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

Abstract

Background and AimsAlcohol 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.DesignThis was a retrospective cohort, longitudinal study.Setting, Participants and MeasurementsData 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.FindingsBinge 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.ConclusionsIn 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.

Unmet need for alcohol use disorder treatment in reproductive-age females, with emphasis on pregnant and parenting populations in the United States: Findings from NSDUH 2015–2021

“…Collectively, while these trends may seem counterintuitive, they emphasize the importance of addressing alcohol misuse among females, irrespective of their socioeconomic status. The finding that women who are not pregnant/not parenting are at a higher risk of AUD aligns with recent work by Adams et al (2023), who identified a time trend of increasing binge drinking and AUD among child-free women of reproductive age in the US (OR = 1.73, 95% CI: 1.42-2.12, in 2018-2019 relative to 1993-1997) [22]. Additionally, there was an inverse association between the transition to parenthood and excessive drinking (the ORs range for binge drinking among 18-24-year-old women without children compared to those who had children was 1.22-1.55) [22].…”

“…The finding that women who are not pregnant/not parenting are at a higher risk of AUD aligns with recent work by Adams et al (2023), who identified a time trend of increasing binge drinking and AUD among child-free women of reproductive age in the US (OR = 1.73, 95% CI: 1.42-2.12, in 2018-2019 relative to 1993-1997) [22]. Additionally, there was an inverse association between the transition to parenthood and excessive drinking (the ORs range for binge drinking among 18-24-year-old women without children compared to those who had children was 1.22-1.55) [22]. The increased risk of AUD in the non-pregnant, non-parenting group also extends to inadvertent alcohol exposure during the early stages of an unplanned pregnancy.…”

Reasons for alcohol use from 1976 to 2020 in the United States among individuals aged 18 to 30: Historical changes and mediation of cohort effects in binge drinking

“…While men remain more likely to binge drink than women, increases in social reasons to drink among adult women have been faster than increases for men, and because endorsing social reasons for drinking is associated with higher rates of binge drinking, this faster increase had led to convergence between men and women. Available evidence indicates that roles associated with more binge drinking, such as college attendance (Bailey & DiPrete, 2016), are increasing more among women than men across the last four decades, and roles associated with less binge drinking are declining, such as marriage/co‐habitation and having children (Adams et al., 2023; McKetta & Keyes, 2019; Mortimer, 2015). Previous analyses have also indicated that increases in binge drinking among adult women are concentrated in those with the highest levels of income, education, and occupational prestige (McKetta et al., 2021; McKetta & Keyes, 2020), which together come with more resources to purchase products such as alcohol.…”

Wine mom culture: Investigating social media influence on mothers’ alcohol norms.

“…The probability of mothers ages 30-44 engaging in binge drinking increased from 17% in 2006 to 32% in 2018. Women in 2018-2019 were more likely to engage in binge drinking and experience symptoms of alcohol use as compared to women in 1993-1997, which may in part be due to increasing numbers of women attending college, where risky drinking habits are often developed (R. S. Adams et al, 2023).…”