Neighborhood factors, drinking behavior, and alcohol use disorder in San Juan, Puerto Rico.

Abstract

Residing in neighborhoods characterized by objective measures of disadvantage has been associated with poorer health outcomes, above and beyond individual characteristics. This study tests a partial mediational model by which the association between neighborhood disadvantage (census-level poverty, undereducation, and unemployment), and the volume of weekly alcohol consumption, binge drinking, and alcohol use disorder (AUD) among Puerto Ricans in San Juan, Puerto Rico, is partially mediated by perceived neighborhood collective efficacy (social cohesion and social control). Data are from a household random sample of 1,510 adults in San Juan, Puerto Rico (response rate, 83%). The direct effect of collective efficacy on the alcohol-related outcomes was not statistically significant. Census-level education and unemployment had no direct influence on collective efficacy. For both men and women, there were no indirect effects of the three census-level indicators of disadvantage on collective efficacy and, in turn, on binge drinking, weekly consumption, and lifetime or past-year AUD. Men residing in areas with high undereducation were less likely to report past-year AUD, and women living in these areas were less likely to report lifetime AUD. Women residing in high poverty areas also reported higher rates of lifetime AUD. The effect of neighborhood disadvantage on drinking outcomes was not explained by collective efficacy. Other factors such as family cohesion or social support may be more important than collective efficacy in mediating the effects of neighborhood disadvantage on drinking outcomes in Puerto Rico. (PsycINFO Database Record (c) 2019 APA, all rights reserved).