Abstract
This multilevel study examined whether state-level variations existed in the prevalence of regular alcohol use in the US after controlling for individual characteristics, evaluating the contribution of both individual socio-economic status
Highlights
Contextual variables are important determinants of health even after accounting for differences in individual-level characteristics [1,2,3]
Our results showed that state socio-economic conditions and state alcohol policy were as important as individual-level characteristics in explaining alcohol use in the U.S Policies aimed at reducing alcohol use may be more effective if they address both situational and individual factors
To investigate whether state variability resulted from individual level factors, we examined whether the state-level variance σμ2 decreased when individual variables were introduced into the model
Summary
Contextual variables are important determinants of health even after accounting for differences in individual-level characteristics [1,2,3]. There has been increasing attention to the ways neighborhood environments may influence alcohol consumption and alcohol-related health problems [7]. Alcohol consumption is influenced by the cultural context of drinking and the level of integration of alcohol in the society [8]. Ecological studies find alcohol-related outcomes occurring disproportionately in neighborhoods with high alcohol outlet density. It appears that an effect of outlet densities on alcohol-related outcomes operates through effects at the neighborhood rather than the individual level [9]
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