Hazardous alcohol consumption and problem drinking in Norwegian and Russian women and men: The Tromsø Study 2015–2016 and the Know Your Heart study 2015–2018

Aim: Harmful use of alcohol is a worldwide public health concern. Cultural differences may affect responses to questions on alcohol problems, making international comparisons difficult. We aimed to compare self-reported alcohol consumption and problem drinking between Norwegian and Russian populations. Methods: We used data from women and men aged 40–69 years participating in the Tromsø Study seventh survey (Tromsø7, N=17646, participation 65%), Tromsø (2015–2016), Norway, and the Know Your Heart study (KYH, N=4099, participation 51%), Arkhangelsk and Novosibirsk (2015–2018), Russia. Alcohol consumption and problem drinking were measured by the Alcohol Use Disorders Identification Test (AUDIT) via questionnaires (Tromsø7) and interviews (KYH). We compared AUDIT scores and components between populations, by sex. Results: Non-drinking was more commonly reported in KYH compared with Tromsø7 (men 15.5% versus 4.9%, women 13.3% versus 7.3%). In men, hazardous consumption (41.4% versus 31.5%) and problem drinking (24.8% versus 19.6%) was higher in KYH compared with Tromsø7, but opposite for women (6.5% versus 12.0%, and 2.3% versus 5.8%). KYH men were less likely to report problem drinking behaviours than Tromsø7 men, with the exception of needing a drink first thing in the morning (13.2% versus 2.4%). KYH women consistently reported less consumption and problem drinking than Tromsø7 women. Conclusions: We found between-study differences in hazardous drinking, but in men these were lower than suggested by differences in country-level statistics on alcohol consumption and alcohol-related health-harms. Study sample selection, stronger social desirability bias effects in the Russian samples, and cultural differences in responding could have affected the results.

Protective Effects of Perceived Control on Prescription Drug Misuse 10-years Later in the MIDUS Study

The current study examined if control beliefs predict prescription drug misuse (PDM) 10-years later and how problem drinking status moderates this relationship. PDM refers to taking medications without a prescription or in a manner not intended by the prescriber. Older adults are especially vulnerable to PDM due to drug sensitivity, comorbid health conditions, and high rates of polypharmacy. Participants were adults (n=2162, 56% female, mean age=54, range=30-84) who completed Waves 2 and 3 of the Midlife Development in the United States (MIDUS) study. At Wave 2, participants reported on two subscales of perceived control (personal mastery and constraints) and past 12-month problem drinking behaviors. At Wave 3, participants reported past 12-month PDM of five substances (painkillers, sedatives, stimulants, tranquilizers, and depression medications). Results indicated that at Wave 3, 10% of the sample reported misusing at least one prescription drug in the past year. Logistic Regression analysis revealed that problem drinking was associated with higher odds of PDM (p<0.001), and perceived control was associated with lower odds of PDM (p<0.05) after controlling for previous PDM and sociodemographic, health behavior, and health status covariates. However, there was an interaction effect such that perceived control was not protective for those individuals who engaged in problem drinking at Wave 2 (p<0.05). Future analyses will explore the meaning of this interaction. Identifying psychosocial protective factors, such as perceived control, predicting PDM will be critical for designing interventions that prevent the adverse consequences of PDM among this population.

Developmental Analysis of Prospective Effects of Problem Drinking and Health Problems in Three-Age Groups

Past research has clearly demonstrated interrelations between drinking and health. However, little research has investigated this from a lifespan-development perspective, which is the objective of the current study. Our hypotheses predicted results consistent with the familiar “J-shaped curve” of drinking effects on health, including that health problems would be (1) lower in moderate drinkers than abstainers and (2) higher in excessive drinkers than moderate drinkers. We also hypothesized that these protective effects of moderate drinking would increase with age across the lifespan. The current study used two waves of data from a large U.S.-representative sample. Analyses used 3*3 between-persons ANCOVAs that tested a three-level Wave-1 drinking-group factor and a three-level Wave-1 age-group factor. Of particular importance were the drinking-group-by-age interactions. Various Wave-2 health outcomes were predicted in different ANCOVAs, and each ANCOVA controlled for Wave-1 levels of the Wave-2 health outcome. Across nearly all health outcomes, young adults did not show significant differences between abstainers and moderate drinkers, whereas midlife and older adults consistently showed better health for moderate drinking versus abstainers. This suggests that protective effects of moderate drinking apply more-so to midlife and older adults than young adults. Surprisingly, excessive drinkers generally did not show poorer health than moderate drinkers, except for mixed evidence for such effects only among older adults. Thus, only older adults showed patterns entirely consistent with our hypothesized “J-shaped curve.” A next analytic step we will conduct in advance of this poster presentation will assess if alternative excessive-drinking operationalizations more consistently signal health problems.

