title: Cross-border policy effects on alcohol outcomes: drinking without thinking on the u.s.-Mexico border?
abstract: BACKGROUND
  Rates of alcohol-related outcomes are sensitive to policy differences in politically distinct, adjacent territories. Factors that shape these cross-border effects, particularly when the policy differences are longstanding, remain poorly understood. We compared the ability of 2 classes of variables with theoretical relevance to the U.S.-Mexico border context-bar attendance and alcohol-related social-cognitive variables-to explain elevated drinking on the U.S. side of the border relative to other areas of the United States.
  
  
  METHODS
  Data were collected from multistage cluster samples of adult Mexican Americans on and off the U.S.-Mexico border (current drinker N = 1,351). Structural equation models were used to test drinking context (frequency of bar attendance) and 6 different social-cognitive variables (including alcohol-related attitudes, norms, motives, and beliefs) as mediators of border effects on a composite drinking index.
  
  
  RESULTS
  The border effect on drinking varied by age (with younger adults showing a stronger effect), consistent with previous findings and known risk factors in the region. Contrary to theoretical expectations, 6 different social-cognitive variables-despite relating strongly with drinking-were comparable in border and nonborder areas (within and across age) and played no role in elevated drinking on the border. Conversely, elevated drinking among border youth was mediated by bar attendance. This mediated moderation effect held after adjusting for potential sociodemographic and neighborhood-level confounders.
  
  
  CONCLUSIONS
  Increased drinking among U.S.-Mexico border youth is explained by patterns of bar attendance, but not by more permissive alcohol-related social-cognitive variables in border areas: Border youth attend bars and drink more than their nonborder counterparts, despite having comparable alcohol-related beliefs, attitudes, norms, and motives for use. Alcohol's heightened availability and visibility on both sides of the border may create opportunities for border youth to drink that otherwise would not be considered.
authors.affiliation: University of Texas School of Public Health - Dallas , Dallas, Texas.
authors.forename: Britain A
authors.initials: BA
authors.lastname: Mills
authors.forename: Raul
authors.initials: R
authors.lastname: Caetano
authors.forename: Patrice
authors.initials: P
authors.lastname: Vaeth
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000208:ethnology* / Q000331:legislation & jurisprudence* / Q000523:psychology; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000208:ethnology* / Q000523:psychology; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D011640:Public Policy / Q000331:legislation & jurisprudence*; D012307:Risk Factors; D013850:Thinking; D014481:United States / Q000208:ethnology; D055815:Young Adult
keywords: Bars; Mexican Americans; Social Cognitions; U.S.-Mexico Border