Prevalence Of Drinking Research Articles

Binge drinking in American Indian Alaskan Native college attending students

ABSTRACT Objectives American Indian and Alaskan Native (AIAN) populations have the highest rate of alcohol use disorder (AUD). Binge drinking is a known predecessor of AUD and is prevalent in college-attending populations. However, little is known about the prevalence and risk factors related to AIAN college student binge drinking. The current study examines prevalence of binge drinking and association with socio-demographic features, other substance use, exposure to discrimination and feelings of belonging within collegiate institutions. Design Data were collected by the Healthy Minds Study. Present analyses were restricted to 2- and 4-year college attending students in the 2021–2022 academic year who identified as AIAN (n = 1383). We used descriptive, bivariate and multivariate Poisson weighted models to evaluate distributions and associations of binge drinking, age, gender, socioeconomic status, degree program, military experience, substance use, sexual assault, discrimination, and feelings of belonging within the institution. Results In the prior 2 weeks, 26.3% of AIAN students reported binge drinking. Binge drinking commonly overlapped with other substance use. AIAN students aged 21–34 reported the highest rates of binge drinking, as did students pursuing bachelor’s degrees. AIAN students who identified as trans or queer gender were less likely to report binge drinking, while across gender identities those reporting sexual assault or racial discrimination were more likely to report binge drinking in multivariate analyses. Conclusion There are multiple factors associated with binge drinking, representing individual and contextual influences on AIAN students. Developing prevention and intervention activities to address overlap in substance use and high concurrence of sexual assault and binge drinking are critical. Additionally, colleges must make concerted efforts to reduce racial discrimination and be more inclusive of AIAN students to reduce institutional-based features that exacerbate risk.

Rural versus urban healthcare through the lens of health behaviors and access to primary care: a post-hoc analysis of the Romanian health evaluation survey

BackgroundWorldwide, rural populations are recognized to be exposed to increased health challenges due to their living and working environment, socioeconomic status, and access to health services. According to the Romanian Country Health Profile 2023, approximately 46% of all deaths recorded in Romania in 2019 could be attributed to behavioral risk factors such as tobacco smoking, dietary risks, alcohol consumption and low physical activity. No data on rural versus urban areas are available to date, and research is needed to document health inequalities, identify barriers to health services, and explore solutions.MethodsThis study is an analysis of data collected during the Health Evaluation Survey carried out by the National Institute of Public Health in 2022 and aimed to reveal differences in health risk factors between rural and urban areas. The analysis was carried out under the methodological framework of the Health Evaluation Survey 2022, which is coordinated by the National Institute of Public Health.ResultsOur study’s objectively measured data revealed that the overall health profile of rural communities is characterized by lower education levels, lower incomes, and higher binge drinking rates than those of their urban counterparts. Additionally, rural inhabitants more often have high blood pressure, are more overweight and obese (per body mass index measurements) and have higher fasting plasma glucose. The health profile of the urban population revealed higher education levels and greater proportions of people with adequate monthly income, people with daily alcohol consumption, people who smoke, and people with hypercholesterolemia. Access to primary health care evaluated through proxy indicators was lower in rural areas but was relatively good overall.ConclusionsOur analysis of the health profile of rural communities revealed a greater prevalence of obesity and overweight, especially among women, and an increased prevalence of heavy drinking among men. Access to primary health care evaluated through proxy indicators is lower in rural areas but is relatively good overall. Lower education levels and the possibility of lower health literacy underpin the need for targeted health education campaigns. Sustainable strategies for rural health need to be identified, especially in the field of health promotion and disease prevention programs.Trial registrationThis study is observational research involving human participants where no interventions were applied to the study population.

Assessing if motives-based vignettes influence plans for drinking and alcohol cues: protocol for a randomised controlled trial

IntroductionIn Sweden and the UK, there is a high prevalence of risky drinking, a pattern of drinking associated with adverse consequences. Drinking motives are a proximal predictor of risky drinking...

