Prospective and cross-sectional associations of neighborhood socioeconomic disadvantage with drinking and heavy drinking in mid-adulthood in a US national cohort.

Abstract

Understanding how neighborhood socioeconomic disadvantage contributes to risk for alcohol use and misuse has important implications for prevention and intervention. Data were from the National Longitudinal Survey of Adolescent to Adult Health. Past-month quantity-frequency of alcohol use and heavy drinking in mid-adulthood (ages 33-43) were prospectively and cross-sectionally predicted from neighborhood socioeconomic disadvantage measured in adolescence (ages 12-21) and in mid-adulthood (ages 33-43). Differences in exposure and vulnerability to neighborhood disadvantage by race/ethnicity, sex, and socioeconomic status were also examined. There was a significant prospective, but not cross-sectional, association between greater neighborhood disadvantage and reduced alcohol use in mid-adulthood. Each additional standard deviation of disadvantage in adolescence was associated with a 14% (p < .001) decrease in the number of drinks (about three fewer drinks) and 20% (p < .001) reduced odds of heavy drinking in the past month in mid-adulthood and this was not affected by the neighborhood to which one was exposed in mid-adulthood. This relation was significantly moderated by race/ethnicity wherein the association between neighborhood disadvantage in adolescence and less alcohol use in mid-adulthood was significant among White but not among Hispanic, Black, or Asian/Pacific Islander individuals. These results suggest that prevention and intervention efforts should focus on exposure to neighborhood disadvantage in adolescence. Research is needed that can identify the mechanisms underlying the effect of neighborhood disadvantage on alcohol outcomes, especially mechanisms specific to race/ethnicity subgroups, accounts for exposure versus vulnerability, and can disentangle causal associations from differential selection into disadvantaged neighborhoods.