcos, Texas, USA
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23
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Vierboom YC. Trends in alcohol-related mortality by educational attainment in the U.S., 2000-2017. POPULATION RESEARCH AND POLICY REVIEW 2020; 39:77-97. [PMID: 32038052 PMCID: PMC7006889 DOI: 10.1007/s11113-019-09527-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 03/28/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Alcohol-related mortality rates in the U.S. have risen since 2000, though how trends vary across socio-economic status is unclear. METHODS This analysis combines data from vital statistics and the National Health Interview Survey (NHIS) to estimate alcohol-related mortality rates at four levels of educational attainment (less than high school, high school/GED, some college/associate's degree, four-year degree or more) over the period 2000-2017. The analysis includes a comprehensive set of 48 alcohol-related causes of death, including causes which are indirectly influenced by alcohol use. I consider period and cohort patterns in inequality using the relative index of inequality (RII). RESULTS Mortality rates increased over the study period, at all levels of educational attainment. Relative increases were larger for females than males at nearly all ages and levels of educational attainment, and were largest among 45-59 year-old women. Male and female members of the 1950-1959 birth cohort exhibited elevated rates of alcohol-related mortality relative to neighboring cohorts. Despite widespread increases in alcohol-related mortality, educational inequalities present at the beginning of the analysis persisted and exceeded those in all-cause mortality. Disparities were typically greatest among younger adults ages 30-44, though inequality in this age group declined over time. Inequality increased among females ages 60-74, as well as among males ages 45-74. IMPLICATIONS While interventions targeting these groups may reduce educational disparities, care should also be taken to stem the increasing prevalence of alcohol-related deaths at all levels of educational attainment.
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Affiliation(s)
- Yana C Vierboom
- Population Studies Center, University of Pennsylvania, McNeil Building, 3718 Locust Walk, Philadelphia, PA, U.S
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24
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Pabst A, van der Auwera S, Piontek D, Baumeister SE, Kraus L. Decomposing social inequalities in alcohol consumption in Germany 1995-2015: an age-period-cohort analysis. Addiction 2019; 114:1359-1368. [PMID: 30882985 DOI: 10.1111/add.14616] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/28/2018] [Accepted: 03/12/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Sandra van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | | | - Sebastian E Baumeister
- Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T, Augsburg, Germany.,Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Munich, Germany.,Department for Public Health Sciences, Stockholm University, Stockholm, Sweden.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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25
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Keyes KM, Jager J, Mal-Sarkar T, Patrick ME, Rutherford C, Hasin D. Is There a Recent Epidemic of Women's Drinking? A Critical Review of National Studies. Alcohol Clin Exp Res 2019; 43:1344-1359. [PMID: 31074877 DOI: 10.1111/acer.14082] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022]
Abstract
Alcohol consumption is increasing in the United States, as is alcohol-attributable mortality. Historically, men have had higher rates of alcohol consumption than women, though evidence for birth cohort effects on gender differences in alcohol consumption and alcohol-related harm suggests that gender differences may be diminishing. We review studies using U.S. national data that examined time trends in alcohol consumption and alcohol-related harm since 2008. Utilizing a historical-developmental perspective, here we synthesize and integrate the literature on birth cohort effects from varying developmental periods (i.e., adolescence, young adulthood, middle adulthood, and late adulthood), with a focus on gender differences in alcohol consumption. Findings suggest that recent trends in gender differences in alcohol outcomes are heterogeneous by developmental stage. Among adolescents and young adults, both males and females are rapidly decreasing alcohol consumption, binge and high-intensity drinking, and alcohol-related outcomes, with gender rates converging because males are decreasing consumption faster than females. This pattern does not hold among adults, however. In middle adulthood, consumption, binge drinking, and alcohol-related harms are increasing, driven largely by increases among women in their 30s and 40s. The trend of increases in consumption that are faster for women than for men appears to continue into older adult years (60 and older) across several studies. We conclude by addressing remaining gaps in the literature and offering directions for future research.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Columbia University, New York, New York.,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, Arizona
| | | | - Megan E Patrick
- Institute for Translational Research in Children's Mental Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Deborah Hasin
- Department of Epidemiology, Columbia University, New York, New York
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26
