Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 1:186:36-43.
doi: 10.1016/j.drugalcdep.2017.12.046. Epub 2018 Mar 7.

Educational differences in alcohol consumption and heavy drinking: An age-period-cohort perspective

Camillia K Lui  1 , William C Kerr  2 , Nina Mulia  2 , Yu Ye  2
Affiliations

Educational differences in alcohol consumption and heavy drinking: An age-period-cohort perspective

Camillia K Lui et al. Drug Alcohol Depend. .

Abstract

Background: Low socioeconomic status (SES) has been associated with lower alcohol consumption, but also with heavier drinking. To explain this contradictory relationship, we examined SES differences in drinking patterns from an age-period-cohort (APC) perspective.

Methods: Data are from seven waves of the U.S. National Alcohol Surveys from 1979 to 2010. As a proxy for SES, educational attainment was used. Past-year alcohol volume was calculated from frequency (never-to-every day) and usual quantity (1-2, 3-4, or 5-6 drinks). Past-year frequency of heavy episodic drinking was labelled as total days of 5+ drinks. Gender-stratified APC fixed-effects models were conducted controlling for demographics and adjusting for survey design and weights.

Results: Significant APC effects by education were found, but the direction varied by alcohol measure. Education and total volume were positively associated across APC. Cross-over effects for age occurred with a positive education-heavy drinking relationship in young adulthood and negative relationship in mid-adulthood. Cohort-by-education effects showed greater heavy drinking among less educated women in 1956-60 cohort and more educated men and women in younger cohorts (post-1976).

Conclusions: Higher SES is consistently associated with total volume across age, period, and cohort, but less consistently with heavy drinking. While there are currently significant intervention efforts to reduce heavy drinking in young adulthood, our study suggests the need for age-specific strategies targeting lower-SES groups in mid-adulthood and cohort-specific strategies for lower-SES women in the baby boomer cohort and higher-SES men and women in younger birth cohorts.

Keywords: Age-period-cohort; Alcohol; Disparities; Education.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

No conflict declared.

Figures

Figure 1
Figure 1. Alcohol consumption by APC and education for women
Notes: APC models with interaction terms for age-education, period-education, and cohort-education. Models controlled for race/ethnicity, income, employment, religion, marital status, and region. Data were adjusted with sample weights and corrected for clustering from sample design. Larger markers indicate a significant interaction term at a p-value of less than 0.05.
Figure 2
Figure 2. Alcohol consumption by APC and education for men
Notes: APC models with interaction terms for age-education, period-education, and cohort-education. Models controlled for race/ethnicity, income, employment, religion, marital status, and region. Data were adjusted with sample weights and corrected for clustering from sample design. Larger markers indicate a significant interaction term at a p-value of less than 0.05.
Figure 3
Figure 3. Heavy drinking (5+ drinks) days by APC and education among women
Notes: APC models with interaction terms for age-education, period-education, and cohort-education. Models controlled for race/ethnicity, income, employment, religion, marital status, and region. Data were adjusted with sample weights and corrected for clustering from sample design. Larger markers indicate a significant interaction term at a p-value of less than 0.05.
Figure 3
Figure 3. Heavy drinking (5+ drinks) days by APC and education among women
Notes: APC models with interaction terms for age-education, period-education, and cohort-education. Models controlled for race/ethnicity, income, employment, religion, marital status, and region. Data were adjusted with sample weights and corrected for clustering from sample design. Larger markers indicate a significant interaction term at a p-value of less than 0.05.
Figure 4
Figure 4. Heavy drinking (5+ drinks) days by APC and education among men
Notes: APC models with interaction terms for age-education, period-education, and cohort-education. Models controlled for race/ethnicity, income, employment, religion, marital status, and region. Data were adjusted with sample weights and corrected for clustering from sample design. Larger markers indicate a significant interaction term at a p-value of less than 0.05.
Figure 4
Figure 4. Heavy drinking (5+ drinks) days by APC and education among men
Notes: APC models with interaction terms for age-education, period-education, and cohort-education. Models controlled for race/ethnicity, income, employment, religion, marital status, and region. Data were adjusted with sample weights and corrected for clustering from sample design. Larger markers indicate a significant interaction term at a p-value of less than 0.05.
See this image and copyright information in PMC

References

    1. Bjork C, Thygesen LC, Vinther-Larsen M, Gronbaek MN. Time trends in heavy drinking among middle-aged and older adults in Denmark. Alcohol Clin Exp Res. 2008;32:120–127. - PubMed
    1. Bleich SN, Jarlenski MP, Bell CN, LaVeist TA. Health inequalities: Trends, progress, and policy. Annu Rev Public Health. 2012;33:7–40. - PMC - PubMed
    1. Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc Natl Acad Sci. 2015;112:15078–15083. - PMC - PubMed
    1. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; Atlanta, GA: 2009. [Accessed: 2012-07-11]. Archived by WebCite® at http://www.webcitation.org/6957pgWFJ.
    1. Cerdá M, Johnson-Lawrence VD, Galea S. Lifetime income patterns and alcohol consumption: Investigating the association between long- and short-term income trajectories and drinking. Soc Sci Med. 2011;73:1178–1185. - PMC - PubMed

Publication types