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Risk Factors for Increased Alcohol Consumption among Young Adults during COVID-19

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Title: Risk Factors for Increased Alcohol Consumption among Young Adults during COVID-19
Language: English
Authors: Sasha Rudenstine (ORCID 0000-0002-7659-0874), Talia Schulder, Krish J. Bhatt, Catherine K. Ettman, Sandro Galea (ORCID 0000-0002-7534-0945)
Source: Journal of American College Health. 2024 72(2):487-492.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 6
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Drinking, Correlation, Low Income Students, COVID-19, Pandemics, Student Characteristics, Stress Variables, Incidence, Depression (Psychology), Anxiety, College Students
Geographic Terms: New York (New York)
DOI: 10.1080/07448481.2022.2040518
ISSN: 0744-8481
1940-3208
Abstract: Objective: This study explored correlates of increased alcohol use among a predominantly low-socioeconomic status student population at two time points during the COVID-19 pandemic. Participants: Participants were students enrolled in at least one course at a City University of New York (CUNY) campus. Methods: Demographic characteristics, stressor endorsements, probable diagnoses, and alcohol use endorsement, were collected via self-report surveys in April and July 2020. Frequencies and multivariable logistic regressions were computed to assess for prevalence and odds of increased alcohol consumption. Results: High cumulative stress was significantly related to increased alcohol use in both April and July 2020. A greater number of specific stressors was associated with increased alcohol use in April as compared to July. Probable diagnoses of depression and anxiety were associated with higher odds of alcohol consumption at both time points. Conclusion: Findings highlight the importance of stress and mental health on increases in alcohol use for public university students.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1419726
Database: ERIC
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  Value: <anid>AN0176405449;acl01feb.24;2024Apr05.04:37;v2.2.500</anid> <title id="AN0176405449-1">Risk factors for increased alcohol consumption among young adults during COVID-19 </title> <p>Objective: This study explored correlates of increased alcohol use among a predominantly low-socioeconomic status student population at two time points during the COVID-19 pandemic. Participants: Participants were students enrolled in at least one course at a City University of New York (CUNY) campus. Methods: Demographic characteristics, stressor endorsements, probable diagnoses, and alcohol use endorsement, were collected via self-report surveys in April and July 2020. Frequencies and multivariable logistic regressions were computed to assess for prevalence and odds of increased alcohol consumption. Results: High cumulative stress was significantly related to increased alcohol use in both April and July 2020. A greater number of specific stressors was associated with increased alcohol use in April as compared to July. Probable diagnoses of depression and anxiety were associated with higher odds of alcohol consumption at both time points. Conclusion: Findings highlight the importance of stress and mental health on increases in alcohol use for public university students.</p> <p>Keywords: Alcohol; anxiety; depression; stress</p> <hd id="AN0176405449-2">Introduction</hd> <p>Alcohol use is associated with long-term psychological and physical health outcomes and has been shown to increase during times of stress or in the aftermath of traumatic events.[[<reflink idref="bib1" id="ref1">1</reflink>], [<reflink idref="bib3" id="ref2">3</reflink>], [<reflink idref="bib5" id="ref3">5</reflink>], [<reflink idref="bib7" id="ref4">7</reflink>]] Previous research has documented a variety of risk factors associated with increased alcohol use during population-level disasters.[<reflink idref="bib2" id="ref5">2</reflink>],[[<reflink idref="bib8" id="ref6">8</reflink>], [<reflink idref="bib10" id="ref7">10</reflink>]] In particular, disaster-related stressors contribute to the onset of psychopathology.[<reflink idref="bib11" id="ref8">11</reflink>],[<reflink idref="bib12" id="ref9">12</reflink>] Several studies have shown increases in depression and anxiety symptoms, in the context of COVID-19.[<reflink idref="bib13" id="ref10">13</reflink>],[<reflink idref="bib14" id="ref11">14</reflink>] Depressive and anxious symptoms are in turn associated with alcohol consumption.[[<reflink idref="bib15" id="ref12">15</reflink>], [<reflink idref="bib17" id="ref13">17</reflink>]]</p> <p>Preliminary research has documented increases in alcohol use during COVID-19.