Drinking profiles social capital and health in later

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Drinking profiles, social capital and health in later life (2013 -2014) Clare Holdsworth (PI)

Drinking profiles, social capital and health in later life (2013 -2014) Clare Holdsworth (PI) Nicola Shelton Marina Mendonça Hynek Pikhart Martin Frisher Cesar Oliveira

Background • Levels of alcohol consumption increased for middle and older age groups in

Background • Levels of alcohol consumption increased for middle and older age groups in the last 30 years for both men and women (Smith and Foxcroft, 2009). – Cohort effect (i. e. Generation) – Period effect (e. g. more financial resources) – Age (e. g. active ageing and greater life expectancy) • Number of elderly population expected to increase 38% in the UK by 2031 (IAS, 2010): Alcohol consumption among the elderly - cause of public concern

Background • U-shape relationship between alcohol consumption and health: Poorer health associated with abstainers

Background • U-shape relationship between alcohol consumption and health: Poorer health associated with abstainers (e. g. ‘sickquitter’ hypothesis ) or excessive drinkers (e. g. Polen et al, 2010). • Relation between drinking and health contradictory in older ages: – Alcohol consumption associated with more physical and mental health problems and higher mortality rates (e. g. Crome, et al. 2011; Dar, 2006; NHS Information Centre, 2008) – But, some studies found no association between levels of alcohol consumption and health (e. g. Lang, et al. , 2007).

Background • Alcohol consumption and health moderated by social capital (Bloomfield et al. ,

Background • Alcohol consumption and health moderated by social capital (Bloomfield et al. , 2006; Marmot 2005) – Alcohol Harm Paradox: Higher social position associated with higher alcohol consumption and better health, whereas alcohol-related illness and mortality linked with deprivation. • Research on drinking behaviours focused both on quantity and frequency of drinking. – But findings suggest that they are not equally associated with health and social capital • Unpacking complexity : Explore relationship between different drinking behaviours/profiles and its association with health and social capital

Aims • To identify and characterize drinking profiles in older age • To analyse

Aims • To identify and characterize drinking profiles in older age • To analyse how these drinking profiles are associated with social capital, health and socio-demographic characteristics

Data English Longitudinal Study of Ageing (ELSA): Panel study of people living in England

Data English Longitudinal Study of Ageing (ELSA): Panel study of people living in England aged 50 and older ELSA W 0 (HSE): Baseline for alcohol variables 1998 1999 2001 W 1 2002/3 W 2 W 3 W 4 2004/5 2006/7 2008/9 W 5 W 6 2010/11 2012/13 • Present study: – W 0: Drinking and health variables – W 1: Social capital variables N = 11205

Variables Drinking Status Amount of Alcohol Frequency of drinking Non-drinker Drinking Profiles Non-Drinker Below

Variables Drinking Status Amount of Alcohol Frequency of drinking Non-drinker Drinking Profiles Non-Drinker Below Limits (Men ≤ 21 units; Women≤ 14 units) Drinker Above Limits (Men > 21 units Women > 14 unit) Occasional (≤ 4 days) Daily Steady Drinker (≥ 5 days) Occasional (≤ 4 days) Daily (≥ 5 days) Low Drinker Focal Drinker Heavy Drinker Social Capital & Health Variables Level of Education Wealth Quintiles SES Self-Rated Health Socio-demographic Age Marital Status

Descriptives: Socio-demographic, social capital and health variables by gender Variables Mean age at baseline

Descriptives: Socio-demographic, social capital and health variables by gender Variables Mean age at baseline 45 -64 65 -74 75 + Marital Status Single Married/remarried Separated/divorced Widowed Educational Qualification No qualification Intermediate High Wealth Bottom quintile 2 nd quintile 3 rd quintile 4 th quintile Top quintile SES Manual Non Manual Self-Rated Health Poor Health Fair Health Good Health Men (%) Women (%) All (%) (n = 5057) 62. 09 (9. 97) 60. 90 25. 71 13. 39 (n = 6148) 62. 63 (10. 49) 59. 22 24. 69 16. 09 (N = 11205) 62. 39 (10. 26) 59. 98 25. 15 14. 87 6. 39 76. 03 9. 20 8. 39 4. 98 61. 04 12. 32 21. 66 5. 62 67. 81 10. 91 15. 67 37. 00 35. 58 27. 42 48. 01 34. 73 17. 25 43. 04 35. 11 21. 84 17. 77 19. 88 19. 74 21. 02 21. 60 21. 07 20. 11 20. 17 19. 21 19. 44 19. 57 20. 00 19. 97 20. 03 20. 42 50. 36 36. 40 42. 69 48. 27 59. 79 54. 60 9. 81 23. 75 66. 44 8. 39 25. 07 66. 54 9. 03 24. 48 66. 49

Descriptives: Percentage distribution of drinking patterns by gender Men Women 64 53. 55 19.

