Associations between binge and heavy drinking and health behaviors in a nationally representative sample

Abstract

Background

Binge and heavy drinking are noted in the literature for their relatively high prevalence and adverse health-related effects.

Design and participants

We used data from the 2006 Behavioral Risk Factor Surveillance Survey (BRFSS) to determine the associations between binge and heavy drinking and a wide range of health-related variables, including positive and negative health behaviors, preventive care practices, and quality of life indices in a nationally representative sample of 344,793 adults.

Results

Rates of binge and heavy drinking in the current sample were 15% and 5%, respectively. Binge and heavy drinking were more common among men, younger adults, and individuals with higher incomes and at least some college education. After controlling for relevant demographic variables, binge and heavy drinking were associated with a number of adverse health-related and preventive care behaviors (e.g., smoking, failing to receive a mammogram), as well as less life satisfaction and a greater number of poor mental health days than those who did not engage in these drinking behaviors. Interestingly, binge and heavy drinking were also associated with some positive health-related variables (e.g., recent physical activity, positive perceptions of one's own health).

Conclusions

The current study findings provide additional information regarding the relations between health-related attitudes and behaviors and binge and heavy drinking in the U.S. population. Implications of study findings are discussed.

Introduction

Binge drinking and heavy drinking are noted in the literature with regard to their high prevalence and associations with a number of adverse health-related outcomes. Binge drinking is generally defined as the consumption of four or more drinks on one occasion for women and five or more drinks on one occasion for men (Courtney and Polich, 2009, Wechsler et al., 1994). Heavy drinking is generally defined as a daily average of more than one drink per day for women and more than two drinks per day for men (USDA & DHHS, 2005). In recent large nationally representative studies, approximately 20% of adults reported binge drinking at least once in the previous year (Substance Abuse and Mental Health Services Administration (SAMHSA), 2007, Substance Abuse and Mental Health Services Administration (SAMHSA), 2008, Schoenborn and Adams, 2010), and these figures are consistent with prevalence rates from 2000 to 2001 (SAMHSA, 2002). Rates of heavy drinking in the U.S. are also notable, stabilizing around 6.9% in 2007 (SAMHSA, 2008) after an increase from approximately 5.6% in 2000–2001 to 6.7% in 2002 (SAMHSA, 2002).

A number of correlates of binge and heavy drinking have been identified. Binge and heavy drinkers are more likely to be White or Hispanic, male, single, younger, and have higher incomes than individuals who do not report these drinking behaviors (Dawson et al., 2008, Miller et al., 1991, Mojtabai, 2005, Naimi et al., 2003, National Institute on Alcohol Abuse and Alcoholism (NIAAA), 2010, Schoenborn and Adams, 2010, Serdula et al., 2004, Tsai et al., 2007). Binge and heavy drinking are also associated with negative health behaviors, including smoking (Dawson et al., 2008, Rosal et al., 2000) and decreased engagement in physical activity (Rosal et al., 2000, Smothers and Bertolucci, 2001); increased physical health problems, including hepatitis (Bradley et al., 2001), hypertension (Dawson et al., 2008, Green and Polen, 2001), gastrointestinal problems (Theobold, Johansson, Bygren, & Engfeldt, 2001), and heart problems (Chen et al., 2006, Dawson et al., 2008, U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (DHHS), 2005); and mental health difficulties (Chen et al., 2006, Dawson et al., 2008, Green and Polen, 2001, Miller et al., 1991).

Taken together, research shows that binge and heavy drinking are associated with a number of negative physical and mental health outcomes, as well as some maladaptive health behaviors. While informative, questions remain regarding our understanding of the health outcomes related to these drinking behaviors, as the majority of extant studies assess only one form of risky drinking (e.g., binge drinking; Dawson et al., 2008) or health outcome (e.g., suicide; Miller et al., 1991). Additionally, while current research is fairly consistent, it is often based on highly restricted study samples [e.g., female veterans from a single Veterans Affairs Medical Center (Bradley et al., 2001); women over 50 from a single state (Fredman et al., 1999)], limiting the generalizability of these findings to the broader U.S. population. Finally, there are few studies assessing the relations between binge and heavy drinking and preventive care practices, and those that exist also primarily focus on circumscribed variables and study samples [e.g., members of a single health plan service (Green et al., 2010); Medicare recipients (Merrick et al., 2008)].

The purpose of the current study was to examine the relations between binge and heavy drinking and health-related variables in a large nationally representative sample. This study extends current research by examining the associations between binge and heavy drinking and a wide range of health-related variables, including both positive and negative health behaviors, engagement in preventive care practices, and quality of life indices that have not been previously examined. These data are particularly useful as they can generalize to the broader U.S. population, and thus, can be used to inform current research and practice.