Interactions of Neighborhood and Individual Socioeconomic Status on Alcohol Outcomes: A Test of Three Theories

Neighborhood socioeconomic status (NSES) influences substance use, but as most studies have focused on main effects of NSES it is unclear whether neighborhood effects vary by individual-level SES (ISES). Theories of double jeopardy, relative deprivation and status inconsistency suggest there may be important interactions of NSES and ISES. We examine these interactions in predicting alcohol outcomes and assess competing hypotheses concerning subgroup differences based on these three theories.

Survey data from the 2000 and 2005 U.S. National Alcohol Surveys (N = 13,975 adults over age 23) were linked to indicators of NSES from the 2000 U.S. Decennial Census. Neighborhoods were classified into 3 groups (disadvantaged, middle-class and affluent) based on composite indicators of tract disadvantage and affluence; ISES was a 3-level variable based on education and income. The sample was restricted to current drinkers for analysis of 12-month drinking patterns and problems (N=8,728). Regression analyses used survey weights, with specific contrasts to test each theory in an overall sample, and for men and women separately.

Across NSES, higher SES persons were most likely to be current drinkers, but heavy drinking and alcohol problems were greatest among low SES drinkers. ISES differences were most pronounced in affluent and disadvantaged neighborhoods. Findings support social comparison/relative deprivation for drunkenness and heavy drinking overall and for men, and also suggest double jeopardy effects for both men and women on the same outcomes. Results did not support a status inconsistency hypothesis. Mechanisms underlying interactive effects of NSES and ISES should be elaborated in future work.