Association Between Perceived Discrimination and Alcohol and Tobacco Consumption in ELSA-Brasil Cohort: Focusing on Gender Differences

Abstract

Background: Discrimination is detrimental to physical and mental health, particularly insofar as health-risk behaviors are concerned. Particular attention has been paid to excess alcohol consumption and smoking in view of the ready availability of these substances in Western societies. Objectives: To determine whether an association exists between perceived discrimination and excess alcohol intake and smoking in women and men enrolled in the ELSA-Brasil cohort study. Methods: The sample included in the ELSA-Brasil cohort consisted of 15,105 civil servants. Data from waves 1 and 2 of the study were used. A multidimensional questionnaire was used to collect sociodemographic characteristics and evaluate perceived discrimination, alcohol consumption, and smoking. Results: An association was found between excess alcohol intake and perceived discrimination only in the men, with this association remaining significant in the youngest age group, in university-educated individuals, and in the group classified as middle-class. An association was found between smoking and lifetime perceived discrimination in women, particularly in those ≥60 years of age, brown-skinned women, those who had completed elementary school, and those classified as upper social class. This same association was found in the men, mainly those of 50–59 years of age, white-skinned males, those who had completed high school, those with a university education, and those classified as upper social class. Conclusions/Importance: Investing in public health policies aimed at combating the different forms of discrimination would appear essential. Not only does discrimination contribute to social injustice, but it also encourages health-risk behaviors such as excess alcohol intake and smoking.

Keywords:

• Gender differences
• perceived discrimination
• health-risk behaviors
• alcohol consumption
• tobacco consumption
• cohort study

Acknowledgments

The authors are grateful to the entire ELSA-Brasil team and to the participants of this cohort who generously provided information on their lives and on their health.

Disclosure statement

The authors have no conflicts of interest to declare.

Additional information

Funding

This study was funded by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science, Technology and Innovation (FINEP and CNPq). Grant numbers: 01 06 0010.00 and 01.10.0643.03 (RS); 01 06 0212.00 and 01.10.0742-00 (BA); 01 06 0300.00 and 01.12.0284.00 (ES); 01 06 0278.00 and 01 10 0746 00 (MG); 01 06 0115.00 and 01.10.0773-00 (SP); and 01 06 0071.00 and 01.11.0093.01 (RJ). Received additional funding from a collaborative project between Brazil and Portugal entitled “Gender and health in adulthood: dialogues between Brazil and Portugal,” sponsored by the Coordination for the Improvement of Higher Education Personnel in Brazil (CAPES) [grant Number 99999.008396/2014-00]. Estela M. L. Aquino is a CNPq fellow whose scientific research output is classified as level 1D.