title: Gender, occupational, and socioeconomic correlates of alcohol and drug abuse among U.S. rural, metropolitan, and urban residents.
abstract: OBJECTIVE
  To estimate the prevalence and correlates of alcohol and drug abuse and dependence among rural, urban, and metropolitan U.S. residents.
  
  
  METHODS
  The National Comorbidity Survey (NCS) (1990-1992) yielded lifetime risks of psychiatric disorders in a probability sample of 8098 respondents in the 48 contiguous states using DSM-III-R for diagnosis. Logistic regressions of alcohol and drug disorders were performed to compare their correlates in rural, urban, and metropolitan areas after stratifying by demographic and socioeconomic variables.
  
  
  RESULTS
  Household income was protective only in rural areas. High occupation strata were positively associated with alcohol disorders. Urban and metropolitan women were less likely to report drug disorders. There was no gender difference in rural drug abuse and dependence. Also, high occupation strata were positively associated with drug disorders.
  
  
  CONCLUSIONS
  Lack of gender differences in rural drug disorders may indicate an increase in drug availability, access, and use among rural women. Workplace alcohol and drug disorders, especially among metropolitan sales, crafts, and service workers should be of concern to policymakers. These results underline the usefulness of using multiple indicators of socioeconomic positions in epidemiologic studies of substance use disorders.
authors.affiliation: Africa Youth Development, 7908 Garland Ave., Suite 2, Takoma Park, MD 20912, USA. africayouthdevelopment@yahoo.com
authors.forename: Chamberlain C
authors.initials: CC
authors.lastname: Diala
authors.forename: Carles
authors.initials: C
authors.lastname: Muntaner
authors.forename: Christine
authors.initials: C
authors.lastname: Walrath
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009790:Occupations / Q000706:statistics & numerical data*; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*