Health-related social control among U.S. adults ages 30–80: Associations with alcohol use over four years

Abstract

Health-related social control (HRSC) includes efforts to regulate or influence others' health behaviors and is an important way interpersonal relationships can affect individual-level health. This study used egocentric network data to describe the size and composition of HRSC networks, identify trajectories of HRSC receipt, and examine how HRSC is related to binge drinking and alcohol-related problems. Data come from a U.S. nationally representative sample of 1235 adults age 30 and older (baseline mean age = 52, 52% female, 64% White) who completed four annual surveys between 2019 and 2022. On average, 30% of adults' network members were HRSC agents who told or reminded them to do things to protect their health. At baseline, 50% of respondents identified a spouse/partner as a HRSC agent, 56% a relative, 46% a friend, and 12% someone else. Respondents' relationships with HRSC agents were generally strong, 93% of agents were described as people “whose opinion matters,” and only 10% were described as hassling or making life difficult for the respondent. Growth mixture modeling identified five trajectories of HRSC receipt over the four-year period: Stable High (36% of sample), Stable Moderate (47%), Stable Low (14%), Decreasing (2%), and Increasing (2%). Binge drinking was relatively consistent for the three Stable HRSC classes (ranging from 11% to 15% of individuals), decreased steadily for the Increasing HRSC class (32%–16%), and fluctuated for the Decreasing HRSC class (decreasing from 10% to 2%, then increasing to 8%). For alcohol problems, the Increasing HRSC class showed the largest increase (2%–21%) before dropping to near-baseline levels (4%), whereas the Decreasing HRSC class fluctuated during the first three waves followed by no individuals reporting alcohol problems at the last wave. Results highlight the importance of examining heterogeneity in adults’ HRSC experiences because of its implications for understanding social influences on health-related behaviors.