The health effects of parental problem drinking on adult children.
BACKGROUND
Much of the research on adult children of alcoholics has focused on the transmission of drinking patterns from parents to their children and the development of alcohol-related problems. Less is known about how exposure to parental problem drinking affects children as they progress into adulthood in terms of other mental health outcomes. This is crucial information, in part because the average age of onset for depression and other mental health disorders is during late adolescence or young adulthood.


OBJECTIVE
The objective of this study was to rigorously assess the long-term impacts of parental problem drinking on adult children's mental and self-perceived overall health. The study improves on previous literature by analyzing a range of mental health markers and other predictors of morbidity, by focusing on a period of adulthood that only a limited number of studies have examined, and by using data from a highly regarded and nationally representative panel study.


METHODS
The analysis used data from the NLSY79, a nationally representative sample of 12,686 men and women. The NLSY79 collected detailed information about personal and family characteristics, including alcohol and other substance use, for a cohort of individuals who were between the ages of 14 and 22 when first surveyed in 1979. The survey was re-administered each year through 1994 and on a biennial basis since then. The dataset provides information on parental drinking and identifies problematic drinking behaviors both among mothers and fathers. Beginning with the 1998 survey, an extensive health module was administered to respondents over 40 years of age to provide a baseline health profile of the respondents before retirement. It includes a set of measures that assess the mental, physical, and behavioral health of the respondents when they reached the age of 40.


METHODS
Estimation was conducted using propensity score matching (PSM) methods. Through the use of PSM methods, we control for a rich set of observed demographic, household, geographic, and economic characteristics, as well as unobserved features correlated with these variables, that predispose a parent to drink problematically, thereby reducing the possibility of estimation bias. In addition, PSM is superior to traditional multivariate regression in that it allows for the possibility of non-linear effects and the comparison of treatment and control individuals with similar characteristics.


RESULTS
The results indicate that parental problem drinking is associated with significant mental health consequences for children that persist far into adulthood. Adult respondents with a problem-drinking father were more likely to have been diagnosed with mental health problems relative to other respondents, while those with a problem-drinking mother had poorer self-perceived health and mental health (SF-12) scores. Respondents with a problem-drinking mother were also more likely to have ever been diagnosed with a mental health problem. Outcomes were worse for daughters of problem drinkers than for sons.


CONCLUSIONS
These long-lasting consequences of parental problem drinking on adult children's mental health should be considered when designing and financing interventions targeting problem drinkers and their families.
Balsa
Ana I
AI
Health Economics Research Group, Department of Sociology, University of Miami, Coral Gables, FL 33124-2030, USA. mfrench@miami.edu
Homer
Jenny F
JF
French
Michael T
MT
D000293:Adolescent; D000328:Adult; D032721:Adult Children / Q000523:psychology*; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D016241:Child of Impaired Parents / Q000523:psychology / Q000706:statistics & numerical data; D005220:Fathers / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D015999:Multivariate Analysis; D010287:Parent-Child Relations; D014481:United States / Q000453:epidemiology; D055815:Young Adult