[[<reflink idref="bib18" id="ref14">18</reflink>], [<reflink idref="bib20" id="ref15">20</reflink>]] However, no studies of which we are aware have, thus far, documented the relationships between COVID-19 related stressors, quality of stressors, total cumulative stress levels, and increases in alcohol use among under-resourced adults in the changing context of the current pandemic.[<reflink idref="bib1" id="ref16">1</reflink>],[[<reflink idref="bib21" id="ref17">21</reflink>], [<reflink idref="bib23" id="ref18">23</reflink>]] Of particular note, alcohol use is highly prevalent among university students in the United States, and university students are at particular risk for developing substance use disorder.[[<reflink idref="bib24" id="ref19">24</reflink>], [<reflink idref="bib26" id="ref20">26</reflink>]] Stressors, particularly around employment, social, and academic stress are correlated with increased alcohol consumption among university students.[<reflink idref="bib27" id="ref21">27</reflink>],[<reflink idref="bib28" id="ref22">28</reflink>] This study, therefore, building on the previous literature, assessed psychiatric symptoms, COVD-19 related stressors, and alcohol use among ethno-racially and socioeconomically diverse adults who were enrolled in at least one course in one of the largest public university in the United States.</p> <hd id="AN0176405449-3">Method</hd> <p></p> <hd id="AN0176405449-4">Participants</hd> <p>Data were collected at two time points, April 2020, and July 2020, with the aim of documenting shifts in the likelihood of increased alcohol use by stressor type, quantity, and probable psychiatric diagnoses. Both April and July samples consisted of adults age 18 or older who were enrolled in at least one course across City University of New York (CUNY) campuses. The April sample had 2925 participants and data were collected from April 8, 2020 to May 2, 2020. The gender breakdown of this sample was as follows: 71.7% women, 27.0% men, and 1.3% identified as another gender, including transgender and nonbinary identities. The ethno-racial group membership breakdown of this sample was as follows: 39.5% of participants in the April sample were Latinx, 20.0% were non-Latinx Asian, 12.3% were non-Latinx Black, 24.3% were non-Latinx White, and 3.8% were other, including Native Hawaiian, other Pacific Islander, American Indian, Alaskan Native, or multiracial. We computed a socioeconomic status (SES) index, outlined in the demographic measures section, which accounted for educational attainment, household income and savings, individual income and savings, and health insurance access. 62.7% of this sample was low-SES and 37.3% was high-SES.</p> <p>The July sample had 1073 participants and data was collected from July 9, 2020 to July 31, 2020. The gender breakdown of this sample was as follows: 68.6% women, 29.5% men, and 1.9% identified as another gender, including transgender and nonbinary identities. The ethno-racial group membership breakdown for this sample was as follows: 21.7% were non-Latinx White, 14.3% were non-Latinx Black, 22.8% were non-Latinx Asian, 34.0% were Latinx, and 4.2% were other including Native Hawaiian, other Pacific Islander, American Indian, Alaskan Native, or multiracial. Majority of this sample was low-SES (64.6%), and 35.4% were high-SES.</p> <hd id="AN0176405449-5">Procedure</hd> <p>Original surveys were sent, via email by university administrators, to all students across six CUNY campuses via Qualtrics from April 8, 2020 until May 2, 2020 and from July 9, 2020 until July 31, 2020 (Qualtrics Provo, UT). Each campus' email blast provided the URL for the survey. Students were informed of the inclusion criteria (being 18 years of age and older), and gave consent by opening the link completing the survey. Resources for psychological services were provided at the end of the survey. There was no financial compensation. This study was approved by the institutional review board at CUNY.</p> <hd id="AN0176405449-6">Measures</hd> <p></p> <hd id="AN0176405449-7">Demographics</hd> <p>Gender was defined via three categories: women, men, or other (including transgender and nonbinary identities). Ethno-racial group membership was defined via seven exclusive categories: non-Latinx white, non-Latinx Black, Latinx, non-Latinx Asian, and non-Latinx other (including American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander, and multiracial). Our SES index was comprised of six variables: educational attainment, household income and savings, individual income and savings, and health insurance access. Scores of one were given to the following endorsements: being a college graduate or above, household incomes of $65,000 or more, household savings of $10,000 or more, individual incomes of $35,000 or more, individual savings of $5,000 or more. For health insurance, scores of 2 were given for private health insurance, scores of 1 for Medicare/Medicaid, and scores of 0 for no health insurance. Total scores of four or higher were considered high-SES, and scores less than four as low-SES.