Environmental correlates of underage alcohol use and related problems of college students.

BACKGROUND: Underage alcohol use is a major contributor to morbidity and mortality in adolescents and young adults. This study examined drinking levels and ensuing problems among college students and factors associated with binge drinking. METHOD: The Harvard School of Public Health College Alcohol Study conducted a self-administered survey. The participants include a random sample of 7061 students aged <21 years (defined as underage drinkers), and 4989 between ages 21 and 23 in 1997 at 116 nationally representative 4-year colleges in 39 states. The outcomes of the study include self-reports of alcohol use, binge drinking (defined as five or more drinks in a row for men and four or more for women at least once in a 2-week period), alcohol-related problems, preferred type of drink, access to alcohol, and price paid per drink. RESULTS: Underage students drink less often but have more drinks per occasion, are more likely to drink in private settings (off-campus, dormitory, and fraternity parties), and pay less per drink than do of-age students. Correlates of underage binge drinking include residence in a fraternity or sorority (odds ratio [OR]=6.2), very easy access to alcohol (OR=3.3), obtaining drinks at lower prices (OR=2.1, for under $1 each or a set fee for unlimited drinks), and drinking beer (OR=9.5). CONCLUSIONS: Effective controls on price, access, and fraternity and off-campus parties, and reinforcing minimum drinking age laws are needed to reduce the high levels of binge drinking and related health and behavioral problems of underage students.

Changes in binge drinking and related problems among American college students between 1993 and 1997. Results of the Harvard School of Public Health College Alcohol Study.

In 1997, the Harvard School of Public Health College Alcohol Study resurveyed colleges that participated in a 1993 study. The findings revealed little change in binge drinking: a slight decrease in percentage of binge drinkers and slight increases in percentages of abstainers and frequent binge drinkers. Two of 5 students were binge drinkers (42.7%); 1 in 5 (19.0%) was an abstainer, and 1 in 5 was a frequent binge drinker (20.7%). As was true in 1993, 4 of 5 residents of fraternities or sororities were binge drinkers (81.1%). Asian students showed a greater increase and White students a greater decrease in binge drinking from 1993 to 1997, compared with all other students. Among students who drank alcohol, increases in frequency of drinking; drunkenness; drinking to get drunk; and alcohol-related problems, including drinking and driving, were reported. Binge drinkers in both 1993 and 1997 were at increased risk of alcohol-related problems, and nonbingers at colleges with high binge drinking rates had increased risks of encountering secondhand effects of binge drinking.

Binge drinking, tobacco, and illicit drug use and involvement in college athletics. A survey of students at 140 American colleges.

Binge drinking (heavy, episodic alcohol consumption), tobacco, and illicit drug use among a random sample of 140 American colleges were examined by means of a mail survey. Students were divided into three groups on the basis of their involvement in athletics: whether they were involved, partly involved, or not involved. In addition, individual correlates of binge drinking among athletically involved students were studied. The survey results indicated that students involved in college athletics engaged in binge drinking and tobacco more often than students not involved in athletics, but were less likely to be cigarette smokers or marijuana users. The strongest predictors of binge drinking among students involved in athletics were residence in a fraternity or a sorority, a party lifestyle, engagement in other risky behaviors, and previous binging in high school. Coaches may play an important role in discouraging substance use and need to be a part of campus prevention efforts.

Correlates of college student binge drinking.

OBJECTIVES: This study examines the individual correlates of college student binge drinking. METHODS: Questionnaires were completed by a representative national sample (n = 17,592) of students on 140 campuses in 1993. Binge drinking was defined as five or more drinks per episode for men and as four or more drinks per episode for women. RESULTS: Overall, 44% of the students (50% of the men and 39% of the women) binged. While demographic factors such as sex and race were significantly related to binge drinking, prior binging in high school was crucial, suggesting that for many students, binge drinking begins before college. The strongest predictors of college binge drinking were residence in a fraternity or sorority, adoption of a party-centered life-style, and engagement in other risky behaviors. CONCLUSIONS: Interventions must be targeted at high school binge drinking as well as at several characteristics of college life--most notably fraternity residence. Legal drinking age fails to predict binge drinking, raising questions about the effectiveness of the legal minimum drinking age of 21 in college alcohol policies.

A gender-specific measure of binge drinking among college students.

This study examined the relationship of volume of alcohol consumed to the occurrence of alcohol-related problems among male and female college students to develop a gender-specific measure of heavy episodic or binge drinking by college students for public health research. A self-administered survey was mailed to a national representative sample of students at 140 4-year colleges in 40 states and the District of Columbia. A total of 17,592 college students completed the survey. Women who typically drink four drinks in a row were found to have roughly the same likelihood of experiencing drinking-related problems as men who typically drink five drinks in a row. Use of the same standard for both sexes underestimates binge drinking and the negative health risks for women.

Economic antecedents of mental hospitalization: a nineteenth-century time-series test.

More than 100 studies have cited M. Harvey Brenner's (1973) claim that fluctuations in the economy increase the onset of mental illness and thus generate increases in mental hospitalization. Published attempts to replicate Brenner, however, have considered only twentieth-century data. One of Brenner's most memorable claims was that a stable inverse relationship between mental illness and the economy could be seen over a 127-year span beginning in the early nineteenth century. Unfortunately, no research since Brenner's has considered nineteenth-century populations. In this paper we analyze the hypothesis that economic change provokes a substantial fraction of first admissions to mental hospitals. We used admissions registers from the three institutions to construct a data base that approximates a psychiatric case register for a nineteenth-century American city from 1881 to 1891. Time-series tests show no support for the "provocation" hypothesis.

Employment and mental hospitalization: the case of Buffalo, New York, 1914-55.

This paper explores the connection between employment trends and state mental hospital admissions first presented by Brenner in Mental Illness and the Economy. The analysis is based on employment data for the Buffalo SMSA and admissions to the SMSAs only major public psychiatric hospital for the years 1914 to 1955. We employ a series of specifications in time-series analyses. Our findings contrast with Brenner's; unlike his analysis, ours indicates that employment is positively related to admissions. Consistent with other previous research, hospital capacity is also found to be important in predicting admissions. We offer a number of interpretations for the results, in particular noting the need for the examination of the stressful effects of work itself, not merely its loss.

Alternative conceptions of class and status and symptoms of psychological distress.

One of the most widely reported generalizations in medical sociology and psychiatric epidemiology links social class with mental illness and psychological distress. Using national survey data, this paper compares the ability of measures of social status and class that reflect functionalist, conflict, and Marxist approaches to explain variation in a 26-item scale of symptoms and psychological distress. The measures are found to be somewhat independent of one another. Although the functionalist conceptualization of status is used in almost all research in this area, the authors' findings indicate that Marxist and conflict conceptualizations are equally useful in explaining the variability in psychological distress. These findings should imply greater attention to theoretical perspectives such as Marxism and conflict theory by social epidemiologists and medical sociologists than has been current practice. Of equal importance, it also was found that no measure, including the functionalist measure of occupational prestige, explains more than a few percentage points of the variation in the symptoms measure. Possible explanations for this are discussed, including sample characteristics, measurement issues, and the possibility of a dissociation between social class and mental illness in the United States over the past few decades.