title: Geographic clustering of underage drinking and the influence of community characteristics.
abstract: The aim of this paper was to examine the extent to which underage drinking clusters geographically in a sample of communities, and to investigate the manner in which community-level contexts are related to this process. We used data from a randomized community trial of underage drinking to provide the first quantitative estimates of the magnitude of the geographic clustering of underage drinking based upon pairwise odds ratios (PWORs). The Enforcing Underage Drinking Laws Randomized Community Trial provided data from repeated cross-sectional samples of youth aged 14-20 from 68 communities surveyed in 2004, 2006, and 2007 (n=18,730). Past 30-day drinking, binge drinking, getting drunk, experiencing non-violent consequences as a result of drinking and making a purchase attempt all significantly clustered within-communities with PWORs ranging from 1.05 to 1.21. After adjustment for individual-level characteristics, results remained relatively unchanged. However, there was evidence that the magnitude of the clustering varied as a function of neighborhood disadvantage, neighborhood disorder, and family structure. Clustering of drunkenness and experiencing non-violent consequences as a result of drinking was greatest in the least economically disadvantaged and least disordered communities with the greatest percentage of married-couple families. The clustering of making a purchase attempt, however, was greatest in more disordered communities, specifically the largest communities with the highest degree of residential mobility and housing density. These findings that clustering of underage drinking behaviors varies by community context has the potential for identifying the types of communities to target for underage drinking behavior-specific preventive interventions.
authors.affiliation: Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.brebouss@wfubmc.edu
authors.forename: Beth A
authors.initials: BA
authors.lastname: Reboussin
authors.forename: John S
authors.initials: JS
authors.lastname: Preisser
authors.forename: Eun-Young
authors.initials: EY
authors.lastname: Song
authors.forename: Mark
authors.initials: M
authors.lastname: Wolfson
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology*; D000435:Alcoholic Intoxication / Q000453:epidemiology / Q000523:psychology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005190:Family; D005260:Female; D005843:Geography; D006801:Humans; D007880:Legislation, Drug; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011153:Population; D012111:Residence Characteristics; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult