Associations of occupational attributes and excessive drinking
Introduction
Understanding the association between occupations and excessive drinking is important from both public health and economic perspectives. In 2010, most (64.8%) full-time employed adults consumed alcohol while 29.7% reported binge drinking and 8.5% reported heavy drinking, defined as binge drinking on 5 or more occasions in the past 30 days (Substance Abuse and Mental Health Services Administration, 2011). Most of the 56.6 million adult binge drinkers (74.7%) and 16.5 million heavy drinkers (74.0%) were employed in 2010 (Substance Abuse and Mental Health Services Administration, 2011). For employers, consequences of employees' excessive drinking include high job turnover rates, co-worker conflict, injuries, higher health benefit costs, and workplace aggression (Mangione et al., 1999; McFarlin and Fals-Stewart, 2002; McFarlin, Fals-Stewart, Major, & Justice, 2001; Webb et al., 1994). Economic costs resulting from lost productivity, health care costs, and legal and criminal consequences of excessive drinking were estimated $223.5 billion in 2006 (Bouchery, Harwood, Sacks, Simon, & Brewer, 2011).
Research on the prevalence of alcohol misuse among workers has found those employed manual occupations have higher rates of excessive drinking (Hemmingsson & Ringback Weitoft, 2001). In particular, farm workers and service industry employees have been found to have higher risk and those working in professional occupations lower risk (Jarman, Naimi, Pickard, Daley, & De, 2007; Matano, Wanat, Westrup, Koopman, & Whitshell, 2002). Workers in construction and oil, gas, and mining extraction occupations had a higher prevalence of excessive drinking than those employed in professional and related occupations (Barnes & Brown, 2013; Larson, Eyerman, Foster, & Gfroerer, 2007; Substance Abuse and Mental Health Services, 1999). Conversely, other research finds alcohol use increases with occupational grade (Berggren & Nystedt, 2006) with managerial workers, particularly women, at increased risk of problem alcohol use when compared to non-managerial workers (Moore, Grunberg, & Greenberg, 2003).
Differences in excessive drinking across occupations may be a result of variation in exposure to distinct work-related risk factors including work stress and workplace social milieu.
Job strain has been proposed as one model of how work stress may affect alcohol use. Under job strain theory (Karasek & Theorell, 1990), jobs are categorized along two dimensions: job demand and job autonomy. High demand, low autonomy jobs are posited to contribute to work-related stress inducing some workers to self-medicate by increasing their alcohol consumption. However, the evidence supporting job strain theory of excessive drinking among workers is contradictory (see Kouvonen et al., 2005 for a review). When examined separately, job demand and job autonomy have been found to relate to alcohol use. Physically and psychologically demanding occupations have been found to contribute to drinking risk (Crum, Muntaner, Eaton, & Anthony, 1995; Frone, 2008). Worker's inability to make autonomous decisions has also been linked to increased alcohol misuse (Hemmingsson and Lundberg, 1998; Hingson, Mangione, & Barrett, 1981).
Social dimensions of workplace risk factors for excessive drinking documented in the literature include job alienation. In particular, alienating job conditions where workers lack contact with others or are not supported or helped has been associated with misuse of alcohol (Hemmingsson & Lundberg, 1998; Yang, Yang, & Kawachi, 2001).
Prior studies on occupational attributes and excessive drinking have tended to focus on specific theoretical mechanisms even though, when considered across studies, the occupational environment appears to affect alcohol consumption through multiple pathways including job strain and job alienation. Yet, few studies have examined these potential workplace risk factors simultaneously (Gimeno, Amick, Barrientos-Gutierrez, & Mangione, 2009). Additionally, many prior studies focus on young, male workers, and use non-representative U.S. samples, making inferences to female or older workers challenging. Our study used a U.S. representative sample of mid-career men and women. Further, to complement theory-driven with data-driven explanations of drinking variation across occupational attributes, we exploited the richness of O*Net, a nationally representative occupation-level database, and combined information from more than 100 occupational attributes into distinct work-related constructs. We found that physical demand-, job autonomy-, and social engagement-related workplace descriptors (i.e. those posited by job strain and job alienation theories) explained the majority of the variation in attributes across occupations. We then tested the association of these constructs with three measures of alcohol use – number of drinking days in the past month, usual number of drinks on drinking days, and number of occasions workers consumed 6 or more drinks. We hypothesized that participants employed in occupations with either high physical demands or low autonomy would have higher levels of excessive drinking. Consistent with job strain theory, we also hypothesized that the combination of higher physical demand and lower job autonomy would be associated with excessive drinking. Per job alienation theory, we hypothesized workers with lower levels of social engagement at work would report higher levels of alcohol misuse. Gender stratified models were then estimated to determine whether the associations between occupational attributes and alcohol consumption patterns varied systematically by the sex of the worker. Differences in the associations between occupational attributes and alcohol use and the implications for research on social inequality across occupational groups are discussed.
Section snippets
Data and participants
This study used data from the 2006 wave of the National Longitudinal Survey of Youth 1979 (NLSY79) cohort (US Department of Labor, 2006). The NLSY79 is collected by the Bureau of Labor Statistics (BLS) and is a nationally representative sample of 12,686 youths first sampled in 1979 when they were 14–21 years old (US Department of Labor, 2006). Participants were 41–49 years old in 2006. Of the 22 interviews administered between 1979 and 2006, the average number of completed interviews for
Sample characteristics
Of the 6426 respondents weighted to be nationally representative of all individuals born in the U.S. between 1957 and 1965, the average participant drank alcohol on 4.9 days in the past 30 (standard deviation (SD) 7.1), consumed 1.5 drinks per drinking occasion (SD 2.0) and consumed 6 or more drinks on 0.3 occasions in the past 30 days (SD 0.7). By construction, each of the three job attribute factors had a sample mean of zero and standard deviation of one and the three factors were not
Discussion
Numerous workplace contributors to excessive drinking have been posited in the literature (Ames & Janes, 1990; Crum et al., 1995; Frone, 1999, 2008; Hemmingsson & Lundberg, 1998; Marchand, Parent-Lamarche, & Blanc, 2011; Martin, Romin, & Blum, 1996; Yang et al., 2001). Prior studies on occupational attributes and excessive drinking have tended to focus on specific theoretical mechanisms even though, when considered across studies, the occupational environment appears to affect alcohol
Acknowledgments
The authors wish to thank Drs. Susan Ettner, Michael Ong, E. Richard Brown, and the reviewers of this paper for their many insightful comments and suggestions.
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