Stressful events, stressful conditions and alcohol problems in the United States: a partial test of Bales's theory.

Bales's theory that sociostructural factors that produce stress for members of a society increase the rate of alcoholism is examined to explain variations in the levels of alcoholism in the 50 states. Two types of social stress are conceptualized and measured at the state level: The first, the "life events" model, is based on life changes that require adaptation. An index is described in which (negative) personal life events in 15 categories (e.g., divorce and plant closings) are aggregated for each state using macro measures. The second model is based on the idea of chronic stressful conditions, and is measured through the Measure of Status Integration and the Index of Relative Opportunities. Alcohol-related problems are measured by death rates for cirrhosis, alcoholism and alcoholic psychosis, and by per capita alcohol consumption. Both stressful events and stressful conditions are correlated with all indicators of alcoholism at the state level, 19 of 20 correlations being in the theoretically expected direction. Correlations are enhanced when age, urbanicity, the percentage of Blacks, low income and education are controlled for. The three macro measures of stress taken together explain 27% of the variation in cirrhosis death rates, 14% of the variation in alcoholism and alcoholic psychosis death rates and 47% of the variation in alcohol consumption rates.