International Journal of Public Health

, Volume 58, Issue 5, pp 777–784 | Cite as

Trends in socioeconomic inequalities in adolescent alcohol use in Germany between 1994 and 2006

  • Matthias Richter
  • Emmanuel Kuntsche
  • Margaretha de Looze
  • Timo-Kolja Pförtner
Original Article



To examine socioeconomic differences in adolescent alcohol use in Germany as well as their changes between 1994 and 2006.


Data were obtained from the “Health Behaviour in School-aged Children” study conducted in North Rhine-Westphalia, Germany in 1994, 1998, 2002 and 2006. The analysis is based on 5.074 15-year-old students. Prevalence and trends were analysed for each category of family affluence and educational track separately using log-binominal regression models.


An increase in weekly alcohol use between 1994 and 2002 was followed by a strong decrease from 2002 to 2006. Family affluence only had a weak effect on weekly drinking with a tendency for lower-affluent students reporting less alcohol use. Educational track showed almost no relationship with weekly alcohol use. Trend analyses within the subgroups revealed that the overall trend in alcohol use was similar in all socioeconomic and educational groups.


Socioeconomic patterns in drinking behaviour are not yet developed in 15-year-old adolescents. Adolescence could therefore be an important time frame for tackling inequalities in alcohol use later in life.


Adolescence Alcohol Socioeconomic position Trends HBSC Germany 


Conflict of interest

None declared.


