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Intersections of poverty, race/ethnicity, and sex: alcohol consumption and adverse outcomes in the United States

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Abstract

We examine whether intersectionality theory—which formalizes the notion that adverse health outcomes owing to having a marginalized social status, identity, or characteristic, may be magnified for individuals with an additional marginalized social status, identity, or characteristic—can be applied using quantitative methods to describe the differential effects of poverty on alcohol consumption across sex and race/ethnicity. Using the National Epidemiologic Survey on Alcohol and Related Conditions, we analyze longitudinal data from Black, Hispanic, and White drinkers (n = 21,140) to assess multiplicative interactions between poverty, as defined by the US Census Bureau, sex, and race/ethnicity, on adverse alcohol outcomes. Findings indicated that the effect of poverty on the past-year incidence of heavy episodic drinking was stronger among Black men and Black women in comparison to men and women of other racial/ethnic groups. Poverty reduction programs that are culturally informed may help reduce racial/ethnic disparities in the adverse outcomes of alcohol consumption.

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Acknowledgements

We would like to thank Lawrence Berger, PhD, Professor of Social Work and Director of the Institute for Research on Poverty at University of Wisconsin-Madison, for his consultations on the measurement of poverty in this study. We are also grateful to Ashley M. H. Glass, MSW, of Group Health Research Institute in Seattle, WA, for her helpful insights into our findings.

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Correspondence to Joseph E. Glass.

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Dr. Glass, Dr. Rathouz, and Dr. Nelson were supported by a grant awarded by the National Institute on Alcohol Abuse and Alcoholism to fund this work (R03AA023639, PI: Glass). The Biostatistics Core at the Institute and Clinical and Translational Research (ICTR) provided statistical support prior to grant submission. ICTR is funded by the NIH Clinical and Translational Science Award grant UL1TR000427. Pilot work was also supported by the Institute for Research on Poverty at the University of Wisconsin-Madison in its role as the National Poverty Research Center, grant number AE00102, awarded by the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Dr. Williams is supported by a Career Development Award from VA Health Services Research & Development (CDA 12-276). The funders played no role in study design, collection, analysis, interpretation of data, writing of the report, or in the decision to submit the paper for publication. The opinions and conclusions expressed herein are solely those of the author(s) and should not be construed as representing the opinions or policy of any agency of the Federal government.

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Glass, J.E., Rathouz, P.J., Gattis, M. et al. Intersections of poverty, race/ethnicity, and sex: alcohol consumption and adverse outcomes in the United States. Soc Psychiatry Psychiatr Epidemiol 52, 515–524 (2017). https://doi.org/10.1007/s00127-017-1362-4

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