Alcohol Use Disparities Research Articles

The absolute truth: Alcohol companies sponsored disproportionately more queer Pride festivals than July Fourth festivals in 2019

Introduction Despite known disparities in alcohol use among queer communities in the United States, little is known about the extent to which alcohol companies sponsor queer Pride festivals each June. This study aimed to (1) examine the nature and extent of alcohol sponsorship of Pride in 2019 and (2) compare the prevalence of alcohol sponsorship for Pride versus Fourth of July festivals. Methods We identified Pride festivals through InterPride’s 2019 Pride Radar Report and Fourth of July festivals by searching Google. Researchers recorded each festival’s name and location, then sorted their sponsors into ten categories. We adjusted for overall population count and same-sex couple count estimates; and only included cities in our sample that hosted both Pride and Fourth of July festivals in 2019. Results Researchers identified 207 Pride and 154 Fourth of July festivals in 45 states and 129 cities, which included 4,643 Pride and 972 Fourth of July festival sponsors. Pride festivals had a significantly higher percentage of alcohol sponsors (9.1% (95% CI: 9.0%, 9.1%)) compared to Fourth of July festivals (2.0% (95% CI: 1.9%, 2.2%)) (p < 0.001). We also found a significant interaction between the prevalence of alcohol sponsors and US region. Conclusions Our findings indicate a greater need to understand the extent to which alcohol marketing at Pride celebrations contributes to alcohol use.

Income Inequality and Socioeconomic Disparities in Alcohol Use Among Eastern European Adolescents: A Multilevel Analysis

PurposeIn this study, we tested the “golden youth” hypothesis, which suggests that in Eastern Europe, affluent adolescents are at an increased risk of alcohol use. Also, we hypothesized that the relationship between high socioeconomic position (SEP) and more alcohol use is stronger in countries with wider income inequality. MethodsIn total, 50,421 adolescents aged 13–15 years were included from 16 Eastern European countries participating in the 2013–2014 Health Behaviour in School-aged Children survey. Multilevel logistic regression analyses were performed. ResultsAffluent adolescents had greater odds of weekly alcohol use (OR = 1.32, 95% CI = 1.23–1.41) and binge drinking (OR = 1.24, 95% CI = 1.16–1.32) than their peers from low-SEP families. However, no significant difference was observed between middle- and low-SEP adolescents. In countries with wider income inequality, the relationship between high family-SEP and weekly alcohol use (p interaction = .006), as well as high family-SEP and binge drinking (p interaction = .007), was stronger compared to countries with lower income inequality. DiscussionPossibly, influenced by the lifestyle choices of their parents, and using alcohol as a status symbol to establish and maintain friendly relationships with peers, Eastern European adolescents from affluent families, particularly in the most unequal settings, are at increased risk of alcohol use, confirming the golden youth hypothesis. Insecure self-image and perceived threat to their high status might be explanatory factors. More research is needed to identify the precise individual and family characteristics responsible for increased alcohol use among wealthy adolescents, especially in Eastern European countries with high income inequality.

