title: Substance-use coping and self-rated health among US middle-aged and older adults.
abstract: The prevalence of alcohol, drug, and tobacco use among US middle-aged and older adults is increasing. A subset of this population uses substances to cope with stress, but the characteristics of these individuals, and the association between substance-use coping and health outcomes remain unclear. We identified correlates of substance-use coping and measured its association with self-rated health in a community-based sample of adults aged 54-99 in the Health and Retirement Study (HRS). In the 2008 HRS, 1351 participants reported their frequency of prescription/other drug-, alcohol-, and cigarette-use coping with stress and reported self-rated health (excellent/very good, good, or fair/poor); 1201 of these participants also reported self-rated health in 2010. One in six participants frequently used substances to cope. The oldest participants were least likely to engage in frequent alcohol-use coping. Those with elevated depressive symptoms were more likely to frequently engage in cigarette- and prescription/other drug-use coping. In multivariable-adjusted analyses, participants who frequently used cigarettes (compared to participants who infrequently used cigarettes) to cope had 2.7 times (95% CI=1.1-6.7) the odds of poor (vs. excellent) self-rated health. Relative to participants who infrequently used prescription/other drugs to cope, participants who frequently used prescription/other drugs to cope had 2.4 times (95% CI=1.1-5.1) the odds of reporting poor self-rated health. The association between prescription/other drug-use coping in 2008 and self-rated health in 2010 was statistically significant (relative OR=3.5, 95% CI=1.7-7.2). Participants engaging in substance-use coping likely have particular demographic and clinical characteristics. Interventions to reduce substance-use coping may prevent adverse health outcomes.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway HH894, Baltimore, MD 21205, USA. Electronic address: pmauro1@jhu.edu.
authors.forename: Pia M
authors.initials: PM
authors.lastname: Mauro
authors.affiliation: Gerontology Research Centre, Simon Fraser University, 2800-515 West Hastings Street, Vancouver, BC V6B 5K3, Canada. Electronic address: scanham@sfu.ca.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Canham
authors.affiliation: Columbia University Mailman School of Public Health, 722 West 168th St Room 509, New York, USA. Electronic address: ssm2183@columbia.edu.
authors.forename: Silvia S
authors.initials: SS
authors.lastname: Martins
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway HH794, Baltimore, MD 21205, USA. Electronic address: aspira@jhu.edu.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Spira
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology
keywords: Coping; Older adults; Self-rated health; Substance use