  1. Andersen A, Holstein BE, Due P (2007) School-related risk factors for drunkenness among adolescents: risk factors differ between socio-economic groups. Eur J Public Health 17:27–32PubMedCrossRefGoogle Scholar
  2. Andersen A-MN, Krølner R, Currie C et al (2008) High agreement on family affluence between children’s and parents’ reports: international study of 11-year-old children. J Epidemiol Commun Health 62:1092–1094CrossRefGoogle Scholar
  3. Batty GD, Bhaskar A, Emslie C, Benzeval M, Der G, Lewars H, Hunt K (2012) Association of life course socioeconomic disadvantage with future problem drinking and heavy drinking: gender differentials in the west of Scotland. Int J Public Health 57(1):119–126PubMedCrossRefGoogle Scholar
  4. Brunner E, Shipley MJ, Blane D et al (1999) When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood. J Epidemiol Commun Health 53:757–764CrossRefGoogle Scholar
  5. Bundeszentrale für gesundheitliche Aufklärung (BZgA) (2011) Der Alkoholkonsum Jugendlicher und junger Erwachsener in Deutschland 2010. BZgA, KölnGoogle Scholar
  6. Casswell S, Pledger M, Hooper R (2003) Socioeconomic status and drinking patterns in young adults. Addiction 98:601–610PubMedCrossRefGoogle Scholar
  7. Cavelaars AE, Kunst AE, Mackenbach JP (1997) Socio-economic differences in risk factors for morbidity and mortality in the European community: an international comparison. J Health Psychol 2:353–372PubMedCrossRefGoogle Scholar
  8. Chen E, Matthews KA, Boyce WT (2002) Socioeconomic differences in children’s health: how and why do these relationships change with age? Psychol Bull 128:295–329PubMedCrossRefGoogle Scholar
  9. Currie C, Molcho M, Boyce WT et al (2008) Researching health inequalities in adolescents: the development of the Health Behaviour in School-aged Children (HBSC) family affluence scale. Soc Sci Med 66:1429–1436PubMedCrossRefGoogle Scholar
  10. Currie C, Nic Gabhainn S, Godeau E et al (2009) The Health Behaviour in School-aged Children: WHO collaborative cross-national (HBSC) study: origins, concept, history and development 1982–2008. Int J Public Health 54:131–139PubMedCrossRefGoogle Scholar
  11. Currie C, Zanotti C, Morgan A et al (2012) Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. WHO Regional Office for Europe, CopenhagenGoogle Scholar
  12. Droomers M, Schrijvers CT, Casswell S et al (2003) Occupational level of the father and alcohol consumption during adolescence: patterns and predictors. J Epidemiol Commun Health 57:704–710CrossRefGoogle Scholar
  13. Friestad C, Klepp KI (2006) Socioeconomic status and health behaviour patterns through adolescence: results from a prospective cohort study in Norway. Eur J Public Health 16:41–47PubMedCrossRefGoogle Scholar
  14. Geckova A, Van Dijk JP, Groothoff JW et al (2002) Socio-economic differences in health risk behaviour and attitudes towards health risk behaviour among Slovak adolescents. Soz Praventivmed 47:233–239PubMedGoogle Scholar
  15. Goodman E, Huang B (2002) Socioeconomic status, depressive symptoms, and adolescent substance use. Arch Pediatr Adolesc Med 156:448–453PubMedCrossRefGoogle Scholar
  16. Hagquist CE (2007) Health inequalities among adolescents: the impact of academic orientation and parents’ education. Eur J Public Health 17:21–26PubMedCrossRefGoogle Scholar
  17. Hanson MD, Chen E (2007a) Socioeconomic status and substance use behaviors in adolescents: the role of family resources versus family social status. J Health Psychol 12:32–35PubMedCrossRefGoogle Scholar
  18. Hanson MD, Chen E (2007b) Socioeconomic status and health behaviors in adolescence: a review of the literature. J Behav Med 30:263–285PubMedCrossRefGoogle Scholar
  19. Hibell B, Guttormsson U, Ahlström S et al (2011) The 2011 ESPAD report: substance use among students in 36 European countries. The Swedish Council for Information on Alcohol and Other Drugs (CAN). StockholmGoogle Scholar
  20. Holmen TL, Barrett-Connor E, Holmen J et al (2000) Health problems in teenage daily smokers versus nonsmokers, Norway, 1995–1997: the Nord-Trondelag Health Study. Am J Epidemiol 151:148–155PubMedCrossRefGoogle Scholar
  21. Khang YH, Yun SC, Lynch JW (2008) Monitoring trends in socioeconomic health inequalities: it matters how you measure. BMC Public Health 8:66PubMedCrossRefGoogle Scholar
  22. Koivusilta LK, Rimpela AH, Kautiainen SM (2006) Health inequality in adolescence. Does stratification occur by familial social background, family affluence, or personal social position? BMC Public Health 6:110PubMedCrossRefGoogle Scholar
