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The first paper outlines the theoretical case for taking a broad multi-level perspective to the problem of alcohol consumption and related harms. A social ecological approach, which holds that an individual’s behavior both influences and is influenced by the physical, social and economic environments with which the individual interacts, emphasizes the need to simultaneously consider macro- and micro-level exposures.
The following papers showcase new empirical evidence to support this theoretical perspective. We begin at the macro level. The second paper describes a mathematical simulation that tests whether the economic geographic conditions common to all retail markets produce greater incidence of alcohol-related problems in lower income areas. Results suggest that without effective interventions, lower income populations will inevitably experience greater risks.
The third paper presents early data from an innovative study using GPS enabled smart phones to track the activity spaces of young people. This study indicates that other physical environments, beyond residential areas, to which adolescents are routinely exposed may contribute to greater risks for alcohol use and problems.
The next paper moves further towards the micro, examining the physical and social environmental correlates of alcohol consumption among adolescents. This study advances prevention science by identifying the circumstances in which drinking occurs and proposes possible context-specific interventions.
The fifth paper takes an even greater micro-level approach, examining the social environments of drinking groups for specific drinking events. Consistent with our theoretical perspective, results suggest that individuals within a group influence the drinking behavior and related risks for the whole group, and vice versa.
Finally, the sixth paper combines observations of physical, social and economic environments within a specific micro-environment: bars. This study suggests that barrooms must be understood within the macro-level environment, and that both macro- and micro-level policies are important for reducing the occurrence of problems within and around bars.
The audience for this symposium will be provided with a framework for understanding the physical, social, and economic determinants of alcohol use and problems, and gain an appreciation for synergistic macro- and micro-level prevention strategies to improve health equity.