Individual and Community Social Determinants of Health and Recovery from Alcohol Use Disorder Three Years following Treatment

ABSTRACT

Prior research on recovery from alcohol use disorder (AUD) has often focused on individual-level factors that promote recovery. Given systemic health inequities, it is also important to study community-level social determinants of health (SDOH) that may promote recovery from AUD. This study extended prior work examining individual profiles of recovery from AUD to assess how individual and community SDOH at the time of treatment entry were associated with recovery from AUD three years after treatment. Data were utilized from the COMBINE study (n = 664), a multisite randomized clinical trial evaluating pharmacological and behavioral treatments for AUD. Public community data sources associated with participants’ study sites were used to measure community SDOH. Multilevel latent profile analyses with individual- and community-level variables as predictors of recovery profiles were estimated. Four profiles were identified based on participants’ alcohol consumption and functioning. Individual SDOH variables, such as fewer years of education and lower income, and community SDOH, including lower rates of health insurance, lower income, and greater income inequality, were each associated with lower functioning profiles. The findings highlight the importance of community SDOH in AUD recovery and the value of including both individual and community SDOH variables in research on long-term recovery.

KEYWORDS:

• Alcohol use disorder
• social determinants of health
• recovery
• community-level

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data sharing policy

The data that support the findings of this study are available from the National Institute on Alcohol Abuse and Alcoholism. These data were derived from the following resources available in the public domain: https://www.niaaa.nih.gov/research/niaaa-data-archive.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This work was supported by the National Institute on Alcohol Abuse and Alcoholism under grants R01 AA022328 and T32 AA018108.