Prospective Associations of Exposure to Discrimination and Alcohol Use: A National Longitudinal Study

Nicholas Guenzel; Cheryl L Beseler; Adam M Leventhal; Junhan Cho; Hongying Daisy Dai

doi:10.1016/j.amepre.2024.12.005

Prospective Associations of Exposure to Discrimination and Alcohol Use: A National Longitudinal Study

Am J Prev Med. 2024 Dec 11:S0749-3797(24)00427-6. doi: 10.1016/j.amepre.2024.12.005. Online ahead of print.

Authors

Nicholas Guenzel¹, Cheryl L Beseler², Adam M Leventhal³, Junhan Cho⁴, Hongying Daisy Dai⁵

Affiliations

¹ College of Nursing - Lincoln, University of Nebraska Medical Center, Omaha, NE, USA.
² Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
³ USC Institute for Addiction Science, University of Southern California, Los Angeles, CA USA; Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA USA.
⁴ Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA USA.
⁵ Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.. Electronic address: [email protected].

PMID: 39672351
DOI: 10.1016/j.amepre.2024.12.005

Abstract

Introduction: This study examined prospective associations of perceived discrimination experience and past-week alcohol use among U.S. adults.

Methods: This longitudinal study analyzed 22 biweekly surveys from the Understanding America Study (UAS) during June 2020-July 2021, a nationally representative U.S. adult panel. Multivariable regressions were conducted to examine prospective associations of perceived discrimination experiences (any vs. none) or mean levels of discrimination (never[0] to almost every day [4]) and past-week alcohol use frequency [days: 0-7]) or binge drinking (yes/no) 2 weeks later, after disaggregating within-person and between-person effects of discrimination regressor and adjusting for covariates. Analyses were conducted in 2024.

Results: Among 8,026 participants, 18.9% reported perceived discrimination experiences. The mean of past-week alcohol drinking was 1.27 days and 9.3% reported past-week binge drinking. Within-person discrimination prevalence and levels of discrimination were associated with higher drinking frequency (IRR[95% CI]=1.05[1.02-1.08], p=.0003 and IRR[95% CI]=1.06[1.02-1.10], p=.002, respectively), and between-person discrimination prevalence was associated with higher drinking frequency (IRR[95% CI]=1.16[1.05-1.30], p=.005) and higher likelihood of binge drinking (AOR[95% CI]=1.90[1.49-2.42], p<.0001). The associations of discrimination prevalence and drinking frequency differed by sex (interaction effect, p-value=.02) and race/ethnicity (interaction effect of Whites vs. Blacks, p-value=.006), with significantly higher numbers of past-week drinking among females (AOR[95% CI]=1.10[1.05-1.15] and Black adults (AOR[95% CI]=1.17[1.07-1.28]), but not among males and Hispanic/other race adults.

Conclusions: Discrimination experiences were prospectively associated with an increased risk of alcohol-drinking outcomes, and the effect was more pronounced among certain demographic groups. Efforts to mitigate the adverse effects of recurrent exposure to discrimination are critical to advance health equity.

Keywords: Binge Drinking; Drinking Frequency; Exposure to Discrimination; Understanding the America Study.