Nationwide prevalence and trends in high-risk drinking among adult men the disabled and non-disabled

Abstract Background Excessive drinking is an important public issue that causes various levels of physical, psychological, behavioral problems. Especially for the disabled, it matters in that it could lead to poor health and secondary health conditions. Methods This study analyzed high-risk drinking (HRD) behaviors over a 9-year period in adult South Korean men according to disability presence, severity, type. We linked national disability registration data with the National Health Insurance claims data. Age-standardized prevalence of HRD were analyzed for each year and the odds of current HRD were determined by multivariate logistic regression after adjusting for income level, residence, insurance type, Charlson comorbidity index. Results The age-standardized HRD prevalence of the mildly disabled was higher than that among the non-disabled. Among the mildly disabled and physically disabled, younger aged group showed higher prevalence of HRD than that of non-disabled. In multivariate logistic regression analysis, the mildly (aOR=1.26, 95% CI = 1.24-1.29), physically (aOR=1.31, 95% CI = 1.28-1.33), communication disabled (aOR=1.12, 95% CI = 1.07-1.17) had higher prevalence of HRD than the non-disabled. Conclusions The prevalence of HRD was higher among the young mildly disabled than the non-disabled, this was more evident in young men physically disabled, communication disabled. This may be a result of the physical and social limitations of severely disabled and should be interpreted with caution. Social activities should be supported, and health policies on alcohol consumption should be implemented to prevent secondary conditions and reduce health disparities. Funding: This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Ministry of Education (No. 2022R1I1A3070074) and by a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC23C0165). Key messages • The prevalence of high-risk drinking was highest among the mild disabled, especially the mild, physical, communication disabled in younger aged men. • Health policies and efforts to improve health disparities aimed at reducing alcohol consumption among people with disabilities are needed.

Sex-differences in the clinical features, managements and outcomes of early-onset atherosclerotic coronary artery disease in China

Abstract Background/Introduction There is an alarming rise in the incidence of atherosclerotic coronary artery disease (CAD) among young adults, particularly in young women. Sex disparities of early-onset CAD in the context of contemporary cardiovascular practice are not well understood. Purpose We aimed to delineate the differences in clinical profiles and prognosis between young men and women with established early-onset CAD. Methods This is a nationwide, hospital-based, longitudinal prospective cohort study. Young patients (aged ≥18 years and ≤ 45 years) with angiographically confirmed severe atherosclerotic obstructive coronary arteries (luminal narrowing ≥ 70%) were included from 38 hospitals across China between May 2017 and May 2020. Coronary risk factors, clinical features and treatments were compared between men and women at baseline. Participants were followed for 3 years. The outcome was major adverse cardiovascular events (MACE), a composite of cardiovascular death, non-fatal myocardial infarction (MI), unplanned revascularization, and ischemic stroke. The Cox regression analyses were used to estimate hazard ratios (HR) with 95% confidence intervals (CIs) for outcome. Results There were 1524 patients (female: 4.4%) included in this study. The female patients were older than the male patients (41.1±4.0 years for females vs. 39.6±4.4 years for males, p=0.006). They showed a lower prevalence of hypertension, lipid disorders, and smoking or drinking (all p<0.01). The female patients were less likely to have at least 1 modifiable risk factors (female: n=45 (67.2%) vs. male: n=1382 [94.6 %], p<0.001); they showed more favorable laboratory results at baseline, including lipids, serum creatinine and uric acid (all p<0.05) as compared to male patients. Besides, young females presented more often with stable angina on admission, whereas young males tended to present with acute MI (p<0.001). There was no significant sex difference in Gensini Score (p=0.15). Female patients were less likely to undergo revascularization procedures than male patients (73.1% vs. 85.3%, p=0.01). During the 3 years of follow-up, female patients were at a significantly higher risk of MACE compared to their male counterparts (13.4% vs. 5.8%, adjusted HR: 3.07, 95% CI:1.36–6.94, p=0.007) after adjusting for age, smoking, drinking, body mass index, hypertension, diabetes, dyslipidemia, diagnosis and revascularization. Conclusions Distinct sex disparities, unfavorable to young females, were documented among patients with early-onset CAD, with the largest gaps noted in the treatment and prognosis. Despite more favorable baseline profiles, young female patients had insufficient care and 3-fold greater risk for MACE compared to young males. These results highlight the need for strengthening the treatment strategies for this vulnerable disease entity.Figure 1

