Education, income and alcohol misuse: a stress process model

  • Marta ElliottEmail author
  • Jennifer Lowman
Original Paper



This study applies stress process theory to study and explain the negative association between socioeconomic status (SES) and alcohol misuse. SES is theorized to reduce alcohol misuse by reducing exposure to stressors and increasing access to resources.


The National Co-Morbidity panel sample (N = 4,979) interviewed in 1990–1992 and 2000–2002 are analyzed to estimate direct and indirect pathways between SES and alcohol misuse over time via stressors and resources.


Higher education and income predict decreased alcohol misuse via internal and external locus of control. External locus of control is associated with increased alcohol intake over time, whereas internal locus of control is associated with a lower likelihood of developing future alcohol-related disorders. Income is also associated with increased alcohol misuse via religiosity, which is more common among people of low income, and protects against alcohol misuse.


SES is negatively associated with alcohol misuse because low SES increases people’s perceptions that their lives are determined by luck, and reduces their sense of personal control. However, low income has a countervailing negative influence on alcohol misuse via its association with religiosity.


Socioeconomic status Alcohol misuse Stressors Resources 



This work was supported by the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health (Grant No. 1R03AA018570-01A1), and by research assistance from Carlene Gonzalez and Victoria Springer.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


  1. 1.
    Grant BF, Dawson DA, Stinson FS, Chou SP, Dufour MC, Pickering RP (2004) The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug Alcohol Depend 74:223–234PubMedCrossRefGoogle Scholar
  2. 2.
    US Department of Health and Human Services (2000) Economic costs of alcohol abuse in the United States. NIH, NIAAA, Washington, pp 1117–1128Google Scholar
  3. 3.
    SAMSHA (2007) Results from the 2006 national survey on drug use and health: national findings (Series H-32, DHHS Publication No.SMA 07-4293), Office of Applied Studies, RockvilleGoogle Scholar
  4. 4.
    Anthony JC, Warner LA, Kessler RC (1994) Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: basic findings from the national co-morbidity survey. Exp Clin Psychopharmacol 2(3):244–268CrossRefGoogle Scholar
  5. 5.
    Pearlin LI, Lieberman MA, Menaghan E, Mullan JT (1981) The stress process. J Health Soc Behav 22:337–356PubMedCrossRefGoogle Scholar
  6. 6.
    Lantz PM, House JS, Mero RP, Williams DR (2005) Stress, life events, and socioeconomic disparities in health: results from the Americans’ changing lives study. J Health Soc Behav 46(3):274–288PubMedCrossRefGoogle Scholar
  7. 7.
    Lachman ME, Weaver SL (1998) The sense of control as a moderator of social class differences in health and well-being. J Personal Soc Psychol 74(3):763–773CrossRefGoogle Scholar
  8. 8.
    Brady KT, Sonne SC (1999) The role of stress in alcohol use, alcoholism treatment and relapse. Alcohol Res Health 23(4):263–271PubMedGoogle Scholar
  9. 9.
    Pierce RS, Frone MR, Russell M, Cooper ML (1994) Relationship of financial strain and psychosocial resources to alcohol use and abuse: the mediating role of negative affect and drinking motives. J Health Soc Behav 35:291–308CrossRefGoogle Scholar
  10. 10.
    Hatch S (2005) Conceptualizing and identifying cumulative adversity and protective resources: implications for understanding health inequalities. J Gerontol B Psychol Sci Soc 60:S130–S134CrossRefGoogle Scholar
  11. 11.
    Sayette MA (1999) Cognitive theory and research. In: Leonard K, Blane H (eds) Psychological theories of drinking and alcoholism, 2nd edn. Guilford, New York, pp 47–291Google Scholar
  12. 12.
    Anisman H, Merali Z (1999) Understanding stress: characteristic and caveats. Alcohol Res Health 23(4):241–249PubMedGoogle Scholar
  13. 13.
    Avison W, Turner RJ (1988) Stressful life events and depressive symptoms: disaggregating the effects of acute stressors and chronic strains. J Health Soc Behav 29:253–265PubMedCrossRefGoogle Scholar
  14. 14.
    Brennan PL, Schuute KK, Moos BS (1999) Reciprocal relations between stressors and drinking behavior: a three-wave panel study of late middle-aged and older women and men. Addiction 94(5):737–749PubMedCrossRefGoogle Scholar
