Journal article
The Relationship Between Neighborhood Poverty and Alcohol Use: Estimation by Marginal Structural Models
Epidemiology (Cambridge, Mass.), v 21(4), pp 482-489
01 Jul 2010
PMID: 20498603
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Previous studies on the relationship of neighborhood disadvantage with alcohol use or misuse have often controlled for individual characteristics on the causal pathway, such as income-thus potentially underestimating the relationship between disadvantage and alcohol consumption.
Methods: We used data from the Coronary Artery Risk Development in Young Adults study of 5115 adults aged 18-30 years at baseline and interviewed 7 times between 1985 and 2006. We estimated marginal structural models using inverse probability-of-treatment and censoring weights to assess the association between point-in-time/cumulative exposure to neighborhood poverty (proportion of census tract residents living in poverty) and alcohol use/binging, after accounting for time-dependent confounders including income, education, and occupation.
Results: The log-normal model was used to estimate treatment weights while accounting for highly-skewed continuous neighborhood poverty data. In the weighted model, a one-unit increase in neighborhood poverty at the prior examination was associated with a 86% increase in the odds of binging (OR = 1.86 [95% confidence interval = 1.14-3.03]); the estimate from a standard generalized-estimating-equations model controlling for baseline and time-varying covariates was 1.47 (0.96-2.25). The inverse probability-of-treatment and censoring weighted estimate of the relative increase in the number of weekly drinks in the past year associated with cumulative neighborhood poverty was 1.53 (1.02-2.27); the estimate from a standard model was 1.16 (0.83-1.62).
Conclusions: Cumulative and point-in-time measures of neighborhood poverty are important predictors of alcohol consumption. Estimators that more closely approximate a causal effect of neighborhood poverty on alcohol provided a stronger estimate than estimators from traditional regression models.
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Details
- Title
- The Relationship Between Neighborhood Poverty and Alcohol Use: Estimation by Marginal Structural Models
- Creators
- Magdalena Cerda (Corresponding Author) - New York Academy of MedicineAna V. Diez-Roux - University of MichiganEric Tchetgen Tchetgen - Harvard UniversityPenny Gordon-Larsen - University of North Carolina at Chapel HillCatarina Kiefe - University of Massachusetts Chan Medical School
- Publication Details
- Epidemiology (Cambridge, Mass.), v 21(4), pp 482-489
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 8
- Grant note
- R24HD050924 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) Robert Wood Johnson Foundation; Robert Wood Johnson Foundation (RWJF)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Web of Science ID
- WOS:000279038600010
- Scopus ID
- 2-s2.0-77953959162
- Other Identifier
- 991020112050404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health