Patterns of alcohol use in Belgium, 2013-2020

Abstract Despite numerous efforts worldwide to reduce the harmful effects of alcohol, its impact on health remains significant, contributing significantly to the loss of healthy life years. In Belgium, alcohol use is still a major public health concern, ranking among the highest in alcohol consumption across Europe. This study aims to use available nationally representative data to estimate and evaluate the time trends of alcohol use patterns in Belgium from 2013 to 2018. We used repeated cross-sectional survey data from the Belgian Health Interview Survey (BHIS), which includes self-reported alcohol use and sociodemographic data, to create a time series of annual consumption from 2013 to 2018. This included current and former drinkers, and lifetime abstainers by year, sex, region, and age groups. We applied a Bayesian hierarchical model, using the Integrated Nested Laplace Approximation to create the time series and forecast trends for 2020. In Belgium, the prevalence of current drinking remained at a similar level of 80% from 2013 to 2020, with similar rates observed in the Flemish (FL) and Walloon (WA) regions. However, the Brussels-Capital region (BR) had a slightly lower prevalence of 70%. Trends remained relatively stable across all regions during this period. The national level of former drinkers increased from 5% in 2013 to 8% in 2020, with BR and FL showing similar increases, while WA experienced a decline. Abstainer rates rose from 15% in 2013 to 19% in 2020 nationally, with varying increases in each region. Specifically, abstainer rates in FL increased from 13% to 17% and in WA from 14% to 20%, while BR saw an increase from 19% to 22%. Overall, declining trends were evident, with men exhibiting higher prevalence rates across all categories. Time trends from the BHIS reveal consistent and high use of alcohol in Belgium over 7 years, emphasizing the ongoing public health challenge. Urgent policy interventions are needed to reduce the impact of alcohol on health Key messages • Alcohol use in Belgium is still a pressing public health issue, with high prevalence rates of current drinking in the population. Different patterns of alcohol use can be seen between regions. • Understanding the role of alcohol on population health as an attributable burden can improve health monitoring.

Links between adolescent binge drinking and midlife alcohol use behaviors by age, sex, and race/ethnicity.

Alcohol use is increasing among adults in midlife (i.e., ages 35-60), but few studies examine specific alcohol use behaviors in this age group. We examined measures of typical drinks, maximum drinks, binge drinking, and high-intensity drinking by age, sex, and race/ethnicity among midlife adults, as well as the prospective association between age 18 binge drinking and midlife behaviors. Data from 5180 respondents participating in the national Monitoring the Future Panel study who were aged 35-60 in 2022 (followed since they were in 12th grade in 1980-2005) were used to estimate past 30-day midlife drinking behaviors (i.e., typical drinks, maximum drinks, binge, and high-intensity drinking) by age group, sex, and race/ethnicity. Associations between age 18 binge drinking status and midlife drinking outcomes were examined, as well as moderation by sociodemographic characteristics. Across ages 35-60, the mean typical number of drinks on drinking days within the past month ranged from 1.4 to 1.8; the mean maximum drinks ranged from 2.3 to 3.2. Past-month binge and high-intensity drinking prevalence ranged from 19.1% to 31.2% and 3.6% to 8.1%, respectively. Estimates of drinking behaviors were generally higher among respondents aged 35-40 (vs. older age groups), males (vs. females), those identifying as White (vs. other racial/ethnic groups), and those who reported age 18 binge drinking (vs. not). Adolescent binge drinking was a stronger predictor of high-intensity drinking among females than males and of typical and maximum drinks among older (age 60) than younger (age 35) respondents. Binge and high-intensity drinking were reported by a meaningful percentage of the US midlife adults. Binge drinking in adolescence was a predictor of subsequent alcohol-related risks. These long-term connections were especially strong among females. Age 18 binge drinking was a stronger predictor of high-intensity drinking at age 60 than earlier in midlife, underscoring that adolescent binge drinking is a key indicator of risk across the lifespan.

