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Heavy drinking in early adulthood and outcomes at mid life
  1. F A Sloan1,
  2. P R Costanzo2,
  3. D Belsky3,
  4. E Holmberg2,
  5. P S Malone4,
  6. Y Wang5,
  7. S Kertesz6
  1. 1Department of Economics, Duke University, Durham, North Carolina, USA
  2. 2Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
  3. 3Health Policy and Administration, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
  4. 4Department of Psychology, University of South Carolina-Columbia, Columbia, South Carolina, USA
  5. 5Department of Economics, Lafayette College, Easton, Pennsylvania, USA
  6. 6Division of Preventive Medicine, University of Alabama-Birmingham, Birmingham, Alabama, USA
  1. Correspondence to Professor Frank A Sloan, Duke University, Department of Economics, 236 Social Sciences Building, PO Box 90097, Durham, North Carolina 27708, USA; fsloan{at}


Background Heavy drinking in early adulthood among Blacks, but not Whites, has been found to be associated with more deleterious health outcomes, lower labor market success and lower educational attainment at mid-life. This study analysed psychosocial pathways underlying racial differences in the impact of early heavy alcohol use on occupational and educational attainment at mid-life.

Methods Outcomes in labor market participation, occupational prestige and educational attainment were measured in early and mid-adulthood. A mixture model was used to identify psychosocial classes that explain how race-specific differences in the relationship between drinking in early adulthood and occupational outcomes in mid-life operate. Data came from Coronary Artery Risk Development in Young Adults, a longitudinal epidemiologic study.

Results Especially for Blacks, heavy drinking in early adulthood was associated with a lower probability of being employed in mid-life. Among employed persons, there was a link between heavy drinking for both Whites and Blacks and decreased occupational attainment at mid-life. We grouped individuals into three distinct distress classes based on external stressors and indicators of internally generated stress. Blacks were more likely to belong to the higher distressed classes as were heavy drinkers in early adulthood. Stratifying the data by distress class, relationships between heavy drinking, race and heavy drinking–race interactions were overall weaker than in the pooled analysis.

Conclusions Disproportionate intensification of life stresses in Blacks renders them more vulnerable to long-term effects of heavy drinking.

  • Heavy drinking
  • psychosocial factors
  • occupational prestige
  • educational attainment
  • addictive behaviour
  • inequalities SI
  • longitudinal data analysis
  • occupational epidem
  • psychological distress

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  • Funding National Institute of Alcohol Abuse and Alcoholism5635 Fishers Lane, MSC 9304Bethesda, MD 20892-9304 Other Funders: NIH.

  • Competing interests None.

  • Ethics approval Approval was obtained from the Duke University IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.