At-School Victimization and Alcohol Use Among Minoritized U.S. Youth, 2009–2017

Sexual minority and/or racial/ethnic minority youth may use alcohol at school as a form of minority stress-based coping. Polyvictimization is particularly prevalent among sexual minority and/or racial/ethnic minority youth and may be a useful proxy measure for minority stressors. Data from local administrations of the Youth Risk Behavior Survey were pooled across 42 jurisdiction years (biennially, 2009-2017) and analyzed in 2022, resulting in a sample of 118,052 U.S. youth. The prevalence of alcohol use at school was examined by sexual identity, race/ethnicity, and their intersections, stratified by sex. Multivariable logistic regression models were built to examine the disparities in alcohol use at school and the impact of school-based polyvictimization. At the intersections of race/ethnicity and sexual identity, 25 of 30 sexual minority and/or racial/ethnic minority subpopulations had greater odds of alcohol use at school than their White heterosexual same-sex peers. Hispanic/Latinx not-sure males (AOR=9.15; 95% CI=5.97, 14.03) and Hispanic/Latinx lesbian females (AOR=11.24; 95% CI=6.40, 19.77) were most likely to report alcohol use at school. After adjusting for polyvictimization, the magnitude of association was attenuated for most sexual minority and/or racial/ethnic minority subpopulations; however, all but 2 significant associations remained. Sexual minority and/or racial/ethnic minority youth were more likely than White heterosexual peers to use alcohol at school, with the greatest odds among multiply marginalized and polyvictimized youth. Interventions should consider addressing more than school-based victimization alone because disparities persisted, although at a lower magnitude, after accounting for polyvictimization. Future longitudinal studies are warranted to further explore the associations between multiply marginalized identities, school-based polyvictimization, and alcohol use at school.

Alcohol use among sexual minority women: Methods used and lessons learned in the 20-Year Chicago Health and Life Experiences of Women Study.

Two decades ago, there was almost no research on alcohol use among sexual minority women (SMW, e.g., lesbian, bisexual). Since then, a growing body of scientific literature documents substantial sexual orientation-related disparities in alcohol use and alcohol-related problems. Research has identified multiple risk factors associated with high-risk/hazardous drinking among SMW. However, this research has almost exclusively used cross-sectional designs, limiting the ability to draw conclusions about processes through which sexual minority status affects alcohol use. Longitudinal designs, although very rare in research on alcohol use among SMW, are important for testing mediational mechanisms and necessary to understanding how changes in social determinants impact alcohol use. To describe the processes and lessons learned in conducting a 20-year longitudinal study focused on alcohol use among SMW. The Chicago Health and Life Experiences of Women (CHLEW) study includes five waves of data collection (2000-present) with an age and racially/ethnically diverse sample of 815 SMW (ages 18-83) originally recruited in the Chicago Metropolitan Area in Illinois, a midwestern state in the United States (U.S.). Measures and focus have evolved over the course of the study. The CHLEW study is the longest-running and most comprehensive study of SMW's drinking in the U.S. or elsewhere. Findings reported in more than 50 published manuscripts have contributed to understanding variations in SMW's risk for hazardous/harmful drinking based on sexual identity, age, race/ethnicity, sex/gender of partner, and many other factors. By describing the process used in conducting this long-term study, its major findings, and the lessons learned, we hope to encourage and support other researchers in conducting longitudinal research focused on SMW's health. Such research is critically important in understanding and ultimately eliminating sexual orientation-related health disparities.

Associations of Relationship Experiences, Dating Violence, Sexual Harassment, and Assault With Alcohol Use Among Sexual and Gender Minority Adolescents.

Sexual and gender minority (SGM) adolescents report higher rates of dating violence victimization compared with their heterosexual and cisgender peers. Research on dating violence often neglects diversity in sexual and gender identities and is limited to experiences in relationships. Further, given that dating violence and alcohol use are comorbid, research on experiences of dating violence could provide insights into alcohol use disparities among SGM adolescents. We aimed to map patterns of relationship experiences, sexual and physical dating violence, and sexual and physical assault and explored differences in these experiences among SGM adolescents. Further, we examined how these patterns explained alcohol use. We used a U.S. non-probability national web-based survey administered to 13–17-year-old SGM adolescents (N = 12,534). Using latent class analyses, four patterns were identified: low relationship experience, dating violence and harassment and assault (72.0%), intermediate dating experiences, sexual harassment, and assault and low levels of dating violence (13.1%), high dating experiences, dating violence, and sexual assault (8.6%), and high dating experiences, dating violence, and sexual harassment and assault (6.3%). Compared to lesbian and gay adolescents, bisexual adolescents reported more experiences with dating, dating violence, and sexual assault, whereas heterosexual adolescents reported fewer experiences with dating, dating violence, and sexual harassment and assault. Compared to cisgender boys, cisgender girls, transgender boys, and non-binary/assigned male at birth adolescents were more likely to experience dating violence inside and outside of relationship contexts. Experiences of dating, dating violence, and sexual harassment and assault were associated with both drinking frequency and heavy episodic drinking. Together, the findings emphasize the relevance of relationship experiences when studying dating violence and how dating violence and sexual harassment and assault might explain disparities in alcohol use.