Changes in Alcohol Intake by Educational Level among Older Men and Women in Spain during the 21st Century

Abstract Background and objectives Despite alcohol use being very common in older adults, studies are scarce and suggest alcohol use may be increasing. Furthermore, despite the known relationship between education and alcohol consumption, there is limited evidence of educational differences in older adults. Our objective was to describe trends in alcohol consumption in individuals aged ≥65 by sex and educational level in Spain. Research design and methods 43,157 participants aged ≥65 years were drawn from Spain’s national health surveys between 2001-2020, representing the non-institutionalized population. The outcomes were various measures of self-reported past-year alcohol intake. Age-standardized rates and negative binomial regression models were used to examine trends and differences in alcohol intake by educational level, sex, and period (2001-2009 vs. 2011-2020). Results The average daily alcohol intake and prevalence of heavy average drinking (>20/10 g/day) decreased over time, especially among men, while moderate average drinking remained unchanged or even increased. Alcohol intake increased with increasing educational levels. All drinking measures showed educational inequalities, and these were greater in women than men. The mean amount of drinking showed the greatest inequality, with and adjusted prevalence ratio of 2.6 in women and 1.1 in men between university relative to primary education level. Discussion and implications Alcohol intake in older adults decreased over time in Spain for heavy average drinking and average drinking amount, although not for moderate average drinking. Consumption remains highest among the highest educational levels, which may negatively affect health. Programs addressing alcohol consumption among older adults are needed to minimize alcohol-related harm.

Analysis of Demographic Characteristics and Drinking Habits at a Southern College Provide Critical Information for Developing an Effective Prevention Program.

To examine the associations of basic demographics (age, race, and gender identity) on alcohol consumption among college students at a mid-sized university. To evaluate the drinking habits of students using the survey tool that will measure basic demographics to collect data. A cross-sectional study that included college students ages 17-21 at Columbus State University in the fall of 2021. Columbus, Georgia. University students (n = 260, mean age 20.5 ± 3.8). One-way ANOVA and independent t-tests were used to test differences in age on alcohol consumption and binge drinking. Chi-Square tests and Fisher's Exact were used to estimate differences in proportions of binge drinking for race and gender. Underage students (57.7%) reported having consumed alcohol in the past. Frequency of alcohol consumption increased with age (P = 0.004). Caucasian students reported drinking most frequently, with 14.8% (n = 12) drinking at least once a week, compared to 0 African American students reporting they drank at least once per week (P < 0.001). There were no significant findings when examining differences in binge drinking for demographics assessed in this sample (P > 0.05). and Relevance: In this cross-sectional research study, the prevalence of underage drinking among college-aged students, there is a need for targeted prevention methods to reduce adverse health outcomes among this vulnerable population.

Prevalence of problem drinking in the Swedish workforce: differences between labour market industries based on gender composition and main job activity