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Leventhal AM, Bello MS, Galstyan E, Higgins ST, Barrington-Trimis JL. Association of Cumulative Socioeconomic and Health-Related Disadvantage With Disparities in Smoking Prevalence in the United States, 2008 to 2017. JAMA Intern Med 2019; 179:777-785. [PMID: 31009023 PMCID: PMC6547249 DOI: 10.1001/jamainternmed.2019.0192] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Understanding emerging patterns of smoking disparities among disadvantaged populations can guide tobacco control policy. OBJECTIVE To estimate disparities in smoking prevalence associated with the number of socioeconomic and health-related disadvantages faced by a population among US adults from 2008 to 2017. DESIGN, SETTING, AND PARTICIPANTS Nationally representative cross-sectional annual household-based probability sample of US noninstitutionalized residents. Polytomous regression estimated associations of disadvantage variables, survey year, and their interaction with the following 3 pairwise contrasts: current vs never smoking (estimate of overall disparities), current vs former smoking (unique contribution of disparities in smoking cessation), and former vs never smoking (unique contribution of disparities in smoking initiation). The setting was in-home face-to-face interviews. Participants were respondents in 2008 to 2017 survey years who were aged 25 years or older (N = 279 559). EXPOSURES Self-reported past-year unemployment, income below the federal poverty line, absence of high school diploma, disability/limitation interfering with daily functions, serious psychological distress on the Kessler 6-item screen, and at least 60 past-year heavy drinking days, each coded yes or no. These indicators were summed in a cumulative disadvantage index (0, 1, 2, 3, 4, or 5 or 6). MAIN OUTCOMES AND MEASURES Self-reported current, former (ever smoked ≥100 cigarettes, had since quit, and not currently smoking), and never (<100 cigarettes) smoking. RESULTS Among 278 048 respondents (mean [SD] age, 51.9 [16.8] years; 55.7% female) with data on smoking history (99.5% of the sample), the mean current smoking prevalence across 2008 to 2017 compared with populations without disadvantages was successively higher among populations with 1 disadvantage (21.4% vs 13.8%; current vs never smoking adjusted odds ratio [OR], 2.34; 95% CI, 2.27-2.43), 2 disadvantages (26.6% vs 13.8%; OR, 3.55; 95% CI, 3.39-3.72), 3 disadvantages (35.1% vs 13.8%; OR, 5.35; 95% CI, 5.05-5.66), 4 disadvantages (45.7% vs 13.8%; OR, 8.59; 95% CI, 7.91-9.34), or 5 or 6 disadvantages (58.2% vs 13.8%; OR, 14.70; 95% CI, 12.30-17.50). In current vs former and former vs never smoking status contrasts, ORs were lower but also showed successively greater associations with increasing cumulative disadvantage. Current (vs never) smoking odds significantly declined each year among populations with 0 (OR, 0.95; 95% CI, 0.94-0.96), 1 (OR, 0.96; 95% CI, 0.95-0.97), or 2 (OR, 0.98; 95% CI, 0.97-0.99) disadvantages but did not change across 2008 to 2017 among those with 3 or more disadvantages. CONCLUSIONS AND RELEVANCE Results of this study demonstrate that US disparities in smoking prevalence from 2008 to 2017 were successively larger with each additional disadvantage faced, were expressed in higher smoking initiation odds and lower smoking cessation odds, and widened over time.
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Affiliation(s)
- Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles.,Department of Psychology, University of Southern California, Los Angeles.,USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles
| | - Mariel S Bello
- Department of Psychology, University of Southern California, Los Angeles
| | - Ellen Galstyan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Stephen T Higgins
- Department of Psychiatry, Vermont Center on Behavior and Health, University of Vermont, Burlington.,Department of Psychological Science, Vermont Center on Behavior and Health, University of Vermont, Burlington
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27
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Chen CF, Kao WT, Liu KT, Chen SL, Huang YT, Huang CC. Alcohol use disorders associated with an increased risk of mesenteric ischemia: A nationwide cohort study. Drug Alcohol Depend 2019; 194:264-270. [PMID: 30469097 DOI: 10.1016/j.drugalcdep.2018.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/26/2018] [Accepted: 10/28/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND To evaluate the relationship of patients with a history of alcohol use disorders (AUD) and its diagnostic categories with risk of subsequent mesenteric ischemia in Taiwan. METHODS A nationwide population-based cohort study was conducted using data from the Taiwan's National Health Insurance Research Database. We identified 73,583 patients hospitalized for AUD between 2001 and 2010, and matched each case with four comparison patients based on age, gender, Charlson comorbidity index, and the index date. Cox proportional hazard models were used to evaluate the risk of mesenteric ischemia between the AUD and non-AUD cohorts. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated. RESULTS Patients with AUD exhibited a significantly increased risk of developing mesenteric ischemia (HR = 2.25; 95% CI 1.92-2.64) compared with those with non-AUD after adjustment for patient sociodemographic, coexisting comorbid conditions, and hospital characteristics. Furthermore, a 2.29- and 2.17-fold higher risk of mesenteric ischemia was observed in patients with alcohol abuse/dependence (HR = 2.29; 95% CI 1.94-2.71) and alcoholic psychosis (HR = 2.17; 95% CI 1.72-2.73), respectively, than in non-AUD comparisons after covariate adjustment. CONCLUSIONS This study confirmed that the risk of mesenteric ischemia was significantly higher among patients with different diagnostic categories of AUD, particularly for those with alcohol abuse/dependence.
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Affiliation(s)
- Chieh-Fan Chen
- Department of Emergency, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan; Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Tsung Kao
- Laboratory of Research, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; Departments of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
| | - Kuan-Ting Liu
- Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Internal Medicine, Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Ling Chen
- Department of Nursing, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan; Department of Shipping Technology, National Kaohsiung University of Science and Technology, Taiwan
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statistics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chun-Che Huang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
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