title: Are area-level effects just a proxy for school-level effects? Socioeconomic differences in alcohol consumption patterns among Swedish adolescents.
abstract: Although recent studies have found significant variations in adolescent alcohol consumption across neighbourhoods, these investigations did not address another important context in adolescents' lives: schools. The purpose of this study was to not only simultaneously assess variations in adolescent alcohol use and binge drinking at the city district level and the school level but also analyse whether any such variations could be ascribed to the socioeconomic characteristics of the examined city districts, schools, and students.
  
  
  
  Cross-sectional study.
  
  
  
  Stockholm, Sweden.
  
  
  
  Ninth-grade students (n=4349) attending schools (n=75) located in the city districts of the Stockholm municipality (n=14).
  
  
  
  Two measures based on information regarding alcohol consumption were constructed: alcohol use (no or yes) and binge drinking among alcohol users (ranging from "very seldom" to "a few times a week"). A wide range of socioeconomic characteristics was included at the city district, school, and student levels. Alcohol use was analysed using mixed-effects logistic regression, whereas binge drinking among users was modelled using mixed-effects ordered logistic regression.
  
  
  
  The results indicated that the school was more important than the city district in assessments of contextual variations in adolescent alcohol use in general and binge drinking in particular. Moreover, proportions of well-educated parents and high-performing students accounted for part of the school-level variation in alcohol use but not binge drinking.
  
  
  
  Failure to account for the school context may have caused past research to overestimate city district differences in alcohol consumption among adolescents.
authors.affiliation: School of Social Sciences, Unit of Social Work, Södertörn University, 141 89 Huddinge, Sweden. Electronic address: per.carlson@sh.se.
authors.forename: Per
authors.initials: P
authors.lastname: Carlson
authors.affiliation: Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, 106 91 Stockholm, Sweden.
authors.forename: Ylva
authors.initials: Y
authors.lastname: B Almquist
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D063425:Binge Drinking / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012574:Schools; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data*; D013548:Sweden
keywords: Adolescents; Alcohol use; Binge drinking; City districts; Schools