Parenting as an inhibitor of gender disparities in alcohol use: the case of early adolescents in China

BackgroundGender differences in alcohol use are more substantial among early adolescents in China than in the United States, presumably because of more permissive drinking norms for boys than girls in Chinese culture. This study tested a theory that gender differences in early experimentation with alcohol can be reduced through general parenting practices. Whereas traditional research has identified mediators of gender differences in alcohol use, the current research isolated moderators of gender differences and developed their implications for prevention programs.MethodsThe study analyzed the data from the China Global School-Based Student Health Survey (n = 8805 middle school students in four cities). Youth completed anonymous surveys in classroom settings. The study examined interaction effects between gender and parenting variables using multiple regression with robust standard errors.ResultsEarly adolescent boys exhibited higher levels of drinking than girls for all drinking outcomes. The gender differences in drinking were negatively associated with the level of perceived parental monitoring, parental involvement in adolescent school performance, and parental empathy in a nonlinear way.ConclusionsResults suggested that early adolescents’ perceptions of general parenting practice nonlinearly moderated gender disparities in alcohol use.

Sexual violence as a mediator of sexual orientation disparities in alcohol use, suicidality, and sexual-risk behaviour among female youth

ABSTRACT Sexual violence exposure represents a serious public health issue among female youth given its association with female youths’ engagement in health-risk behaviours. Sexual minority female youth are particularly vulnerable to sexual violence exposure, alcohol use, suicidality, and sexual-risk behaviour. Using the population-based 2017 Youth Risk Behaviour Survey, we examined sexual violence as a mediator of sexual orientation disparities in health-risk behaviours among female youth. This study included 7,532 female students in grades 9 through 12 across the US. Participants identified their sexual orientation as heterosexual (73.5%); bisexual (12.2%); and, gay or lesbian (2.2%). Compared to heterosexual female youth, sexual violence exposure, alcohol use, binge drinking, and multiple sex partners were more common among bisexual female youth. The elevated risk of suicidality was most notable among gay or lesbian female youth relative to heterosexual female youth and bisexual female youth relative to heterosexual female youth. Mediation analyses showed that sexual violence exposure partially explained the sexual orientation disparity in these co-occurring health-risk behaviours between bisexual female youth and heterosexual female youth. Our findings highlight the need for clinical attention to be paid to assessing and treating the health effects of sexual violence, especially among bisexual female youth.

Ethnocultural diversity in alcohol use and misuse.

Hazardous alcohol use is associated with deleterious health effects and social consequences, reduced work productivity, and increased medical and criminal justice expenditures. Research has consistently shown not only ethnic differences in prevalence rates of drinking behaviors and alcohol use disorders but also negative alcohol-related consequences and treatment-seeking patterns. Mainstream alcohol research has tended to focus on determinants and mechanisms that are common across ethnocultural groups; hence, there are tremendous opportunities to address issues that are especially pertinent to alcohol use and misuse in ethnic minority communities. Articles in this special issue present state-of-the-science investigations that address risk and protective factors associated with alcohol initiation, cognitions around alcohol use, high-risk behaviors, and drinking outcomes across segments of the U.S. population. Using generalizability, group differences, and multicultural approaches, as well as variable- and person-centered methods, these articles showcase a range of factors that warrant systematic examination. We encourage scholars, practitioners, and policymakers to consider culturally relevant factors and pathways across individual, social, and cultural levels and to develop a comprehensive understanding of alcohol use outcomes. These approaches have the translational potential to reduce ethnic disparities in alcohol use and misuse. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Epilogue for the special issue on sociocultural factors and mechanisms in alcohol use: Epidemiology, prevention, and intervention among ethnic minority groups: Lessons learned.

