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APHA Scientific Session and Event Listing

Recorded presentation

Nina Mulia, DrPH¹, Yu Ye, MA², Sarah Zemore, PhD¹, Thomas Greenfield, PhD², and Sarah Keithly, BS³. (1) Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, 510-597-3440, nmulia@arg.org, (2) Alcohol Research Group, Public Health Institute, Bay Center, Building C, Suite 400, 6475 Christie Ave., Emeryville, CA 94608, (3) School of Public Health, University of California, Berkeley, 140 Warren Hall #7360, Berkeley, CA 94720

In recent years, considerable attention has focused on the deleterious health effects of social disadvantage, and the health disparities that these foster. Alcohol studies have not often examined social disadvantage in relation to alcohol problems. In this study, we consider the effects of social inequality on heavy drinking and alcohol-related problems among current drinkers, and whether these effects vary by race/ethnicity.

Using data from the 2005 US National Alcohol Survey (partial N=3300 drinkers), our measures of social inequality include poverty level, unfair treatment, and racial stigma. Outcomes include heavy drinking and alcohol-related problems (2+ drinking consequences, and DSM-IV alcohol dependence). In multivariate analyses, we found that people with greater exposure to unfair treatment, poverty, and stigma were more likely to report alcohol-related problems. The effect of unfair treatment was strongest, and was also positively related to heavy drinking. Further, our social inequality measures had main effects on alcohol problems independent of heavy drinking. We found a similar result for cumulative inequality (a composite of all three measures). In general, the effects of social inequality were stronger in white and black drinkers than among Hispanic drinkers.

These results highlight the importance of social inequality to understanding alcohol problems, particularly among white and black drinkers. They are also consistent with recent suggestions that, independent of drinking pattern, the socially disadvantaged experience greater alcohol problems. Future research should assess the directionality of effects, and consider the role of drinking norms and community reactions in explaining ethnic variation in alcohol problems.

Learning Objectives:

• Describe the relationships between social inequality, heavy drinking, and alcohol-related problems.
• Recognize that these relationships vary by racial/ethnic group.
• Appreciate the importance of social inequality to the study of alcohol problems, and articulate factors that could possibly explain why these relationships might vary by ethnic subgroup.

Keywords: Alcohol Problems, Social Inequalities

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation