title: The association between neighborhood disorder, social cohesion and hazardous alcohol use: a national multilevel study.
abstract: BACKGROUND
  Evidence on associations of alcohol use with neighborhood disorder and social cohesion is limited. The aim of this study was to further investigate these associations.
  
  
  METHODS
  Individual data of 14,258 Dutch adults, living in 1546 neighborhoods across The Netherlands, were obtained from the 2006 to 2009 national health survey (POLS). Data on neighborhood disorder and social cohesion were derived from the 2006 Netherlands Housing Research (WoON). Hazardous drinking was measured as: ≥14, ≥21, and ≥28 drinks/week for women, and ≥21, ≥28, and ≥35 for men. Multilevel logistic regression models were adjusted for age, gender, ethnicity, marital status, education, income, wealth, predominant neighborhood religion, and population density. Potential mediation of psychological distress (depression and anxiety) and general mental health (MHI-5 score) was tested.
  
  
  RESULTS
  High neighborhood disorder was associated with more hazardous alcohol use for women (OR cut-off 3: 3.72 [2.03-6.83]), but not for men (OR cut-off 3: 1.08 [0.72-1.62]). There was no mediation by psychological distress, and modest mediation by general mental health. Social cohesion had no linear association with hazardous alcohol use, but for males moderate social cohesion was associated with more hazardous alcohol use (OR cut-off 1: 1.29 [1.08-1.53]). In predominantly Protestant neighborhoods this association seemed weaker.
  
  
  CONCLUSIONS
  Hazardous alcohol use seems to have a stronger and more consistent relationship with neighborhood disorder than with social cohesion. This suggests that negative aspects of the social environment have more impact on the prevalence of hazardous alcohol use than positive factors related to sociability and support.
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.a.kuipers@amc.uva.nl
authors.forename: Mirte A G
authors.initials: MA
authors.lastname: Kuipers
authors.forename: Mireille N M
authors.initials: MN
authors.lastname: van Poppel
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.forename: Marleen
authors.initials: M
authors.lastname: Wingen
authors.forename: Anton E
authors.initials: AE
authors.lastname: Kunst
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012067:Religion; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012737:Sex Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult