Drinking patterns and alcohol use disorders in São Paulo, Brazil: the role of neighborhood social deprivation and socioeconomic status

• Published in: PloS one Vol. 9; no. 10; p. e108355
• Main Authors: Silveira, Camila Magalhães, Siu, Erica Rosanna, Anthony, James C, Saito, Luis Paulo, de Andrade, Arthur Guerra, Kutschenko, Andressa, Viana, Maria Carmen, Wang, Yuan-Pang, Martins, Silvia S, Andrade, Laura Helena
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.10.2014; Public Library of Science (PLoS)
• Subjects: Abuse; Addictions; Adolescent; Adult; Aged; Alcohol Drinking - epidemiology; Alcohol use; Alcohol-Related Disorders - epidemiology; Alcoholic beverages; Behavior disorders; Biology and Life Sciences; Brazil - epidemiology; Cardiovascular disease; Deprivation; Diagnostic systems; Disorders; Disturbances; Drinking Behavior; Employment; Epidemiology; Female; Females; Humans; Income; Interdisciplinary aspects; Male; Males; Medicine; Medicine and Health Sciences; Mental health; Metropolitan areas; Middle Aged; Neighborhoods; Odds Ratio; Population; Prevalence; Probabilistic methods; Psychiatry; Public health; Public Health Surveillance; Residence Characteristics; Risk Factors; Social Class; Socioeconomic factors; Socioeconomic status; Socioeconomics; Studies; Womens health; Young Adult; Brazil; New York; United States > US; Ukraine; Russia; Latin America; Michigan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0108355

Research conducted in high-income countries has investigated influences of socioeconomic inequalities on drinking outcomes such as alcohol use disorders (AUD), however, associations between area-level neighborhood social deprivation (NSD) and individual socioeconomic status with these outcomes have not been explored in Brazil. Thus, we investigated the role of these factors on drink-related outcomes in a Brazilian population, attending to male-female variations. A multi-stage area probability sample of adult household residents in the São Paulo Metropolitan Area was assessed using the WHO Composite International Diagnostic Interview (WMH-CIDI) (n = 5,037). Estimation focused on prevalence and correlates of past-year alcohol disturbances [heavy drinking of lower frequency (HDLF), heavy drinking of higher frequency (HDHF), abuse, dependence, and DMS-5 AUD] among regular users (RU); odds ratio (OR) were obtained. Higher NSD, measured as an area-level variable with individual level variables held constant, showed an excess odds for most alcohol disturbances analyzed. Prevalence estimates for HDLF and HDHF among RU were 9% and 20%, respectively, with excess odds in higher NSD areas; schooling (inverse association) and low income were associated with male HDLF. The only individual-level association with female HDLF involved employment status. Prevalence estimates for abuse, dependence, and DSM-5 AUD among RU were 8%, 4%, and 8%, respectively, with excess odds of: dependence in higher NSD areas for males; abuse and AUD for females. Among RU, AUD was associated with unemployment, and low education with dependence and AUD. Regular alcohol users with alcohol-related disturbances are more likely to be found where area-level neighborhood characteristics reflect social disadvantage. Although we cannot draw inferences about causal influence, the associations are strong enough to warrant future longitudinal alcohol studies to explore causal mechanisms related to the heterogeneous patterns of association and male-female variations observed herein. Hopefully, these findings may help guide future directions for public health.