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

Camila Magalhães Silveira, Erica Rosanna Siu, James C. Anthony, Luis Paulo Saito, Arthur Guerra De Andrade, Andressa Kutschenko, Maria Carmen Viana, Yuan Pang Wang, Silvia S. Martins, Laura Helena Andrade

Research output: Contribution to journalArticle

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Original languageEnglish (US)
Article numbere108355
JournalPLoS One
Volume9
Issue number10
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

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socioeconomic status
drinking
Social Class
Alcohol Drinking
Brazil
alcohols
Alcohols
Drinking
Alcoholism
income
Sampling Studies
Unemployment
unemployment
Longitudinal Studies
Public health
Public Health
odds ratio
Odds Ratio
socioeconomics
Interviews

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Silveira, C. M., Siu, E. R., Anthony, J. C., Saito, L. P., De Andrade, A. G., Kutschenko, A., ... Andrade, L. H. (2014). Drinking patterns and Alcohol use disorders in São Paulo, Brazil: The role of neighborhood social deprivation and socioeconomic status. PLoS One, 9(10), [e108355]. https://doi.org/10.1371/journal.pone.0108355

Drinking patterns and Alcohol use disorders in São Paulo, Brazil : The role of neighborhood social deprivation and socioeconomic status. / 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.

In: PLoS One, Vol. 9, No. 10, e108355, 01.10.2014.

Research output: Contribution to journalArticle

Silveira, CM, Siu, ER, Anthony, JC, Saito, LP, De Andrade, AG, Kutschenko, A, Viana, MC, Wang, YP, Martins, SS & Andrade, LH 2014, 'Drinking patterns and Alcohol use disorders in São Paulo, Brazil: The role of neighborhood social deprivation and socioeconomic status', PLoS One, vol. 9, no. 10, e108355. https://doi.org/10.1371/journal.pone.0108355
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. / Drinking patterns and Alcohol use disorders in São Paulo, Brazil : The role of neighborhood social deprivation and socioeconomic status. In: PLoS One. 2014 ; Vol. 9, No. 10.
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abstract = "Background: 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.Methods: A multi-stage area probability sample of adult household residents in the S{\~a}o 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.Results: 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.Conclusions: 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.",
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AU - Siu, Erica Rosanna

AU - Anthony, James C.

AU - Saito, Luis Paulo

AU - De Andrade, Arthur Guerra

AU - Kutschenko, Andressa

AU - Viana, Maria Carmen

AU - Wang, Yuan Pang

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N2 - Background: 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.Methods: 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.Results: 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.Conclusions: 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.

AB - Background: 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.Methods: 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.Results: 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.Conclusions: 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.

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