Cohabitation, Gender, and Alcohol Consumption in 19 Countries: A Multilevel Analysis

Abstract

We used an ecological paradigm and multilevel analytic techniques to analyze gender-specific relationships of cohabitation (versus marriage) to drinking in 19 countries (n = 32,922) and to “heavy episodic drinking” (HED) in 17 countries (n = 24,525) in surveys (1996–2004) from Gender, Alcohol, and Culture: An International Study. Cohabitation was associated with elevated risk of HED among drinkers of both genders, controlling for age, education, and societal characteristics. The association between cohabitation and HED tended to be stronger for female drinkers than for male drinkers. HED was more prevalent among younger drinkers, especially among younger women in countries with higher per capita gross domestic product. Cross-culturally, cohabiters deserve special attention in prevention efforts for hazardous drinking, considering both individual-level and societal factors.

RÉSUMÉ

Cohabitación, Género y consumo de Alcohol en 19 países: un análisis multinivel

Se utilizó un paradigma ecológico y técnicas de análisis mulinivel para analizar, en hombres y mujeres, la relación entre la cohabitación (versus matrimonio) y el consumo de alcohol en 19 países (n = 32,922), así como el consumo concentrado de alcohol (tambien conocido como binge drinking) en 17 países (n = 24,525). Las encuestas (1996–2004) forman parte del estudio Género, Alcohol y Cultura: Un estudio multi-nacional (GENACIS). La cohabitación se asoció con mayor riesgo de consumo concentrado de alcohol en bebedores de ambos sexos, controlando la edad, educación y características sociales. La asociación entre cohabitación y el consumo concentrado de alcohol tiende a ser mayor en mujeres que consumen alcohol que en hombres bebedores. El consumo concentrado de alcohol resultó mas frequente entre los bebedores más jovenes, sobre todo en las mujeres de países con mayor PIB per capita. A nivel transcultural, los cohabitantes requieren mayores esfuerzos de prevención sobre el consumo concentrado de alcohol, considerando ambos niveles, el nivel individual y los factores sociales. (La elaboración de este artículo fue financiada por el National Institute on Alcohol Abuse and Alcoholism/National Institutes of Health –Grant no. R01AA015775.)

RESUMEN

Cohabitation, genre et consommation d’alcool dans 19 pays : Une analyse à niveaux multiples

Nous avons utilisé un paradigme écologique et des techniques d’analyses à niveaux multiples afin d’analyser les différences de genres quant à l’association entre la cohabitation (par contraste au mariage) et la consommation d’alcool (dans 19 pays; n = 32,922) et la consommation épisodique excessive (dans 17 pays; n = 24,525) sur la base de données du projet GENACIS (Gender, Alcohol and Culture: An International Study; enquêtes menées entre 1996 et ). La cohabitation était associée à un risque supérieur de consommations épisodiques excessives pour les deux genres (association contrôlée pour l’âge, le niveau éducationnel, et diverses caractéristiques du niveau sociétal). L’association entre cohabitation et consommations épisodiques excessives tendait à être plus forte pour les femmes que pour les hommes (consommatrices/eurs d’alcool uniquement). La consommation épisodique excessive était en outre plus fréquente chez les jeunes consommateurs, et en particulier chez les jeunes femmes dans les pays à haut Produit Intérieur Brut. Au travers des cultures, et en considérant tant des facteurs individuels que sociétaux, les personnes vivant en cohabitation méritent une attention particulière dans le cadre d’efforts de prévention des consommations d’alcool à risque. (La préparation de cet article a été permise par le soutien financier no. R01AA015775 du National Institute on Alcohol Abuse and Alcoholism/National Institutes of Health.)

Keywords :

• cohabitation
• gender
• alcohol
• multilevel modeling
• global health
• cross-national comparisons
• culture

THE AUTHORS

Qing Li, M.D., DrPH, is a postdoctoral fellow in the Pediatric Prevention Research Center, Wayne State University, Detroit, Michigan, USA. At the time of the study, she was a postdoctoral fellow in the Department of Clinical Neuroscience, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, North Dakota, USA. She received her M.D. and OBGYN residency from Sun Yat-sen University, Guangzhou, China, and DrPH in maternal and child health with a focus on perinatal epidemiology from University of Alabama at Birmingham, USA. Her primary research interests are social, reproductive, and perinatal epidemiology, health disparities, gender, violence, alcohol consumption, and HIV, using the life-course, social–ecological, and cross-cultural perspectives. She has applied multilevel analyses into public health research on structural barriers and/or “handles” at the neighborhood, societal, or workplace levels for health promotion and disease prevention.

Richard W. Wilsnack, Ph.D., is Professor in the Department of Clinical Neuroscience, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, North Dakota, USA. He holds a B.A. from Pomona College, M.Sc. (Econ.) from the London School of Economics, and M.A. and Ph.D. in sociology from Harvard University. His research interests include gender influences on alcohol consumption and related problems; cross-cultural patterns of alcohol consumption and related problems; and longitudinal and retrospective research on adult life histories. Sharon Wilsnack and Richard Wilsnack direct a 20-year national longitudinal study of alcohol use and abuse in U.S. women and coordinate the multinational GENACIS project which generated the data analyzed in this paper.

Sharon Carlson Wilsnack, Ph.D., is Chester Fritz Distinguished Professor in the Department of Clinical Neuroscience, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, North Dakota, USA. She received her M.A. and Ph.D. in clinical psychology from Harvard University and studied as a Fulbright Fellow at the University of Freiburg, Germany. She has published widely on issues related to substance abuse in women and has served on numerous national and international advisory groups concerned with gender, alcohol abuse, and health. With Richard Wilsnack she directs a 20-year longitudinal study of drinking behavior in U.S. women and coordinates the GENACIS project, a multinational study of gender and alcohol that involves researchers from more than 40 countries.

Arlinda F. Kristjanson, Ph.D., is Associate Professor in the Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA. She received her M.A. and Ph.D. in Experimental Psychology from the University of North Dakota. She is the project manager for the 20-year longitudinal study directed by Sharon and Richard Wilsnack and the project coordinator for the GENACIS project, directed by Sharon Wilsnack. Her research interests are gender-specific alcohol consumption patterns and risks of developing alcohol-related problems.

Glossary

• Cohabitation: Living together with one's intimate partner outside marriage.

• Cross-cultural research: Research methods designed to study cultural similarities and differences across diverse societies.

• Heavy episodic drinking: Consuming five or more drinks in a single day.