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Area-level disadvantage and alcohol use disorder in northern Mexico
Orozco, R., Benjet, C., Ruiz Velasco-Acosta, S., Moreno Altamirano, L., Karriker-Jaffe, K. J., Zemore, S., Cherpitel, C., & Borges, G. (2017). Area-level disadvantage and alcohol use disorder in northern Mexico. Drug and Alcohol Dependence, 175, 219-226. https://doi.org/10.1016/j.drugalcdep.2017.02.011
Background In Mexico, the Northern States are highly impacted by alcohol consumption and associated problems. Little is known about the association between contextual social disadvantage and alcohol use disorder in this region. Methods Information from 1265 current drinkers surveyed in the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC) was combined with official data on neighborhood disadvantage (index of urban marginalization, a composite of ten indicators of area-level social disadvantage) for 302 neighborhoods. Using statistical marginal models, we estimated the association of neighborhood disadvantage with alcohol use disorder (AUD; based on DSM-5 criteria), alone and with adjustment for individual and contextual covariates. We also tested for moderation of neighborhood disadvantage effects by sex, education, internal migration and border area. Results There was a statistically significant increase in the odds of AUD of 59% (AOR = 1.59; 95%CI = 1.03, 2.46) for every one-point increase on the neighborhood disadvantage scale, after adjustment for covariates. A significant interaction between sex and neighborhood disadvantage was indicated by two measures of additive interaction (AP = 0.55; p
