Geographic clustering of underage drinking and the influence of community characteristics

Abstract

The aim of this paper was to examine the extent to which underage drinking clusters geographically in a sample of communities, and to investigate the manner in which community-level contexts are related to this process. We used data from a randomized community trial of underage drinking to provide the first quantitative estimates of the magnitude of the geographic clustering of underage drinking based upon pairwise odds ratios (PWORs). The Enforcing Underage Drinking Laws Randomized Community Trial provided data from repeated cross-sectional samples of youth aged 14-20 from 68 communities surveyed in 2004, 2006, and 2007 (n=18, 730). Past 30-day drinking, binge drinking, getting drunk, experiencing non-violent consequences as a result of drinking and making a purchase attempt all significantly clustered within-communities with PWORs ranging from 1.05 to 1.21. After adjustment for individual-level characteristics, results remained relatively unchanged. However, there was evidence that the magnitude of the clustering varied as a function of neighborhood disadvantage, neighborhood disorder, and family structure. Clustering of drunkenness and experiencing non-violent consequences as a result of drinking was greatest in the least economically disadvantaged and least disordered communities with the greatest percentage of married couple families. The clustering of making a purchase attempt, however, was greatest in more disordered communities, specifically the largest communities with the highest degree of residential mobility and housing density. These findings that clustering of underage drinking behaviors varies by community context has the potential for identifying the types of communities to target for underage drinking behavior-specific preventive interventions.

Social Influences on the Clustering of Underage Risky Drinking and Its Consequences in Communities

“…Clustering was estimated within communities using the ALR method developed by Carey and colleagues (1993) and implemented by other researchers in the area of drug use (e.g., Bobashev and Anthony, 2000;Delva et al, 2000;Anthony, 2000, 2003;Reboussin et al, 2010Reboussin et al, , 2011Wells et al, 2009). PWOR estimated from ALR refl ect how strongly behaviors co-occur in communities (referred to as clustering).…”

“…This will provide evidence as to whether social factors have infl uence over the individual disadvantage of youth that predisposes them to participate in risky drinking (Massey, 1996;Wilson, 1996). Several individual-level characteristics of the participants-some of which mark varying levels of vulnerability, predisposition, or risk of underage drinking and that were found in our previous analyses of these data to be important (Reboussin et al, 2010;Song et al, 2009)-were considered. These include age, gender, race, parental education, and family structure as defi ned in Table 2.…”

“…Although researchers have identifi ed several individual and community-level influences on underage drinking (Johnston et al, 2011;Reboussin et al, 2006Reboussin et al, , 2010Song et al, 2009), each adolescent is also making decisions about drinking within a particular social setting. In contrast to the early developmental years, adolescents spend approximately twice as much time with peers as they spend with parents or other adults, making peers a major source of socialization and development for adolescents (National Research Council and Institute of Medicine, 2004).…”

“…Recently, our research group found that underage risky drinking behaviors and consequences cluster within communities (Reboussin et al, 2010). Clustering in this context refers to the tendency of the behaviors of youth residing within the same community to be more alike to one another than they are to those of others from different communities.…”

School context and American Indian substance use

“…For example, most community-level explanations of crime and delinquency have emphasized the causal role that economic deprivation plays in explaining high crime and delinquency rates in impoverished communities (e.g., social disorganization theory, relative deprivation, concentrated disadvantage). However, multilevel studies of neighborhood disadvantage and substance use have produced mixed results, with some studies finding economic disadvantage to be positively associated with substance use behaviors (e.g., Hoffmann, 2002; Chuang, Ennett, Bauman, & Fosheee, 2005; Frank, Cerda, & Rendon, 2007; Henry & Slater, 2007; Xue, Zimmerman, & Caldwell, 2007; Whaley, Smith, & Hayes-Smith, 2011; see Gardner, Barajas, & Brooks-Gunn 2010 for a comprehensive review), while others have found that community affluence , rather than disadvantage is associated with a higher likelihood of adolescent substance use (Snedker, Herting, and Walton 2009; Reboussin, Preisser, Song, & Wolfson, 2010; Cronley et al, 2012). Likewise, despite the reality that many racial and ethnic minorities disproportionately reside in economically disadvantaged communities, cumulative evidence suggests that most racial and ethnic minority youth in America use substances less frequently than (both non-Hispanic and Hispanic) whites (SAMHSA 2009; Wallace, Vaughn, Bachman, O'Malley, Johnston & Schulenberg, 2009).…”