Neighborhood Disadvantage, High Alcohol Content Beverage Consumption, Drinking Norms, and Drinking Consequences: A Mediation Analysis

Abstract

Alcohol use can cause significant harm. We examined the relationships between neighborhood disadvantage, consumption of high-alcohol-content beverages (HACB), drinking norms, and self-reported drinking consequences using data from the 2000 and 2005 National Alcohol Surveys (N09,971 current drinkers) and the 2000 Decennial Census. We hypothesized that (1) individuals living in disadvantaged neighborhoods would report more negative drinking consequences than individuals living in more affluent neighborhoods, and (2) this relationship would be mediated by HACB consumption and pro-drunkenness drinking norms. Neighborhood disadvantage was based on a composite measure of socioeconomic indicators from the 2000 Decennial Census (five-item composite, alpha00.89). We measured high alcohol content beverage consumption in terms of whether respondents engaged in frequent or heavy consumption of malt liquor, fortified wine, or distilled spirits/liquor. The outcome was a dichotomous indicator of two or more of 15 past-year social, legal, work, and health consequences. Simultaneous, multivariate path modeling tested direct and indirect effects of neighborhood disadvantage, HACB consumption, and prodrunkenness norms on consequences. Individuals living in disadvantaged neighborhoods reported significantly more negative drinking consequences than individuals living in more affluent neighborhoods. Consumption of high-alcoholcontent beverages and pro-drunkenness norms did not mediate this relationship. However, heavy distilled spirits/liquor use was a significant mediator of other neighborhood characteristics (i.e., percent African American). Living in an African American neighborhood was related to increased spirits/liquor consumption and, in turn, reporting more negative drinking consequences. Greater scrutiny of advertising and tax policies related to distilled spirits/liquor is needed to prevent future drinking problems, especially in minority neighborhoods.

Longitudinal associations of neighborhood socioeconomic characteristics and alcohol availability on drinking: Results from the Multi-Ethnic Study of Atherosclerosis (MESA)

“…Beer is more affordable than most wine and liquor, so our results may simply reflect financial preferences. Jones-Webb and Kariker-Jaffee (2013) examined the association between neighborhood disadvantage and high alcohol content consumption and found that disadvantage was associated with the consumption of malt liquor and fortified wine but not high spirit volumes. Although additional research is necessary to better understand how neighborhood SES influences specific types of alcohol use, our results are in accordance with the limited evidence that the neighborhood context is not equally associated with all types of alcohol use (Jones-Webb & Karriker-Jaffe, 2013).…”

Associations of Alcohol Availability and Neighborhood Socioeconomic Characteristics With Drinking: Cross-Sectional Results From the Multi-Ethnic Study of Atherosclerosis (MESA)

“…One of the strengths of our study was the focus on multiple patterns of alcohol use and types of alcohol consumed. Only two studies of which we are aware examined neighborhood effects on beverage-specific alcohol use (Picone et al, 2010, Jones-Webb and Karriker-Jaffe 2013). Developing a better understanding of how neighborhood context influences beverage-specific alcohol use has several important public health implications.…”

Individual, peer, and family factor modification of neighborhood-level effects on adolescent alcohol, cigarette, e-cigarette, and marijuana use

“…In a comprehensive review (Jackson et al, 2014), most studies did not find significant associations between disadvantage and alcohol use that may be partly attributable to lack of consideration of effect modifiers and the use of different definitions of neighborhood disadvantage. Many studies lack generalizability by focusing on samples with limited racial/ethnic diversity, or high-risk youth (Buu et al, 2009; Fite et al, 2009; Fuller et al, 2005; Jones-Webb and Karriker-Jaffe, 2013), and are older studies (Crum et al, 1996) that may not accurately reflect current neighborhood socioeconomic conditions or current ATOD use patterns.…”