School contextual influences on the risk for adolescent alcohol misuse.

This study investigates the association between school context and adolescent alcohol misuse. Data are from the first two waves of the National Longitudinal Study of Adolescent Health (N = 10,574 adolescents nested within 128 schools). Multilevel multinomial logistic regression is used to assess the association between school-level characteristics and the risk for non-, moderate, and heavy drinking. The risk for adolescent alcohol misuse varies significantly across schools after adjusting for adolescent-level predictors. Several school-level characteristics predict alcohol misuse. Notably, the risk for heavy drinking is elevated in schools located in communities that are socioeconomically advantaged, have high proportions of Non-Hispanic White residents, and are located in suburban (versus urban) areas. High aggregate levels of intoxication in schools increases the risk for heavy drinking among individual adolescents. Results suggest that the influence of social contexts on health is not uniform and that adolescent drinking is more likely in communities that are conceptualized as advantaged.