Interactive effects of social networks and neighborhood disadvantage on heavy drinking: A longitudinal study

Background: Where you live influences your drinking, with disadvantaged neighborhoods increasing problem drinking. Support or pressure to reduce alcohol use may buffer negative effects of poor neighborhoods, whereas heavy drinking social networks may worsen outcomes.

Methods: We used longitudinal data from a probability sample of 660 problem drinkers (defined using heavy drinking, alcohol abuse, and social consequences) interviewed at baseline and after one year. Geocoded baseline addresses were linked with Census data on neighborhood poverty. Social network characteristics included baseline support and pressure to reduce drinking, and increase in number of heavy drinkers in social network from baseline to follow-up. Effects of disadvantage on problem drinking at follow-up were analyzed using generalized estimating equations stratified by social network characteristics, which accounted for neighborhood clustering and individual demographics.

Results: Findings supported hypotheses. There were significantly higher odds of remaining a problem drinker for those in disadvantaged neighborhoods. There also was an interaction between support to reduce drinking and disadvantage. Stratified models showed disadvantage significantly increased problem drinking only for people without network support for sobriety. Although interactions with disadvantage were not significant for pressure nor heavy drinkers in network, stratified models showed disadvantage significantly increased problem drinking for people without pressure to cut down and for people with increasing numbers of heavy drinkers in their networks.

Conclusions: Results suggest social networks can buffer effects of neighborhood disadvantage on problem drinking. Prevention efforts should focus on helping problem drinkers develop supportive social networks, especially in disadvantaged neighborhoods, to reduce alcohol problems.