BackgroundIdentifying problem drinking patterns across industries is essential for addressing drinking problems in the workforce. Still, it is not well understood how problem drinking differs across industries and whether it is associated with industry gender composition. This study aimed to measure the prevalence of problem drinking (PPD) across Swedish industries and investigate possible associations between gender-typed industries and problem drinking.Methods9,155 current workers were selected from the Swedish Longitudinal Occupational Survey of Health (SLOSH) data collected in 2020. Participants’ work industries were identified through the Swedish Standard Industrial Classification (SNI) codes. Seven gender-typed industry categories were created based on gender composition and main job activity in each industry. Self-reported problem drinking was measured using a slightly modified Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire and a cut-off score 2 was used to determine problem drinking. Poisson regression with robust standard errors was used to investigate the association between gender-typed industries and problem drinking.ResultsPPD in the workforce was 6.6%. Men (8.5%) had a higher prevalence than women (5.3%). Across industries, PPD varied from 2.3% in Water supply and waste management to 15.4% in Mining and quarrying. The highest prevalence for men was in Mining and quarrying (18.2%), whereas for women it was in Construction (11.1%). Within gender-typed industries, the highest PPD was in male-dominated Goods and Energy Production (7.7%), and the lowest was in female-dominated Health and Social Care (4.7%). In the regression analysis, both Education (aPR: 1.39, p = 0.03) and Labour-intensive Services (aPR: 1.39, p = 0.02) had higher adjusted prevalence ratios (aPR) compared with Health and Social Care. However, there was no significant difference in aPR among gender-typed industries when considering the gender composition of industries only.ConclusionsPPD in the Swedish workforce varied significantly across industries, with differences observed between men and women. Problem drinking differed between industries when categorized by gender composition and main job activity, but not when categorized by gender composition only. Future research should investigate how industry-specific psychosocial factors influence individual alcohol consumption.

Sex differences in state level prevalence of alcohol use among Black women and men in the United States

ABSTRACT Background To investigate differences in alcohol use among Black men and women across U.S. states, using data from the Behavioral Risk Factor Surveillance System. Methods Measured any alcohol use, heavy drinking (i.e., 8+/15+ drinks for women/men in a 7-day period), and binge drinking (i.e., 4+/5+ drinks in one session). Weighted prevalence estimates were age-standardized to the 2000 US population. Results Binge drinking among Black men in Midwestern states was high, ranging from 40% in Minnesota to 45.8% in Iowa. Black women in Southern states had 6–10% points higher prevalence of heavy drinking than Black men. Conclusions Drinking prevalence in Southern states was higher than expected, especially among Black women.

Effects of social and environmental restrictions, and changes in alcohol availability in adolescents' binge drinking during the COVID-19 pandemic.

The aim of the present study was to estimate the evolution of binge drinking since the pre-pandemic period, and throughout the pandemic period with the application and lifting of the restrictions in adolescents aged 12 to 19 years old in school in Central Catalonia. Quasi-experimental time series study with two samples of adolescents. The first sample (1st wave of survey, pre-pandemic period) was obtained between the months of September 2019 to March 2020 (n = 6621) and the second sample (2nd wave of survey, pandemic period) between the months of October 2021 and March 2022 (n = 7576). The dependent variable was monthly binge drinking. The main independent variable was the period of data collection (1st and 2nd wave), and gender and grade were also included. Twenty-one time slices were performed by fortnight and the binge drinking prevalence of the previous month was extracted in each of them. Interrupted time series analysis was performed and Poisson regression models with robust variance were estimated. The data indicated a significant increase in the prevalence of binge drinking in certain periods in girls [easing of measures in October, aPR: 2.25 (1.03-4.89); and total lifting of restrictions in February, aPR: 3.29 (1.57-6.89)] and a reduction in consumption in periods of tightening of restrictions. After the upturn before the return to the pre-pandemic situation binge drinking followed a decreasing trend in both sexes [aPR boys: 0.73 (95%CI: 0.66-0.81); aPR girls: 0.78 (95%CI: 0.71-0.86)]. Periods of community interventions aimed at protecting people's health have had an impact on other health behaviors or aspects of health such as binge drinking, and differentially across groups and communities.

Perceived Risk of Binge Drinking among Older Alcohol Users: Associations with Alcohol Use Frequency, Binge Drinking, Alcohol Use Disorder, and Alcohol Treatment Use.

