Alcohol patterns through mid-adolescence and socioeconomic position: the ALSPAC birth-cohort
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Socioeconomic inequalities of adolescent alcohol use are not as consistent as for other health risk behaviours. Thesis hypotheses were that a) alternative familial early socioeconomic position indicators of both immaterial and material resources presented specific associations with several modalities of alcohol consumption; b) associations of immaterial capital typically diluted from early to middle adolescence and material/immaterial influences varied between genders; and c) the socioeconomic context of schools exerted influence on middle adolescent alcohol misuse. Outcome data were collected at age 12, 13 and 15 from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth-cohort. Self-reported early alcohol onset, ever/past use, misuse and problem use were investigated in early and mid-adolescence. Socioeconomic position included mother's reported questionnaire-based measures of maternal education, parental social class and disposable household income. School level indicators were retrieved from Annual School Census data linked to ALSPAC. Multiple logistic regressions assessed associations between variables. Sensitivity analyses used multiple imputations. Multilevel models accounted for ALSPAC participants nested within schools. Maternal education was negatively associated with most measures of alcohol investigated, including early onset and use/misuse at both age 13 and 15. Conversely, household income had positive associations with measures of early alcohol use and later measures of alcohol misuse. Girls in more disadavantaged families were at lower risk of alcohol related problems than boys. However, for increasing levels of income and maternal education their risks overtook and matched that of boys, respectively. Non negligible residual variance of alcohol misuse among schools (~ to 3%) was not explained by the school socioeconomic context. Socioeconomic gradients on underage drinking manifest since early alcohol exposure and differ by construct through mid-adolescence. Policies on youth drinking should reflect that material advantage across the socioeconomic spectrum may increase risk of alcohol misuse and problem use, particularly in girls.