Natalie Sumetsky1,2, Paul J Gruenewald3, Sharon Lipperman-Kreda3, Juliet P Lee3, Christina Mair1,2. 1. Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania. 2. Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania. 3. Prevention Research Center, Pacific Institute for Research and Evaluation, Calverton, Maryland.
Abstract
OBJECTIVE: To better quantify the impact of specific on- and off-premise drinking contexts on population-level alcohol-related problems, we evaluated context-specific risks relative to frequency of use of each context. METHOD: We surveyed 860 adult (21-100 years) past-year drinkers in the California East Bay, sampled in areas of high versus low median household income and off-premise alcohol outlet densities. We examined associations of context-specific drinking frequencies in seven on- and off-premise drinking locations with individual and area characteristics using negative binomial regression. Next, we used heteroscedastic ordered logistic regression to relate context-specific drinking frequencies and continued volumes to five drinking-related problems (Alcohol Use Disorders Identification Test scores, physiological problems, risky sex, social problems, and driving after drinking too much). To estimate population-level effects, we assessed drinking frequencies relative to mean past-year use of each drinking context. RESULTS: Higher individual annual income (>$60,000) was associated with more frequent drinking in all on-premise drinking contexts (bars/clubs, restaurants, and stadiums). Heavier overall drinking was associated with drinking more frequently at bars. Drinking more frequently in respondents' own homes and heavier drinking at friends'/relatives' homes were associated with most drinking-related problems. The population-level effects of physiological problems and driving after drinking too much were highest for parties and friends'/relatives' homes, whereas that of risky sex outcomes was highest for bars. CONCLUSIONS: Assessing context-specific risks related to heavy and/or frequent drinking, in combination with scaling these risks to determine population-level impacts, can help tailor interventions to reduce alcohol-related problems across different on- and off-premise contexts.
OBJECTIVE: To better quantify the impact of specific on- and off-premise drinking contexts on population-level alcohol-related problems, we evaluated context-specific risks relative to frequency of use of each context. METHOD: We surveyed 860 adult (21-100 years) past-year drinkers in the California East Bay, sampled in areas of high versus low median household income and off-premise alcohol outlet densities. We examined associations of context-specific drinking frequencies in seven on- and off-premise drinking locations with individual and area characteristics using negative binomial regression. Next, we used heteroscedastic ordered logistic regression to relate context-specific drinking frequencies and continued volumes to five drinking-related problems (Alcohol Use Disorders Identification Test scores, physiological problems, risky sex, social problems, and driving after drinking too much). To estimate population-level effects, we assessed drinking frequencies relative to mean past-year use of each drinking context. RESULTS: Higher individual annual income (>$60,000) was associated with more frequent drinking in all on-premise drinking contexts (bars/clubs, restaurants, and stadiums). Heavier overall drinking was associated with drinking more frequently at bars. Drinking more frequently in respondents' own homes and heavier drinking at friends'/relatives' homes were associated with most drinking-related problems. The population-level effects of physiological problems and driving after drinking too much were highest for parties and friends'/relatives' homes, whereas that of risky sex outcomes was highest for bars. CONCLUSIONS: Assessing context-specific risks related to heavy and/or frequent drinking, in combination with scaling these risks to determine population-level impacts, can help tailor interventions to reduce alcohol-related problems across different on- and off-premise contexts.
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