title: Gender differences in hazardous drinking among middle-aged in Europe: the role of social context and women's empowerment.
abstract: BACKGROUND
  The aim of this study was to estimate the magnitude of gender differences in hazardous drinking among middle-aged people and to analyse whether these differences are associated with contextual factors, such as public policies or socioeconomic factors.
  
  
  METHODS
  Cross-sectional design. The study population included 50- to 64-year-old residents of 16 European countries who participated in the Survey of Health, Ageing and Retirement in Europe project conducted in 2010-12 (n = 26 017). We estimated gender differences in hazardous drinking in each country. To determine whether different social context or women's empowerment variables were associated with gender differences in hazardous drinking, we fitted multilevel Poisson regression models adjusted for various individual and country-level variables, which yielded prevalence ratios and their 95% confidence intervals (95% CI).
  
  
  RESULTS
  Prevalence of hazardous drinking was significantly higher in men than women [30.2% (95% CI: 29.1-31.4%) and 18.6% (95% CI: 17.7-19.4%), respectively] in most countries, although the extent of these differences varied between countries. Among individuals aged 50-64 years in Europe, risk of becoming a hazardous drinker was 1.69 times higher (95% CI: 1.45-1.97) in men, after controlling for individual and country-level variables. We also found that lower values of the gender empowerment measure and higher unemployment rates were associated with higher gender differences in hazardous drinking.
  
  
  CONCLUSIONS
  Countries with the greatest gender differences in hazardous drinking were those with the most restrictions on women's behaviour, and the greatest gender inequalities in daily life. Lower gender differences in hazardous drinking seem to be related to higher consumption among women.
authors.affiliation: 1 Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain 2 Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain 3 Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Bosque-Prous
authors.affiliation: 1 Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain 2 Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain 4 CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain 5 Departament de Psicobiologia i Metodologia en Ciències de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Spain aespelt@aspb.cat.
authors.forename: Albert
authors.initials: A
authors.lastname: Espelt
authors.affiliation: 1 Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain 2 Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain 3 Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain 4 CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
authors.affiliation: 1 Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain 2 Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain.
authors.forename: Montse
authors.initials: M
authors.lastname: Bartroli
authors.affiliation: 1 Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain 2 Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Guitart
authors.affiliation: 1 Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain 2 Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain 3 Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain 4 CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain.
authors.forename: Joan R
authors.initials: JR
authors.lastname: Villalbí
authors.affiliation: 1 Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain 2 Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain.
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Brugal
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D000434:Alcoholic Beverages; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D005783:Gender Identity; D059066:Gross Domestic Product; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D012931:Social Environment; D012959:Socioeconomic Factors