Exploring the two-way linkages between binge drinking and unemployment

Many studies have found that problem drinking is related to subsequent unemployment; however, the reverse association is unclear. Some studies have found that unemployment can increase total drinking, alcohol disorders, and/or problem drinking while others have found that unemployment can decrease drinking or have no effect at all. An analysis of binge drinking as either a predictor or outcome of unemployment has found that binge drinking among women seems to have a significant association with long-term unemployment.

Results will be published in the November 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Problem drinking while employed could impact on your ability to perform work tasks, due to hang-overs, health problems caused by drinking, frequent absences, or actual 'drunk working,'" explained Mona C. Backhans, a postdoctoral researchers at the Karolinska Institutet as well as corresponding author for the study. "While unemployed, problem drinking may have an impact on your search activity. Employers are also likely to not choose people who lack references from a former employer, who have extensive absence records from their previous employment, or frequent job changes/periods of unemployment."

Backhans explained that contradictory research results may be due to varied circumstances. "Given that unemployment can be seen as a stressor, and alcohol can temporarily reduce tension, many have hypothesized that unemployment should lead to higher consumption," she said. "However, if you are an abstainer or light drinker, it is less likely that you use alcohol in this manner. In fact, given that the unemployed often have financial difficulties and may become socially isolated, some may even reduce their drinking."

Backhans and her colleagues analyzed data on 13,031 Swedish residents (45 % males), 20 to 59 years of age, and currently employed or on leave. The data were collected during two surveys, one in 2002 and another in 2007, and included one question about the frequency of binge drinking. Binge drinking was defined as consuming an amount corresponding to at least 37 cl of spirits at a single occasion in 2002. In 2007, the question was changed to the third AUDIT question and referred to six or more drinks, corresponding to at least 24 cl of spirits.

"For women, binge drinking once a week or more as a predictor was associated with long-term unemployment," said Backhans. "For both men and women, initial associations between frequent binges and any unemployment were explained by the characteristics of the binge drinkers – younger, lower educational qualifications – and in addition for men, more previous unemployment."

When analyzed as an outcome of unemployment, there were no associations between unemployment and later binge drinking for men. Conversely, there were initial associations between long-term unemployment and frequent binges for women, but this was explained by the characteristics of those who became unemployed, Backhans noted, such as prior drinking habits.

"These gender differences reflect the fact that frequent binge drinking probably is a stronger marker for problem drinking for women, as it is less common, and not 'normalized' to the extent that it is for men," said Backhans. "Also, the measure itself may be biased as it refers to the same level of consumption for both men and women, even though women's tolerance levels for alcohol tend to be lower."

Backhans believes it is important to continue researching this topic, in various settings and subgroups, and with various measures of alcohol drinking and problems. "A question here is to what extent a single question on binge drinking can be said to reflect or predict alcohol problems – something that may differ between settings and subgroups," she said. "A strength of our study is that we have been able to adjust both for unemployment and binge drinking prior to the exposure, which enhances the validity of findings, in that they are more likely to be causal than otherwise. Also, women are included, which is still rare. In addition, since women's employment is almost on a par with men in this setting, they are not a selected group, as they should be in societies where women's employment rates are low."

For the women in this group, added Backhans, clearly preceded rather than was preceded by . "However, in times of distress it is always wise to watch one's intake, whether you are male or female," she said.

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