  15. 15.
    Moos RH, Fenn CB, Billings AG, Moos BS (1989) Assessing life stressors and social resources: applications to alcoholic patients. J Subst Abuse 1(2):135–152CrossRefGoogle Scholar
  16. 16.
    Walton MA, Blow FC, Bingham CR, Chermack ST (2003) Individual and social/environmental predictors of alcohol and drug use 2 years following substance abuse treatment. Addict Behav 28:627–642PubMedCrossRefGoogle Scholar
  17. 17.
    Seeman M, Anderson CS (1983) Alienation and alcohol: the role of work, mastery, and community in drinking behavior. Am Sociol Rev 48:60–77PubMedCrossRefGoogle Scholar
  18. 18.
    Koenig HC, Hays JC, George LK, Blazer DG, Larson DB, Landerman LR (1997) Modeling the cross-sectional relationships between religion, physical health, social support, and depressive symptoms. Am J Geriatr Psychiatry 5(2):131–144PubMedCrossRefGoogle Scholar
  19. 19.
    Krause N (2006) Exploring the stress-buffering effects of church-based and secular social support on self-rated health in late life. J Gerontol B Psychol Sci Soc Sci 61(1):S35–S43PubMedCrossRefGoogle Scholar
  20. 20.
    Kessler RC (1990–92) National comorbidity survey (computer file). University of Michigan, Survey Research Center, 2nd ICPSR edn. Inter-university consortium for political and social research (producer and distributor), Ann ArborGoogle Scholar
  21. 21.
    Swendsen J, Conway KP, Degenhardt L, Glantz M, Jin R, Merikangas KR, Sampson N, Kessler RC (2010) Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the national comorbidity survey. Addiction 105(6):1117–1128PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Muthén LK, Muthén BO (1998–2007) Mplus user’s guide, 5th edn. Muthén & Muthén, Los Angeles, pp 1998–2007Google Scholar
  23. 23.
    Hu LT, Bentler PM (1999) Cutoff criteria for fit indices in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model 6(1):1–55CrossRefGoogle Scholar
  24. 24.
    Asparouhov T (2005) Sampling weights in latent variable modeling. Struct Equ Model 12:411–434CrossRefGoogle Scholar
  25. 25.
    Poikolainen K, Podkletnova I, Alho H (2002) Accuracy of quantity-frequency and graduated frequency questionnaires in measuring alcohol intake: comparison with daily diary and commonly used laboratory markers. Alcohol Alcohol 37(6):573–576PubMedCrossRefGoogle Scholar
  26. 26.
    Gmel G, Graham K, Kuendig H, Kuntsche S (2006) Measuring alcohol consumption––should the ‘graduated frequency’ approach become the norm in survey research? Addiction 101:16–30PubMedCrossRefGoogle Scholar
  27. 27.
    Grant BF (1996) DSM-IV, DSM-III-R, and ICD-10 alcohol and drug abuse/harmful use and dependence, United States, 1992: a nosological comparison. Alcohol Clin Exp Res 20(8):1481–1488PubMedCrossRefGoogle Scholar
  28. 28.
    Rotter JB (1990) Internal versus external control of reinforcement: a case history of a variable. Am Psychol 45(4):489CrossRefGoogle Scholar
  29. 29.
    Lugo L (2012) Nones on the rise: one-in-five adults have no religious affiliation. Accessed 20 Jan 2014
  30. 30.
    Schieman S (2008) The religious role and the sense of personal control. Sociol Relig 69(3):273–296CrossRefGoogle Scholar
  31. 31.
    Michalak L, Trocki K, Bond J (2007) Religion and alcohol in the US National Alcohol Survey: how important is religion for abstention and drinking? Drug Alcohol Depend 87(2):268–280PubMedCrossRefGoogle Scholar
  32. 32.
    Ferri M, Amato L, Davoli M (2006) Alcoholics anonymous and other 12-step programmes for alcohol dependence. Cochrane Database Syst Rev (3):CD005032Google Scholar
  33. 33.
    Alcoholics Anonymous (2004) Twelve steps and twelve traditions, Alcoholics Anonymous World Services. Accessed 31 May 2013
  34. 34.
    Hester RD, Miller WR (1995) Handbook of alcoholism treatment approaches: effective alternatives, 2nd edn. Allyn and Bacon, BostonGoogle Scholar
  35. 35.
    Ross CE, Mirowsky J (2013) The sense of personal control: Social structural causes and emotional consequences. In: Aneshensel CS, Phelan JC, Bierman A (eds) Handbook of the sociology of mental health, 2nd edn. Springer, Netherlands, pp 379–402Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Sociology/300University of Nevada, RenoRenoUSA

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