A life course approach to understanding racial/ethnic differences in transitions into and out of alcohol problems

Abstract

Aims: Alcohol problems are most prevalent in young adulthood and decrease thereafter, but some studies find that racial/ethnic minorities have elevated alcohol risk beyond the 20s. This study examines racial/ethnic differences in the transitions into and out of alcohol problems, and whether these are explained by heavy drinking (HD), socioeconomic disadvantages and adult role transitions from the 20s to 30s. Short summary: Racial/ethnic groups had similar risks for earlier onset and recurrence/persistence of alcohol problems, but Blacks were at significantly greater risk than Whites for later onset in the 30s. Cumulative poverty and heavy drinking explained away this disparity, and were risk factors for recurring/persistent problems. Methods: Using data from the US National Longitudinal Survey of Youth 1979-1994 waves (n = 6098), past-year alcohol problems were measured in 1989 (mean age = 28) and in 1994 (mean age = 33) among drinkers. Patterns of alcohol problems were categorized as no problems, earlier onset in 20s/offset in 30s, later onset in 30s, and recurrence or persistence (at both time points). Multinomial regression models adjusted for demographics, cumulative poverty, HD and timing of social role transitions (marital, parental). Results: Compared to Whites, Blacks and Hispanics had similar risks for earlier alcohol problems but greater risk for developing problems in their 30s (AORs = 1.69 and 1.27, respectively, for later onset versus no problems); however, only the Black-White disparity was statistically significant. This was eliminated after taking into account cumulative poverty and lifecourse HD. There were no racial/ethnic differences in risk for recurring/persistent alcohol problems, which were associated with greater cumulative poverty and HD. Conclusions: While Whites appear to 'age out' of alcohol problems in their 30s, Blacks are at greater risk after young adulthood. These findings signal a need for interventions that target racial/ ethnic minorities beyond young adulthood.