Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.
RTI International, Berkeley, CA, USA.
Addiction. 2022 Aug;117(8):2225-2234. doi: 10.1111/add.15882. Epub 2022 Apr 3.
To estimate longitudinal pathways from childhood socio-economic position (SEP) to educational attainment and mid-life heavy drinking in black Americans in order to identify potential points of early intervention to reduce risk for alcohol-related problems in adulthood.
DESIGN, SETTING AND PARTICIPANTS: Data are from 1299 black Americans in the US National Longitudinal Survey of Youth, followed from 1979 (aged 15-19 years) to 2012. Given gender differences in factors related to education and alcohol outcomes, gender-stratified path models were analyzed.
Youth socio-economic indicators included parental education (approximating childhood SEP) and adolescent poverty duration. Education-related measures included high-poverty school, perceived school safety, academic problems, suspension from school, educational expectations and educational attainment. Adulthood measures included repeated unemployment, poverty duration and mean frequency of heavy drinking (six or more drinks/day) in young adulthood and mid-life. Covariates included age, dual-parent household, marital status, early drinking onset and family history of alcohol problems.
For both genders, two main pathways originating from low childhood SEP flowed to educational attainment through (1) educational expectations and (2) suspension and from educational attainment to mid-life heavy drinking [total indirect effect = 0.131, 95% confidence interval (CI) = 0.072-0.197 for women and 0.080, 95% CI = 0.035-0.139 for men]. For both genders, adolescent poverty (standardized βs ≥ 0.139), academic problems (βs ≥ 0.221) and school suspension (βs ≥ 0.166) were significantly (Ps < 0.05) related to lower educational expectations. In adulthood, educational attainment was indirectly protective against mid-life heavy drinking through its significant effects (Ps < 0.05) on young adult heavy drinking for both genders (βs ≤ -0.204) and economic hardships for women (βs ≤ -0.372).
Low childhood socio-economic position among black Americans appears to be associated with subsequent, adverse socio-economic and school experiences that lead to lower educational attainment and, ultimately, greater heavy drinking at mid-life. Interventions that mitigate these earlier, adverse experiences might have indirect effects on mid-life heavy drinking.
评估童年社会经济地位（SEP）与教育程度和黑人群体中年人重度饮酒之间的纵向关联路径，以便确定潜在的早期干预点，以降低成年后与酒精相关问题的风险。
设计、地点和参与者：本研究的数据来自美国国家青年纵向调查中的 1299 名美国黑人，从 1979 年（15-19 岁）开始追踪至 2012 年。鉴于与教育和酒精相关结果相关的因素在性别上存在差异，因此对性别分层路径模型进行了分析。
青少年时期的社会经济指标包括父母的教育程度（近似于童年时期的 SEP）和青少年时期贫困持续时间。与教育相关的测量指标包括在高贫困学校就读、感知到的学校安全、学业问题、被学校停学、教育期望和教育程度。成年期的测量指标包括反复失业、贫困持续时间以及年轻人和中年时期重度饮酒（每天 6 次或以上）的平均频率。协变量包括年龄、双亲家庭、婚姻状况、早期饮酒开始时间和家族酒精问题史。
对于两性而言，源自低童年 SEP 的两个主要路径通过（1）教育期望和（2）停学，从教育程度流向中年重度饮酒[总间接效应=0.131，95%置信区间（CI）=0.072-0.197（女性）和 0.080，95%CI=0.035-0.139（男性）]。对于两性而言，青少年时期的贫困（标准化β≥0.139）、学业问题（β≥0.221）和学校停学（β≥0.166）与较低的教育期望显著相关（P<0.05）。在成年期，教育程度通过对两性年轻人重度饮酒的显著影响（P<0.05，β≤-0.204）以及对女性经济困难的影响（β≤-0.372），间接地对中年重度饮酒起到了保护作用。
美国黑人的童年社会经济地位较低，这似乎与随后的不利社会经济和学校经历有关，这些经历导致教育程度较低，最终导致中年时重度饮酒。减轻这些早期不利经历的干预措施可能会对中年重度饮酒产生间接影响。
