Neighborhood Contextual Factors, Alcohol Use, and Alcohol Problems in the United States: Evidence From a Nationally Representative Study of Young Adults

Abstract

Background There is considerable variation in alcohol use and problems across the United States, suggesting that systematic regional differences might contribute to alcohol involvement. Several neighborhood contextual factors may be important aspects of this “alcohol environment.” Methods Participants were 15,197 young adults (age 18–26) from Wave III of the National Longitudinal Study of Adolescent to Adult Health, a nationally-representative United States survey. Measures of past-year alcohol use and problems were obtained via structured in-home interviews. Tract-level neighborhood contextual factors (density of on- and off-premises alcohol outlets, neighborhood disadvantage, rural versus urban residence) were derived from census indicators and geocoded state-level alcohol outlet licenses. Multivariate logistic regression, ordered logistic regression, or negative binomial regression models, including age, sex, race, and household income as covariates, were fit to examine the relation of the neighborhood contextual factors with alcohol use and problems. Results The most consistent finding across four of the five measures of alcohol involvement was their association with neighborhood advantage; the active ingredient underlying this effect was primarily the proportion of educated residents in the neighborhood. The densities of alcohol outlets were associated with any alcohol use – they were not associated with binge drinking or alcohol problems, nor could they explain any of the neighborhood advantage effects. The influence of alcohol outlet densities on alcohol involvement did not differ for those above or below the legal age to purchase alcohol. Living in a rural versus an urban neighborhood was associated with a different alcohol use pattern characterized by a lower likelihood of any drinking, but among those who drank, consuming more alcohol per occasion. Conclusions Living in a more advantaged and educated urban neighborhood with greater densities of bars and restaurants is associated with greater alcohol involvement among 18–26-year-olds in the United States.

The neighbourhood social environment and alcohol use among urban and rural Scottish adolescents

“…Conversely, many studies have found that, among adults, those in urban areas have higher rates of alcohol use compared to those in rural areas (Dixon and Chartier 2016; Slutske et al 2016). Comprehension of different drinking trajectories across the life course, in terms of urban/rurality, is needed to explain this pattern.…”

“…It is important to note that the sample was made up of 15-year-olds; therefore, findings of an urban/rural gradient in having ever drunk represent a more delayed initiation to drinking but do not necessarily translate to lifetime abstention throughout adulthood. Conversely, many studies have found that, among adults, those in urban areas have higher rates of alcohol use compared to those in rural areas (Dixon and Chartier 2016 ; Slutske et al 2016 ). Comprehension of different drinking trajectories across the life course, in terms of urban/rurality, is needed to explain this pattern.…”

“…Research examining neighbourhood characteristics and adolescent drinking typically focuses on urban environments (Bryden et al 2013 ). However, adolescents’ urban/rural status has been found to associate with their alcohol use and has been theorised to contribute to geographic variation in drinking behaviours (Slutske et al 2016 ). Contemporary research has shown that adolescents residing in rural areas tend to drink alcohol at higher rates than those in urban areas (Dixon and Chartier 2016 ; Donath et al 2011 ).…”

Alcohol Drinking Pattern Is Associated with Demographic Features of Primary Health Care Patients in Poland: A Cross-Sectional Study

“…The associations between drinking pattern and demographic features, like age and sex, as well as neighborhood contextual factors, have been observed. A study of 15 197 young adults living in the USA has shown that more advantaged and educated people living in urban neighborhoods with higher densities of places selling alcohol have higher alcohol involvement among people 18–26 years olds [ 12 ]. However, a recent study among young white and black women in the USA revealed that ethno-cultural diversity also significantly influences alcohol use [ 13 ].…”

Moderation of Genetic Influences on Alcohol Involvement by Rural Residency among Adolescents: Results from the 1962 National Merit Twin Study

“…Families residing in rural areas are more likely to be living in poverty than families living in urban areas (Kusmin 2016; Miller and Rowley 2002). Although there is not a consistent association between socioeconomic status and alcohol use in adolescence (Hanson and Chen 2007; Slutske et al 2016), it is plausible that the expression of the genetic propensity to use alcohol may be restricted among those with limited financial means to purchase alcohol.…”