Despite the high prevalence of alcohol use and binge drinking among older adults, little research has been conducted on the association between their alcohol risk perception and alcohol use patterns. Using data on past-year alcohol users aged 50 and older (N = 6693) in the 2022 National Survey on Drug Use and Health, we examined the (1) associations between risk perception of binge alcohol use 1-2 times a week and alcohol use frequency, binge use frequency, and alcohol use disorder (AUD), and (2) the association between alcohol treatment use and risk perception. About 40% of past-year alcohol users perceived great risk of binge alcohol use 1-2 times a week, and 27% of past-year users had binge drinking in the past month. Multivariable analyses showed the negative association between great risk perception and alcohol use frequency (IRR = 0.60, 95%CI = 0.48-0.74 for daily use) and past-month binge alcohol use (IRR = 0.33, 95%CI = 0.19-0.57 for 6-19 days of binge use). The odds of great risk perception were also lower among those with mild AUD. Risk perception was not significantly associated with alcohol treatment. The lower likelihood of risk perception among problematic alcohol users and low treatment use is concerning. Education and interventions to reduce harm from alcohol are needed.

Examining Demographic & Socio-Cultural Factors as Predictors of Alcohol Consumption Among African American Male College Students Attending an Urban Historically Black College and University

ABSTRACT Alcohol consumption among college students continues to be a significant public health concern for colleges and universities across the country. However, a preponderance of research primarily included White samples from predominantly white institutions. Unsurprisingly, this practice limits what is known regarding alcohol consumption among African American male college students on historically Black campuses. Notably, as a “rite of passages” from childhood to adulthood, early exposure to alcohol consumption has been viewed as a cultural norm in African American families. The negative consequences associated with alcohol abuse, early exposure to alcohol, and the prevalence of problem drinking among college students in general, mandated further research facilitating a better understanding of this public health concern on historically Black campuses. This study examined alcohol use among African American male college students, investigating relationships between demographics and socio-cultural factors as predictors of alcohol consumption among African American male college students who drink. A convenience sample of 94 students was used. A multiple regression was conducted to test whether demographics and socio-cultural factors were predictors of alcohol consumption. Findings from this study will advance social work research and stimulate discussions about substance abuse disparities among African American male college students who consume alcohol. Furthermore, this research highlights the public health issue, prompting the development of prevention and intervention programs aimed at addressing the social problem of alcohol consumption among African American male college students at historically Black universities.

Effect of the national integrated demonstration area for the prevention and control of noncommunicable diseases programme on behavioural risk factors in China: a synthetic difference-in-differences study

The government-led community-based Chinese National Integrated Demonstration Areas for the Prevention and Control of Noncommunicable Diseases programme was launched in 2011, but no rigorous impact evaluation has been conducted to date. We aimed to evaluate the causal effects of this programme on behavioural risk factors. We used data from the latest five waves of the China Chronic Disease and Risk Factor Surveillance. The primary outcome is a behavioural risk score combining current smoking, passive smoking, drinking in last month, regular exercise, body mass index, and waist circumference. We applied the synthetic difference-in-differences method and constructed synthetic controls from the non-demonstration areas with the outcome. The average treatment effects on the treated were estimated for overall effect and by short- (1-2), medium- (3-4), and long-term (6-7 years) effects. We identified 26 demonstration areas (N=72,193) and 100 non-demonstration areas (N=275,397). Participants in the demonstration areas had higher education and income levels and different pre-implementation trends than non-demonstration areas. Using synthetic controls instead of non-demonstration areas reduced these pre-implementation differences. Compared to the synthetic controls, declines were observed in current smoking (-1.78% [-4.51%, 0.96%]), passive smoking (-8.09% [-14.27%,-1.90%]), and drinking in last month (-4.04% [-8.75%, 0.67%]) but not in the other factors. Behavioural risk score declined by 1.05 short-term (95% CI:-1.84,-0.26), 1.15 medium-term (95% CI:-2.08,-0.22), 2.82 long-term (95% CI:-4.79,-0.85), and 1.54 overall (95% CI:-2.51,-0.56). The programme improved behavioural risk scores, primarily through reductions in the prevalence of smoking and drinking, and the effect was long-lasting. Our findings provided empirical evidence for utilizing an integrated prevention and control strategy to fight against NCD in China and other countries facing similar challenges. The China National Key Research and Development Program (2018YFC1315304 and 2017YFC1310902); National Natural Science Foundation of China (81872721).