Descriptives: Percentage distribution of drinking patterns by gender Men Women 64 53. 55 19. 75 13. 86 7. 36 Non-drinker 12. 19 8. 18 Low Steady 7. 16 11. 29 2. 67 Focal Heavy

Multinomial Logistic Regression: Odds of being Steady and Heavy/Binge Drinker versus Low Drinker Note:

Multinomial Logistic Regression: Odds of being Steady and Heavy/Binge Drinker versus Low Drinker Note: *** p<. 001, **p<. 01, *p<. 05 Heavy/Focal Steady Men Women 1. 54*** 2. 21*** 1. 94*** 3. 05*** . 75**. 53*** . 92. 78 1. 38 . 67 1. 60** . 79 Separated/divorced . 76 . 80 1. 46** 1. 06 Widowed . 96 . 81 1. 57** . 93 . 90. 71 . 92 1. 03 1. 24 1. 46** . 82 1. 03 1. 14 1. 25 1. 19* 1. 27* 1. 45** 1. 77*** 1. 45*** 1. 57*** 1. 08 1. 28 1. 77** 2. 36*** 1. 12 1. 08 1. 55* 2. 47*** 1. 04. 86 1. 01 1. 34* 1. 08 1. 02 1. 33 2. 00*** 1. 17 1. 41** . 97 1. 63*** Age groups (Ref: 45 -64) 65 -74 75+ Mar. Stat. (Ref: Married) Single Self-Rat. Heal. (Ref: Poor) Fair Good Educ. Qual. (Ref. : No qual. ) Intermediate High Wealth (Ref. : Bottom) 2 nd 3 rd 4 th Top SES (Ref. : Manual) Non Manual

Summary • Gender: Important moderator of drinking behaviours. Men are more likely to be

Summary • Gender: Important moderator of drinking behaviours. Men are more likely to be drinkers and to be heavy/focal drinkers than women. • Age: Older participants are more likely to be steady drinkers, while those at ‘younger’ older ages are more likely to engage in heavy/focal drinking. • Health: Drinking profiles are generally not associated with self-rated health, but male heavy drinkers are more likely to report better health. • Social Capital: People in higher social position are more likely to be steady and heavy drinkers. This association is stronger for women. • Marital Status: Being married seems to be a protective factor for men against heavy drinking

Thank you for your attention! For further information please contact mmendonca@keele. ac. uk

Thank you for your attention! For further information please contact mmendonca@keele. ac. uk

Descriptives: Sociodemographic, Health and Drinking Variables by Gender Variables Mean age at baseline 45

Descriptives: Sociodemographic, Health and Drinking Variables by Gender Variables Mean age at baseline 45 -64 65 -74 ≥ 75 Marital Status Single Married/remarried Separated/divorced Widowed Educational Qualification No qualification Intermediate High Wealth Bottom quintile 2 nd quintile 3 rd quintile 4 th quintile Top quintile SES Manual Non Manual Self-Rated Health Poor Health Fair Health Good Health Drinking Profiles Non-drinkers Low drinkers Steady drinkers Focal drinkers Heavy drinkers Men (%) (n = 5057) 62. 09 (9. 97) 60. 90 25. 71 13. 39 Women (%) (n = 6148) 62. 63 (10. 49) 59. 22 24. 69 16. 09 All (%) (N = 11205) 62. 39 (10. 26) 59. 98 25. 15 14. 87 6. 39 76. 03 9. 20 8. 39 4. 98 61. 04 12. 32 21. 66 5. 62 67. 81 10. 91 15. 67 37. 00 35. 58 27. 42 48. 01 34. 73 17. 25 43. 04 35. 11 21. 84 17. 77 19. 88 19. 74 21. 02 21. 60 21. 07 20. 11 20. 17 19. 21 19. 44 19. 57 20. 00 19. 97 20. 03 20. 42 50. 36 36. 40 42. 69 48. 27 59. 79 54. 60 9. 81 23. 75 66. 44 8. 39 25. 07 66. 54 9. 03 24. 48 66. 49 7. 36 53. 55 12. 19 7. 16 19. 75 13. 86 63. 99 8. 18 2. 67 11. 29 10. 93 59. 28 9. 99 4. 70 15. 10