The research articles in this special issue edited by Zamboanga and Lui focus on sociocultural factors and processes that underlie ethnic disparities in alcohol use in the United States. Major ethnic minority groups such as African Americans, Asian Americans, and Hispanics are included. Contributors to this special issue present their research findings and draw implications for research, theory, and intervention. The focus is clearly needed. We know enough to say that serious alcohol-use disparities exist; finding effective solutions to these problems is vitally important, especially in our increasingly diverse society; and much more research is needed. Priority for ethnic minority research has increased because of the growing ethnic diversity of the nation; concerns over disparities, social justice, and the welfare of minority populations; and increasing political clout of different minority groups. Nevertheless, greater efforts are needed to address research inadequacies and those programs and policies that affect the mental health of various ethnic minority groups. What have we learned from these articles? To address this question, it is important to have a context for viewing the research. In this context, I make three major points. First, the social sciences in general and psychology in particular have not traditionally embraced the importance of culture. Consequently, conducting ethnic minority research has been difficult. Second, the significance of ethnicity and culture in alcohol use is undeniable. The real task is to understand the complexities in ethnic alcohol use. Third, in addition to culture, ethnic minority groups have minority status in our society that affects all facets of alcohol use and its consequences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Homophobic Bullying and Sexual Minority Youth Alcohol Use: Do Sex and Race/Ethnicity Matter?

Sexual minority youth (SMY) are more likely to use alcohol than their heterosexual peers, yet a lack of research on within-group differences and modifiable mechanisms has hindered efforts to address alcohol use disparities. The purpose of the current study was to examine differences in the mediating role of homophobic bullying on the association between sexual orientation identity and drinking frequency and heavy episodic drinking frequency by sex and race/ethnicity. We used data from a subsample of 20,744 youth in seven states from the 2015 Youth Risk Behavior Survey, a population-based data set of 9-12th grade high school students in the United States. We included youth who self-identified as male or female; heterosexual, lesbian/gay, bisexual, or unsure of their sexual orientation identity; and White, Black, or Latino. Within-group comparisons demonstrated that SMY alcohol use disparities were concentrated among Latino bisexual and unsure youth. All subgroups of SMY at the intersection of race/ethnicity and sex were more likely than their heterosexual counterparts to report homophobic bullying. Homophobic bullying mediated alcohol use disparities for some, but not all, subgroups of SMY. Homophobic bullying is a serious risk factor for SMY alcohol use, although youths' multiple identities may differentiate degrees of risk. Sexual orientation identity-related disparities in alcohol use among Latino, bisexual, and unsure youth were not fully attenuated when adjusted for homophobic bullying, which suggests that there may be additional factors that contribute to rates of alcohol use among these specific subgroups of SMY.

The Future of Research on Alcohol-Related Disparities Across U.S. Racial/Ethnic Groups: A Plan of Attack.

Research suggests striking disparities in alcohol use, problems, and treatment across racial/ethnic groups in the United States. However, research on alcohol-related disparities affecting racial/ethnic minorities remains in its developmental stages. The current article aims to support future research in this growing field by highlighting some of the most important findings, questions, and approaches, focusing on psychosocial research. This article advances seven research needs (i.e., questions and topics meriting attention) that we believe are of crucial importance to the field. We draw on the existing literature to illuminate under-explored areas that are highly relevant to health intervention and that complement the field's existing focus. Identified research needs include research that (a) better describes disparities in alcohol-related health conditions and their drivers, (b) identifies appropriate screening and brief intervention methods for racial/ethnic minorities, (c) investigates disparities in access to and use of alcohol treatment and support services, (d) examines the comparative efficacy of existing alcohol interventions and develops tailored interventions, (e) explores the impacts of specific alcohol policies across and within racial/ethnic groups, and (f) describes the full spectrum of alcohol-related harms and how and why these may vary across racial/ethnic groups. We also call for (g) continuing research to monitor disparities over time. This article points to specific strategies for describing, explaining, intervening on, and monitoring some of the most substantial alcohol-related disparities. Conclusions outline methods and processes that may be advantageous in addressing these priorities, including the use of longitudinal designs; consideration of life course changes; attention to nontraditional intervention settings; and inclusion of disadvantaged populations in all aspects of research.