Binge Drinking Disparities by Grade, Race and Ethnicity, Sexual Orientation, and Gender Identity.

Binge drinking disparities between sexual and gender minority (SGM) students and their heterosexual, cisgender peers are well-established. Data limitations have precluded understandings of whether the onset and progression of these disparities differ by grade. Additionally, little is known about whether and how SGM-related binge drinking varies across groups of students coincidingly defined by sexual orientation or gender identity (SOGI), race, and ethnicity. In the current study, we used a large, statewide sample of secondary school students in California to describe the prevalence of binge drinking among subgroups of adolescents at the intersections of grade, race and ethnicity, and SOGI. Data were from the 2017-2019 cycle of the California Healthy Kids Survey, one of the largest statewide cross-sectional surveys of secondary school students in the United States (n = 925 744). We described the grade-specific prevalence rates of past 30-day binge drinking by (1) grade level, (2) race and ethnicity, and (3) SOGI. Predicted probabilities estimated adjusted percentages of students' binge drinking by subgroups. SGM-related binge drinking differences were present early in secondary school. Several subgroups of SGM adolescents with minoritized racial and ethnic identities reported higher binge drinking rates relative to their same-grade, white, non-SGM peers. Prevention and intervention programs must consider developmentally- and culturally-informed strategies to most effectively promote health among minoritized students.

Racial and ethnic disparities in the natural history of alcohol-associated liver disease in the United States.

Outcomes in alcohol-associated liver disease (ALD) are influenced by several race and ethnic factors, yet its natural history across the continuum of patients in different stages of the disease is unknown. We conducted a retrospective cohort study of U.S. adults from 2011 to 2018, using three nationally representative databases to examine potential disparities in relevant outcomes among racial and ethnic groups. Our analysis included logistic and linear regressions, along with competing risk analysis. Black individuals had the highest daily alcohol consumption (12.6 g/day) while Hispanic participants had the largest prevalence of heavy episodic drinking (33.5%). In a multivariable-adjusted model, Hispanic and Asian participants were independently associated with a higher ALD prevalence compared to Non-Hispanic White interviewees (OR: 1.4, 95% CI: 1.1-1.8 and OR: 1.5 95% CI:1.1-2.0, respectively), while Blacks participants had a lower ALD prevalence (OR: .7 95% CI: .6-.9), and a lower risk of mortality during hospitalization due to ALD (OR: .83 95% CI: .73-.94). Finally, a multivariate competing-risk analysis showed that Hispanic ethnicity had a decreased probability of liver transplantation if waitlisted for ALD (SHR: .7, 95% CI: .6-.8) along with female Asian population (HR: .40, 95% CI: .26-.62). After accounting for key social and biological health determinants, the Hispanic population showed an increased risk of ALD prevalence, even with lower alcohol consumption. Additionally, Hispanic and Asian female patients had reduced access to liver transplantation compared to other enlisted patients.

Binge drinking at time of bariatric surgery is associated with liver disease, suicides, and increases long-term mortality.

Alcohol use disorder has been reported in patients undergoing bariatric procedures, but the pattern of alcohol consumption has not been evaluated. We investigated the prevalence, risk factors, and impact of binge drinking (BD) at the time of surgery and during follow-up. A prospective, longitudinal study of subjects undergoing bariatric surgery was included in the LABS-2 registry between 2006 and 2009. Participants with AUDIT questionnaire at the time of surgery and a minimum of 12 months follow-up were included. BD was defined as consuming ≥5 drinks on at least 1 occasion in the previous month. Liver biopsies were obtained during bariatric procedures in not all cases. Survival analysis was performed with the adjusted Cox regression model and competing risk. A total of 2257 subjects were included, with a median follow-up of 79 months. The prevalence of BD at time of surgery was 12%, and it raised up to 23% during follow-up. Patients with BD predominantly had a binge eating disorder (OR=1.35 [95% CI: 1.04-1.76]), regularly consumed fast food [OR=1.4 (95% CI: 1.07-1.85)] and used other drugs (OR=2.65 [95% CI: 1.74-4.04]). Within liver biopsies evaluation, BD showed higher hepatic iron deposits (OR=3.00 [95% CI: 1.25-7.21]). BD at the time of surgery was associated with a higher risk of BD during follow-up (OR=10.49 [95% CI: 7.86-14.00]) and long-term mortality (HR: 3.21 [95% CI: 1.67-6.18]). Specific causes of death in these patients with BD were liver disease (p=0.020), suicide (p=0.015), neoplasms (p=0.034), and respiratory (p=0.025). The prevalence of BD in patients undergoing bariatric surgery is high and increases the risk of postoperative liver disease, suicides, and long-term mortality.

