Exposure to neighborhood poverty and drinking patterns over five years

Few US studies have examined residential migration of heavy drinkers over time. We examined impacts of longitudinal drinking patterns on exposure to neighborhood poverty and assessed moderators of these effects. We expected persistently heavy drinkers have longer exposure to neighborhood poverty than those whose drinking declined over time, and that this effect would be most likely for heavy drinkers who had been to treatment. We used data from problem drinkers recruited from alcohol treatment programs and a probability sample of heavy drinkers drawn from the same county. Drinking patterns were derived using latent class growth modeling including cases with 4 waves of data over 5 years. Analyses focused on respondents whose drinking declined over time (N=217), compared to those with consistently moderate alcohol use (N=229) and those with consistently heavy alcohol use (N=572). Multivariate generalized estimating equations tested associations of drinking pattern with proportion of time in high-poverty neighborhoods (using geocoded addresses from 5 waves over 7 years), adjusting for neighborhood clustering, individual demographics and baseline neighborhood median income. Results partially supported hypotheses. Exposure to neighborhood poverty was significantly longer for heavy drinkers and marginally higher for moderate drinkers compared to those with declining use. There was a significant interaction of drinking pattern with receiving treatment, with both heavy and moderate drinkers who went to treatment showing significantly longer duration of exposure to poverty than counterparts who went to treatment and reduced drinking over time. Reducing drinking after attending substance abuse treatment may help decrease exposure to high-risk neighborhoods.