Trends in U.S. Women’s Binge Drinking in Middle Adulthood by Socioeconomic Status, 2006-2018

Cluster members Sarah McKetta and Katherine Keyes recently published research regarding national trends in binge drinking among women in the mid-life.

Multiple national surveys have found that women in the mid-life (~30-49) have dramatically increased binge drinking in recent years. While multiple hypotheses have been suggested to explain this increase, few have been empirically investigated. One hypothesized determinant of these trends is that shifts in women’s education and social position may be contributing to increases in binge drinking; if that’s true, the researchers anticipated that the increases in binge drinking prevalence would be concentrated among highly educated women and women with higher socio-economic status.

McKetta and Keyes used data from the National Health Interview Surveys (NHIS) from 2006 to 2018 to examine how trends in binge drinking among women ages 30-49 varied across two different measures of socio-economic status: education and family income.

They found that women had increases in binge drinking at all levels of education and income, but those with higher education and higher income had the most pronounced increases in binge drinking in recent years. For example, among women with less than high school education, the model-based predicted probability of binge drinking in 2006 was 10%, and 13% in 2018, adjusting for covariates (adjusted OR [AOR] 1.02, 95% CI 0.99, 1.04); among those with a college degree, binge drinking increased from a predicted 14% to 34% (AOR 1.10, 95% CI 1.08–1.11).  There appeared to be a threshold at college completion, as the increases among women in higher education categories were nearly identical.  Among women with family incomes less than 100% of the Federal Poverty Level (FPL), the model-based probability of binge drinking increased from 11% to 16% from 2006 to 2018 (AOR 1.03, 95% CI 1.01–1.05); whereas among those at the highest income level, 400% of the FPL or higher, binge drinking increased from 17% to 36% (AOR 1.09, 95% CI 1.07–1.10). In sensitivity analyses examining these trends among men, the socio-economic patterning of trends in binge drinking was much less pronounced.

The authors interpret these findings as evidence that increases in women’s binge drinking are concentrated among women at the highest levels of socio-economic status. This research corroborates previous research demonstrating the importance of college as a risk factor for binge drinking. This research also provides further evidence that alcohol researchers examining determinants of recent trends should be considering social factors, including the changing social landscape for women, such as increases in labor force engagement and role strain for women. The authors caution that the groups traditionally considered “high-risk” (i.e., young, college-aged men) are changing, and that providers should be screening all patients for alcohol consumption.

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