Victimization as a mediator of alcohol use disparities between sexual minority subgroups and sexual majority youth using the 2015 National Youth Risk Behavior Survey

BackgroundAlcohol use among underage youth is a significant public health concern. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol is the “drug of choice” among adolescents, meaning more youth use and abuse alcohol than any other substance. Prevalence of alcohol use is disproportionately higher among sexual minority youth (SMY) than among their heterosexual peers. We examined sexual identity and sexual behavior disparities in alcohol use, and the mediational role of bullying in a sample of high school students. MethodsData from the 2015 National Youth Risk Behavior Survey were used to assess the association between sexual minority status (identity and behavior) and alcohol use with weighted logistic regression. Due to well-documented differences between males and females, we stratified models by gender. Physical and cyberbullying were examined as mediators of the relationship between sexual minority status and alcohol use. ResultsWe detected associations between certain subgroups of sexual minority youth and alcohol use across all four drinking variables (ever drank alcohol, age at first drink, current alcohol use, and binge drinking). Most of these associations were found among bisexual-identified youth and students with both male and female sexual partners; these individuals had up to twice the odds of engaging in alcohol use behaviors when compared with sexual majority students. Associations were strongest among females. Bullying mediated sexual minority status and alcohol use only among bisexual females. ConclusionsAs disparities in alcohol use differ by gender, sexual identity, and sexual behavior, interventions should be targeted accordingly.

Alcohol Use Among Black and White Adolescents: Exploring the Influence of Interracial Friendship, the Racial Composition of Peer Groups, and Communities

Black adolescents use less alcohol, on average, than white adolescents. Prior research has struggled to explain the disparity in alcohol use between blacks and whites but not for a lack of potential mediating mechanisms. The current study draws on differential association theory and two waves of panel data (n = 1,016) to examine the influence of interracial friendship, the racial composition of peer groups, and communities on black–white differences in alcohol use. Findings indicate that (1) the racial composition of peer groups and communities influence changes in alcohol use, and (2) racial segregation contributes to racial disparities in alcohol use while interracial friendship reduces these disparities. Results suggest that the socially conservative values of the African-American community are a strong deterrent to adolescent drinking, affecting even those adolescents who are themselves white but associate with black youth.

Disparities in alcohol use: Does race matter as much as place?

ObjectivesNational estimates of race differences in alcohol use suggest that whites are more likely to be current and binge users of alcohol. These findings fail to account for race differences in the social and environmental context where people live. This study aims to determine whether race disparities persist in alcohol use among individuals who share similar social and environmental conditions. MethodsWe compared race disparities between individuals living in a low-income racially integrated urban community without race differences in socioeconomic status (EHDIC-SWB) to individuals from the National Health Interview Survey (NHIS 2003) to determine if race disparities in alcohol use were attenuated in the integrated environment. ResultsIn the NHIS 2003 sample, compared to whites, African Americans had lower odds of being a current drinker (OR=0.56, 95% CI=0.49–0.64) and binge drinker (OR=0.68, 95% CI=0.58–0.80) independent of covariates. However in the EHDIC-SWB sample, African Americans had similar odds of being a current drinker (OR=0.94, 95% CI=0.67–1.33) and binge drinker (OR=1.02, 95% CI=0.77–1.35) compared to whites. ConclusionsAmong individuals who share similar social and environmental risk exposures, race group differences in alcohol use patterns are similar.