Lifespan Developmental Analysis of Health Problems and Problem Drinking Across White and Underrepresented Adults

Research has illustrated potential health benefits from moderate drinking, but also health risks from excessive drinking. Few studies have contrasted drinking effects on health across different periods of the lifespan, and how such contrasts may vary across sociodemographic subpopulations. In this study, we investigated underrepresented racial and ethnic group status as a moderator of drinking effects on health across the lifespan. Analyses used data from two waves of a large U.S.-representative sample. We estimated a series of 3*3 between-persons ANOVAs testing effects of Wave-1 drinking group (abstainer, moderate drinkers, and excessive drinkers), age (young adulthood, midlife, and older adulthood), and drinking-group-by-age interactions in White versus underrepresented status. The outcome variable was Wave-2 hypertension (controlling for Wave-1 hypertension). In the older-adult White group, results reflected the familiar “j-shaped” curve of alcohol effects on health. Specifically, abstainers experienced higher hypertension than moderate drinkers (with marginal significance: p=.054), and excessive drinkers experienced higher hypertension than moderate drinkers (p= .002). In contrast, among underrepresented older adults, hypertension levels did not vary significantly by drinking group. Graphical results clarified that the lack of drinking effects among underrepresented older adults reflected that they had similarly elevated hypertension across all three drinking groups, whereas the White older adults only had comparably elevated hypertension in the excessive-drinker group. These findings suggest that the positive health effects of moderate drinking apply primarily to White older adults. Our poster will discuss potential explanations for the apparent lack of health benefits of safe-drinking practices among underrepresented older adults.

The influence of multidimensional deprivation on problem drinking developmental trajectory among young adults: a longitudinal study using latent class growth analysis

Background Many young people in Korea today experience deprivation in various areas of life. The social determinants of health approach maintains that social factors play an important role in an individual’s physical and mental health. This study aimed to investigate the problem drinking trajectory of young Korean people and identify the effects of multidimensional deprivation on problem drinking. Methods The study used data from 2012 to 2018 found in the Korea Welfare Panel Study. Latent class growth analysis was performed to determine the number of trajectories of problem drinking. After identifying latent classes, a multinomial logistic regression analysis was utilized to examine multidimensional deprivation as a predictor of class membership. Results Latent class analysis yielded three groups: (1) a low-level maintenance group (low level of alcohol use maintained at the low level), (2) a moderate-level increasing group (moderate level of problem drinking with a moderate increase in problem drinking), and (3) a risky drinking increasing group (high level of problem drinking with a rapid increase in problem drinking). Results from multinomial logistic regression showed that deprivation in housing and social deprivation increased the probability of belonging to the risky drinking increasing group compared to other reference groups. Conclusion The study speaks to the need to establish appropriate intervention strategies according to the level and changes in the pattern of alcohol use. The implications of housing and social deprivation concerning problem drinking among young Korean people are also discussed.

Problem-Drinking Across the Lifespan: Cross-Sectional Versus Longitudinal Effects Among Midlife and Older Adults

When considering problem drinking from a lifespan-developmental perspective, an often-stated premise is that problem drinking escalates during adolescence, peaks around early young adulthood, and then declines throughout the remainder of the lifespan. However, while there is a strong empirical basis for such changes throughout adolescence and young adulthood, the notion of continued declines throughout midlife and older adulthood is less firmly established and based primarily on cross-sectional data. Thus, this study contrasted cross-sectional versus longitudinal age effects on problem-drinking changes across the lifespan, with particular focus on midlife and older adulthood. Analyses used data from a large, two-wave, U.S.-representative sample. We generated descriptive “porcupine figures” graphically depicting both cross-sectional and longitudinal age effects simultaneously, and we estimated mixed-ANOVAs to partition, test, and contrast cross-sectional versus longitudinal age effects. As expected, analyses confirmed the well-known rise and fall of problem drinking across young adulthood in both cross-sectional and longitudinal age effects. In contrast, in midlife and older adulthood, only cross-sectional age effects were consistent with the notion of continued age-related declines throughout these ages, whereas the longitudinal data showed a mixture of stability and escalation at these ages. Age-confounded cohort effects are one plausible explanation for how cross-sectional data can lead to spurious conclusions about developmental change. By potentially yielding a more accurate understanding of lifespan-developmental change in midlife and older adulthood, findings like ours could help guide lifespan-developmentally-informed interventions for midlife and older-adult problem drinkers; an objective of increasing importance in light of the ongoing aging of the U.S. population.