Sexual Identity and Heavy Drinking Among Adults in Canada by Racially Minoritized Status and Income, 2015-2020.

Purpose: Our objective was to estimate inequities in heavy drinking between heterosexual, gay or lesbian, and bisexual or pansexual individuals, by sex/gender, and to determine whether this association is heterogeneous across racially minoritized status and income groups in Canadians aged 15 and older. Methods: We pooled three Canadian Community Health Survey cycles (2015-2020) and used separate modified Poisson regressions to explore the sex/gender-specific association between sexual identity and heavy drinking prevalence by racially minoritized status, and income, adjusted for survey cycle, age, marital status, and region. Results: With racially minoritized status, and income categories collapsed, heavy drinking was 1.3 times higher (95% confidence interval [CI] = 1.0-1.7) among bisexual or pansexual women compared with heterosexual women, with no differences among men. Among racially minoritized women, heavy drinking was 2.9 (95% CI = 1.3-6.4) times higher among bisexual or pansexual women and 1.9 (95% CI = 0.7-5.2) times higher among gay or lesbian women compared with heterosexual women. Among racially minoritized men, heavy drinking was 1.9 (95% CI = 0.9-4.0) times higher among gay men compared with heterosexual men. No differences were observed across sexual identity in White men or women. Bisexual or pansexual women reported increased heavy drinking relative to heterosexual women across income quintiles. Conclusion: Heavy drinking is distributed heterogeneously across sexual identity, sex/gender, racially minoritized status, and income. These results encourage equity-focused interventions to reduce heavy drinking among intersecting sociodemographic groups experiencing a greater burden of heavy drinking.

Estimating substance use disparities across intersectional social positions using machine learning: An application of group-lasso interaction network.

An aim of quantitative intersectional research is to model the joint impact of multiple social positions on health risk behaviors. Although moderated multiple regression is frequently used to pursue intersectional research hypotheses, such parametric approaches may produce unreliable effect estimates due to data sparsity and high dimensionality. Machine learning provides viable alternatives, offering greater flexibility in evaluating many candidate interactions amid sparse data conditions, yet remains rarely employed. This study introduces group-lasso interaction network (glinternet), a novel machine learning approach involving hierarchical regularization, to assess intersectional differences in substance use prevalence. Utilizing variable selection and parameter stabilization functionality for main and interaction effects, glinternet was employed to examine two-way interactions between three primary social positions (gender, sexual orientation, and race) predicting heavy episodic drinking, cannabis use, and cigarette use prevalence. Analyses were conducted using the All of Us Research Program (N = 283,403), a national sample with high representation from populations historically underrepresented in biomedical research. Results were replicated using holdout cross-validation and compared against logistic regression estimates. Glinternet prevalence estimates were more stable across discovery and replication samples relative to logistic regression, particularly among sparsely represented groups. Prevalence estimates for cigarette and cannabis use were elevated among sexual minority and White cisgender women compared to heterosexual and non-White women, respectively. Glinternet may improve upon traditional moderated multiple regression methods for pursuing intersectional hypotheses by improving model parsimony and parameter stability, providing novel means for quantifying health disparities among intersectional social positions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).