Structural Models of Gender, Alcohol Consumption, and Health

Abstract

Background. Gender differences exist in patterns of alcohol consumption and in the health and social effects of alcohol use, but little is known about gender differences in how alcohol use is affected by mental and physical health conditions. Methods. We used structural equation modeling techniques to examine gender differences in the relationships among alcohol consumption, physical and mental health, functional status, and social and demographic characteristics. Data were obtained from a random sample of the adult membership of a health maintenance organization in the U.S. Pacific Northwest. Simultaneous models evaluated gender differences in predictors of drinking vs. nondrinking status and, among drinkers, amount of alcohol consumed. Results. Physical health was twice as strong a predictor of drinker/nondrinker status among women compared with men, but among drinkers, there were no gender differences in predictors of amount of alcohol consumed. Mental health predicted drinking status and alcohol consumption among drinkers, but these relationships did not differ by gender. Overall, sociodemographic characteristics and physical health were stronger predictors of alcohol use among women than among men. Conclusions. Women may be more amenable than men to alcohol-related preventive messages that target physical health concerns. Treating mental health conditions may be an important method for reducing alcohol consumption.

• Alcohal consumption
• Gender
• Gender health differences

Resumen

Antecedentes. Las diferencias por género existen en los patrones de consumo de alcohol y en sus efectos en la salud y el ámbito social, pero poco se conoce sobre las diferencias por género sobre cómo el consumo de alcohol es afectado por las condiciones de salud mental y física. Métodos. Utilizamos técnicas de modelos de ecuaciones estructurales para examinar las diferencias por género en las relaciones entre el consumo de alcohol, la salud física y mental, el estado funcional y las características sociales y demográficas. Se obtuvieron datos de una muestra aleatoria de miembros adultos en un plan de seguros de atención médica en el Noroeste de los Estados Unidos. Los modelos simultáneos evaluaron las diferencias por géneros en cuanto a variables que permitían pronosticar estatus como consumidor y no-consumidor de alcohol y, entre los consumidores, la cantidad de alcohol consumida. Resultados. La salud física fue la variable que, con el doble de exactitud, permitió predecir como consumidor/no-consumidor a los participantes en el estudio, distinguiendo entre hombres y mujeres. Sin embargo, entre los consumidores de alcohol no hubo diferencias por género en la variable de predicción de la cantidad de alcohol consumida. La categoría de salud mental pronosticó el estatus como consumidor y la cantidad consumida entre aquellas personas que tomaban alcohol, pero estas relaciones no variaron en función de género. En general, las características sociodemográficas y la salud física fueron variables más sólidas en la predicción de consumo de alcohol entre mujeres que entre hombres. Conclusiones. Las mujeres pueden ser más receptivas que los hombres a los mensajes preventivos asociados a los problemas de salud física. El tratamiento de las condiciones de salud mental puede ser un método importante para reducir el consumo de alcohol.

Résumé

Contexte. La consommation d’alcool, ses effets sur la santé et ses conséquences sociales diffèrent selon le sexe, mais l’influence de la santé mentale et de l’état physique sur la consommation d’alcool selon le sexe est peu connue. Méthodes. Nous avons utilisé des techniques de modélisation par équation structurelle pour étudier les différences entre les sexes quant à la relation entre la consommation d’alcool, l’état physique et la santé mentale, l’état fonctionnel et les caractéristiques sociodémographiques. Les données sont issues d’un échantillon aléatoire d’adultes faisant partie d’une organisation américaine de soins de santé intégrés dans la région du Nord-Ouest du Pacifique. Des modèles simultanés ont permis d’évaluer les différences entre les sexes en ce qui a trait aux prédicteurs de consommation ou de non-consommation d’alcool et, chez les buveurs, la quantité d’alcool consommée. Résultats. L’état physique s’est révélé un prédicteur de consommation ou de non-consommation d’alcool deux fois plus important chez les femmes que chez les hommes; toutefois, chez les buveurs, aucune différence entre les sexes n’a été notée quant aux prédicteurs de la quantité d’alcool consommée. La santé mentale du sujet permet de prévoir l’état de buveur et l’importance de la consommation d’alcool chez les buveurs, mais on ne note aucune différence entre les sexes. Dans l’ensemble, les caractéristiques sociodémographiques et l’état physique se sont révélés de meilleurs prédicteurs de consommation d’alcool chez les femmes que chez les hommes. Conclusions. Les femmes sont probablement plus sensibles que les hommes aux messages de modération quant à la consommation d’alcool s’ils sont axés sur le maintien de la santé. Le traitement des désordres mentaux peut être un moyen efficace de réduire la consommation d’alcool.

Additional information

Notes on contributors

Carla A. Green

Carla A. Green, Ph.D., M.P.H. is Research Assistant Professor in the Department of Public Health and Preventive Medicine at Oregon Health and Science University, and Adjunct Investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon. She received her Ph.D. in Systems Science/Sociology from Portland State University in 1995 and her M.P.H. in Epidemiology and Biostatistics from Oregon Health Sciences University in 2000. Dr. Green received a National Research Service Award postdoctoral fellowship in health services research from the Agency for Health Care Policy and Research, and a Fulbright dissertation award. Her current research interests include gender differences in substance use, abuse, and treatment, recovery from serious mental health problems, quality of life, and comorbidity between mental health and substance use. In addition, she works with the Oregon Node of the National Institute on Drug Abuse's Clinical Trials Network. Dr. Green's work to date includes examinations of factors affecting alcohol consumption, including gender, health care service use and costs, home- and community-based care, and quality of life.

Michael R. Polen

Michael R. Polen, M.A. is a sociologist and Senior Research Associate at the Kaiser Permanente Center for Health Research in Portland, Oregon. His undergraduate work was in history at Bowling Green State University, where he also received an M.A. in sociology. He completed further graduate work in sociology at the University of Michigan. His research interests include the relationships between alcohol and other drug consumption, with health, utilization, and costs of health services, and tobacco control among adolescents.

Nancy A. Perrin

Nancy A. Perrin is a Quantitative Psychologist, Senior Investigator at the Kaiser Permanente Center for Health Research, and Professor at Oregon Health and Science University. She completed her undergraduate work at the University of California, Los Angeles and received her Ph.D. from Ohio State University. Her research centers on applications of multivariate statistical models to health outcomes, and she has used these methods to examine the role of social support in the adjustment to breast cancer, the psychosocial, biomedical, and lifestyle risk factors for low birth weight babies, to predict frailty in the elderly, to explore absenteeism after an on-the-job injury, and to investigate comorbidity of HIV and mental illness. She has conducted research in the area of measurement and has been a member of numerous research teams investigating areas such as substance abuse, caregiver strain, psychological adjustment to tinnitus, and depression in the elderly.