Neighborhood education inequality and drinking behavior

Abstract

Background: The neighborhood distribution of education (education inequality) may influence substance use among neighborhood residents.

Methods: Using data from the New York Social Environment Study (conducted in 2005; n=4000), we examined the associations of neighborhood education inequality (measured using Gini coefficients of education) with alcohol use prevalence and levels of alcohol consumption among alcohol users. Analyses were adjusted for neighborhood education level, income level and income inequality, as well as for individual demographic and socioeconomic characteristics and history of drinking prior to residence in the current neighborhood. Neighborhood social norms about drinking were examined as a possible mediator.

Results: In adjusted generalized estimating equation regression models, one-standard-deviation-higher education inequality was associated with 1.18 times higher odds of alcohol use (logistic regression odds ratio=1.18, 95% confidence interval 1.08-1.30) but 0.79 times lower average daily alcohol consumption among alcohol users (Poisson regression relative rate=0.79, 95% confidence interval 0.68-0.92). The results tended to differ in magnitude depending on respondents' individual educational levels. There was no evidence that these associations were mediated by social drinking norms, although norms did vary with education inequality.

Conclusions: Our results provide further evidence of a relation between education inequality and drinking behavior while illustrating the importance of considering different drinking outcomes and heterogeneity between neighborhood subgroups. Future research could fruitfully consider other potential mechanisms, such as alcohol availability or the role of stress; research that considers multiple mechanisms and their combined effects may be most informative.

Figure 1

Prevalence of alcohol use in the past 12 months by individual educational attainment levels, New York Social Environment Study, New York, New York, 2005. Alcohol use was self-reported and was defined as drinking 12 or more drinks in the past 12 months.

Figure 2

Average neighborhood proportion of respondents reporting they feel it is unacceptable for adults to drink alcohol, by neighborhood education Gini residual and individual education levels, New York Social Environment Survey, New York, New York, 2005. A high education Gini residual indicates a wider education distribution per level of neighborhood mean educational attainment, while a low education Gini residual indicates a narrower education distribution per level of neighborhood mean educational attainment. Respondents with higher education levels were less likely to report restrictive individual drinking norms. This pattern was more pronounced in neighborhoods with high education inequality than in neighborhoods with low education inequality.