Alcohol Climates and Drinking Opportunities: Accelerating Risks for at-Risk Groups

Introduction: While there are several different extensive empirical literatures (and far too many statistically motivated arguments) that attempt to identify community and neighborhood correlates and causes of alcohol-related problems, there has been no systematic attempt to formally analyze relationships between alcohol environments and risks for alcohol problems among at-risk groups (e.g.underage drinkers, young adults, older drinkers likely to be labeled as alcohol dependent).  This presentation provides a cook’s tour of some plausible social dynamics that lead alcohol climates, the “wet” and the “dry”, to accelerate risks for problems among at-risk drinking groups.

Methods: The theoretical approach of the analysis is to, first, formally identify the drinking dynamics that underlie drinking problems in at-risk groups, then, second, show how those dynamics will be altered by greater and lesser alcohol availability across communities and neighborhoods.  Since neighborhoods within communities exhibit very large differences in availability, these different neighborhoods provide us with small social laboratories in which to study these effects.  A strong ecological perspective is taken in which relatively observable person-person and person-environment interactions are critical.  Discrete dynamic models are applied throughout.

 

Results:  Two critical observations arise from this theoretically motivated work.  First, alcohol climates affect outcomes by accelerating risks within groups.  Greater availability leads to a proliferation in drinking contexts for adult and underage drinkers, lower search costs for underage drinkers, a proliferation of adult models for problem drinking, and market segmentation and stratification that supports adult problem drinking.  Second, a wealth gradient underlies these effects altering the way they appear across rich and poor neighborhoods; drinking contexts will differ between wealthy and poor underage drinkers, both extreme wealth and poverty will be related to lower search costs (for different reasons), and dependence will be related to a bifurcation of use across commercial and social contexts.

 

Conclusions: Formal ecological analyses of alcohol use environments using multi-scale models can help reveal significant impacts of changes in alcohol climates upon drinking risks in at-risk groups.  Formal analyses of this kind are very suggestive of theoretical and empirical ways forward in efforts to prevent alcohol problems from an environmental perspective.