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Differential Consequences: Racial/Ethnic and Gender Differences in the Enduring Impact of Early Disadvantage on Heavy Drinking in Midlife

Abstract

We use a “chain of risks” model to identify risk factors for prolonged heavy drinking in a nationally representative US sample followed from adolescence to middle age, focusing on educational mediators and differential consequences of early exposure to family poverty and area-level disadvantage. Using data from the 1979 National Longitudinal Survey of Youth (civilian respondents ages 14–19 at baseline, N = 5781), longitudinal path models assessed racial/ethnic and gender differences in indirect effects of early disadvantage (duration of exposure to family poverty and area-level disadvantage during adolescence) on midlife heavy drinking. Educational mediators were high school academic performance (taking remedial coursework), high school completion, and attaining a college education. Subgroups were based on race/ethnicity (50.7% White, 30.5% Black, 18.8% Hispanic respondents) and gender (49.6% males). There was a significant indirect path from family poverty during adolescence to poor high school academic performance, lower educational attainment, and more heavy drinking in midlife. For Black respondents, there was an additional direct effect of early area-level disadvantage on greater midlife heavy drinking that was not seen for other groups. The effect of family poverty on reduced high school graduation was stronger for males than females. Enduring impacts of family poverty duration during adolescence on educational attainment have consequences for health risk behaviors in midlife. Due to differential exposure to early adversity, intersectoral interventions are needed to reduce disparities in alcohol outcomes and to promote health equity among high-risk populations.

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Funding

The current secondary analysis study was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health (NIH) (R01AA022668, N. Mulia, PI, and P50AA005595, W. Kerr, PI). The research was conducted with restricted access to Bureau of Labor Statistics (BLS) data. The views expressed here do not necessarily reflect the views of the BLS. Content is solely the responsibility of the authors and does not represent official views of the NIH or NIAAA, which had no role in the study design, collection, analysis or interpretation of the data, writing of the manuscript, or the decision to submit the manuscript for publication.

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Correspondence to Katherine J. Karriker-Jaffe.

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All procedures performed in the National Longitudinal Survey of Youth (NLSY) involving human participants were in accordance with ethical standards described in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The current study is a secondary analysis of NLSY data. The Institutional Review Board of the Public Health Institute reviewed the study protocol and found it to be exempt.

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Karriker-Jaffe, K.J., Witbrodt, J. & Mulia, N. Differential Consequences: Racial/Ethnic and Gender Differences in the Enduring Impact of Early Disadvantage on Heavy Drinking in Midlife. Prev Sci 20, 1009–1020 (2019). https://doi.org/10.1007/s11121-019-01033-1

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Keywords

  • Alcohol use
  • Racial/ethnic disparities
  • Socioeconomic disadvantage
  • Education