Editorial - Health Disparities in Alcohol Use, Delinquency and Violence among Minority Adolescents

Editorial - Health Disparities in Alcohol Use, Delinquency and Violence among Minority Adolescents

Raced and Gendered Reactions to the Deviance of Drunkenness: A Sociological Analysis of Race and Gender Disparities in Alcohol Use

Research has consistently documented race and gender disparities in alcohol use. In this article, I refine the “time-out” hypothesis while arguing that these longstanding disparities in use are in part due to the impact of gender and race on deviance categorization. Public drinking behaviors operate within social spaces that may or may not be hospitable to a given person's gender and/or race status. I explore how formal and informal modes of social control influence alcohol use behavior. Findings are based on semistructured interviews with 78 American Black, White, male and female college students. Grounded theory was used in the development of three themes: (a) Acute awareness of women's otherness: multiple jeopardy and the multiple standard of alcohol use; (b) the gendered violence of women's marginalization; and (c) fear of violent victimization: alcohol and the dangerous Black male. Each theme illustrates how social inequalities structure alcohol use and reactions to alcohol use differently, depending on the intersections of race, gender, and situated contexts.

Mental Health Service Utilization and Drinking Outcomes in a National Population Sample: Are There Racial/Ethnic Differences?

ABSTRACT Racial and ethnic disparities in alcohol use and alcohol-related problems have been well-documented. Less information is available about possible disparities in outcomes related to mental health services utilization. The differential effect of mental health services use by race on drinking outcomes was examined. Wave 2 of a national population sample of employed adults who reported having at least one alcoholic drink in the past year (N = 1,058) encompassed measures of the prevalence of mental health services use in response to stress, and alcohol-related outcomes. Non-white participants who reported using any mental health services, four or more mental health visits in the past year, and eight or more mental health visits in the past year reported lower rates of problematic drinking behaviors, including frequency of drinking to intoxication, heavy episodic drinking, and modified Brief MAST scores, than whites who reported similar use of mental health services.

Sexual Orientation Disparities in Longitudinal Alcohol Use Patterns Among Adolescents

To compare sexual orientation group differences in the longitudinal development of alcohol use behaviors during adolescence. Community-based prospective cohort study. Self-reported questionnaires. A total of 13,450 Growing Up Today Study participants (79.7% of the original cohort) aged 9 to 14 years at baseline in 1996 were followed up for more than 7 years. Main Exposure Self-reported sexual orientation classified as heterosexual, mostly heterosexual, bisexual, or gay/lesbian. Age at alcohol use initiation, any past-month drinking, number of alcoholic drinks usually consumed, and number of binge drinking episodes in the past year. Compared with heterosexual participants, youth reporting any minority sexual orientation reported having initiated alcohol use at younger ages. Greater risk of alcohol use was consistently observed for mostly heterosexual males and females and for bisexual females, whereas gay and bisexual males and lesbians reported elevated levels of alcohol use on only some indicators. Gender was an important modifier of alcohol use risk; mostly heterosexual and bisexual females exhibited the highest relative risk. Younger age at alcohol use initiation among participants with minority sexual orientations significantly contributed to their elevated risk of binge drinking. Our findings suggest that disparities in alcohol use among youth with a minority sexual orientation emerge in early adolescence and persist into young adulthood. Health care providers should be aware that adolescents with a minority sexual orientation are at greater risk of alcohol use.

Racial disparities in alcohol use: comparison of 2 American Indian reservation populations with national data.

American Indian alcohol use has received scrutiny in recent decades,1 but data derived from samples that permit direct comparisons to other US epidemiological studies have been less commonly reported.2–4 This brief places rates of the quantity and frequency of alcohol use in 2 tribally defined reservation samples in such a comparative epidemiological context.