  23. Kuntsche E, Gmel G, Wicki M et al (2006) Disentangling gender and age effects on risky single occasion drinking during adolescence. Eur J Public Health 16:670–675PubMedCrossRefGoogle Scholar
  24. Lampert T, Thamm M (2007) Tabak-, Alkohol- und Drogenkonsum von Jugendlichen in Deutschland. Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:600–608PubMedCrossRefGoogle Scholar
  25. Levin KA, Currie C, Muldoon J (2009) Mental well-being and subjective health of 11- to 15-year-old boys and girls in Scotland, 1994–2006. Eur J Public Health 19:605–610PubMedCrossRefGoogle Scholar
  26. Liu Y, Wang M, Tynjälä J, Villberg J, Lv Y, Kannas L (2012) Socioeconomic inequalities in alcohol use of adolescents: the differences between China and Finland. Int J Public Health. doi: 10.1007/s00038-012-0432-3
  27. Mackenbach JP (2012) The persistence of health inequalities in modern welfare states: the explanation of a paradox. Soc Sci Med 75:761–769PubMedCrossRefGoogle Scholar
  28. Mclellan L, Rissel C, Donnelly N et al (1999) Health behaviour and the school environment in New South Wales, Australia. Soc Sci Med 49:611–619PubMedCrossRefGoogle Scholar
  29. Melotti R, Heron J, Hickman M et al (2011) Adolescent alcohol and tobacco use and early socioeconomic position: the ALSPAC birth cohort. Pediatrics 127:e948–e955PubMedCrossRefGoogle Scholar
  30. Molcho M, Nic Gabhainn S, Kelleher CC (2007) Assessing the use of the family affluence scale (FAS) among Irish schoolchildren. Ir Med J 100(suppl):37–39PubMedGoogle Scholar
  31. Ottova V, Hillebrandt D, Kolip P et al (2012) HBSC-Studie in Deutschland: Studiendesign und Methodik. Das Gesundheitswesen 74:8–14CrossRefGoogle Scholar
  32. Pitel L, Madarasova Geckova A, Reijneveld SA, van Dijk JP (2012) Socioeconomic gradient shifts in health-related behaviour among Slovak adolescents between 1998 and 2006. Int J Public Health. doi: 10.1007/s00038-012-0382-9
  33. Rehm J, Mathers C, Popova S et al (2009) Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet 373:2223–2233PubMedCrossRefGoogle Scholar
  34. Richter M, Leppin A (2007) Trends in socio-economic differences in tobacco smoking among German schoolchildren, 1994–2002. Eur J Public Health 17:565–571PubMedCrossRefGoogle Scholar
  35. Roberts C, Freeman J, Samdal O et al (2009) The health behaviour in school-aged children (HBSC) study: methodological developments and current tensions. Int J Public Health 54:140–150PubMedCrossRefGoogle Scholar
  36. Simons-Morton B, Haynie DL, Crump AD et al (2000) Peer and parent influences on smoking and drinking among early adolescents. Health Educ Behav 28:95–107CrossRefGoogle Scholar
  37. Simons-Morton BG, Farhat T, Ter Bogt TF et al (2009) Gender specific trends in alcohol use: cross-cultural comparisons from 1998 to 2006 in 24 countries and regions. Int J Public Health 54:199–208PubMedCrossRefGoogle Scholar
  38. Starfield B, Riley AW, Witt WP et al (2002) Social class gradients in health during adolescence. J Epidemiol Commun Health 56:354–361CrossRefGoogle Scholar
  39. Tuinstra J, Groothoff JW, Van Den Heuvel WJ et al (1998) Socio-economic differences in health risk behavior in adolescence: do they exist? Soc Sci Med 47:67–74PubMedCrossRefGoogle Scholar
  40. Vereecken C, Maes L, De Bacquer D (2004) The influence of parental occupation and the pupils’ educational level on lifestyle behaviors among adolescents in Belgium. J Adolesc Health 34:330–338PubMedGoogle Scholar
  41. West P, Sweeting H (2004) Evidence on equalisation in health in youth from the West of Scotland. Soc Sci Med 59:13–27PubMedCrossRefGoogle Scholar
  42. Windle M (2003) Alcohol use among adolescents and young adults. Alcohol Res Health 27:79–85PubMedGoogle Scholar
  43. Wooldridge J (2002) Introductory econometrics. South Western, New YorkGoogle Scholar

Copyright information

© Swiss School of Public Health 2013

Authors and Affiliations

  • Matthias Richter
    • 1
  • Emmanuel Kuntsche
    • 2
    • 3
  • Margaretha de Looze
    • 4
    • 5
  • Timo-Kolja Pförtner
    • 1
  1. 1.Institute of Medical Sociology (IMS), Martin Luther University Halle-WittenbergHalle (Saale)Germany
  2. 2.Research InstituteAddiction SwitzerlandLausanneSwitzerland
  3. 3.Behavioural Science InstituteRadboud University NijmegenNijmegenThe Netherlands
  4. 4.Department of Interdisciplinary Social Sciences, Faculty of Social and Behavioral SciencesUtrecht UniversityUtrechtThe Netherlands
  5. 5.Department of Child and Adolescent Studies, Faculty of Social SciencesUtrecht UniversityUtrechtThe Netherlands

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