</p> <hd id="AN0176405449-8">COVID-19-related stressors</hd> <p>Thirteen stressors that have been used in previous COVID-19 research were used to assess COVID-19-related stress: not being able to get food due to shortages, not being able to get supplies due to shortages, losing a job, a member of your household losing a job, having financial problems, and having difficulty paying rent, seeing friends in person less, seeing family in person less, death of someone close to you due to COVID-19, family or relationship problems, and feeling alone, being forced to leave campus and challenges finding childcare.[<reflink idref="bib13" id="ref23">13</reflink>],[<reflink idref="bib14" id="ref24">14</reflink>] Endorsements of each stressor were scored as one, and total stressor scores were subsequently split, with scores of five and above constituting high stress levels, and scores less than five as low levels, in accordance with previous research.[<reflink idref="bib13" id="ref25">13</reflink>]</p> <hd id="AN0176405449-9">Probable diagnoses</hd> <p>The Patient Health Questionnaire-9 (PHQ-9) was used to assess for probable depression diagnoses. The PHQ-9 is a 9-item clinically validated self-report scale with a cutoff score of 10 that indicates probable clinical levels of depression.[<reflink idref="bib29" id="ref26">29</reflink>] Items are on a 4-point scale from 0 to 3 (0- not at all, 1- several days, 2- more than half the days, 3- nearly every day). The Cronbach's α for our April sample was.89, and for July was.90, which is in accordance with published internal reliability estimates.[<reflink idref="bib29" id="ref27">29</reflink>] The Generalized Anxiety Disorder-7 (GAD-7) was used to assess for probable anxiety diagnoses. The GAD-7 is a 7-item validated self-report tool with a cutoff score of 10, that indicates probable clinical levels of anxiety.[<reflink idref="bib30" id="ref28">30</reflink>] Items are rated on a 4-point scale, from 0 to 3 (0- not at all, 1- several days, 2- more than half the days, 3- nearly every day). The Cronbach's α for our April sample was.92, and for July was.93 which is in accordance with previously established reliability.[<reflink idref="bib30" id="ref29">30</reflink>]</p> <hd id="AN0176405449-10">Alcohol use</hd> <p>We assessed for increased alcohol consumption with a single item that prompted "since coronavirus or COVID-19 started, are you drinking more, the same, or less alcohol than you did before coronavirus started?", the response choices were: (<reflink idref="bib1" id="ref30">1</reflink>) drinking more alcohol, (<reflink idref="bib2" id="ref31">2</reflink>) drinking less alcohol, (<reflink idref="bib3" id="ref32">3</reflink>) drinking the same amount of alcohol, (<reflink idref="bib4" id="ref33">4</reflink>) I have never had alcohol. Due to our variables of interest being correlates of increased use, we re-coded the variable, with 0 referring to same consumption, less consumption, or never having consumed alcohol, and 1 referring to increased use.</p> <hd id="AN0176405449-11">Data analysis</hd> <p>We first computed frequencies to assess for demographic characteristics, stress levels, and probable diagnoses, in total for each sample. We then ran crosstabulations to assess for frequencies of demographic characteristics, stress levels, and probable diagnoses by increased alcohol use in both April and July. We next ran logistic regressions to examine the odds of increased alcohol use by specific stressor type, by total binary stress level, and by probable diagnosis of depression and anxiety, for both April and July.</p> <hd id="AN0176405449-12">Results</hd> <p>Table 1 displays prevalence of demographic characteristics, stress levels, and probable diagnoses, as well as prevalence of increased alcohol use for each endorsement, and <emph>p</emph> values of <emph>χ</emph><sups>2</sups> tests, in both April and July 2020. As shown, non-Latinx white (42.5% in April and 39.6% in July) and Latinx participants (32.1% in April and 36.3% in July) endorsed greater increased alcohol use at both time points as compared to other ethno-racial group memberships. Across both time points, those who endorsed higher stress endorsed greater percentages of increased alcohol use (63.2% in April and 54.9% in July), as compared to those who endorsed low stress. In April, low-SES students endorsed greater percentages of increased alcohol use (54.3%), as compared to July, when high-SES students endorsed greater percentages of increased use (60.6%).</p> <p>Table 1. Prevalence of sample and reports of increased alcohol consumption in April and July by demographic characteristics.</p> <p> <ephtml> <table><thead><tr><td /><td>April</td><td>July</td></tr></thead><tbody valign="top"><tr><td>Total</td><td>Drinking more</td><td /><td>Total</td><td>Drinking more</td><td /></tr><tr><td><italic>n</italic></td><td>%</td><td><italic>n</italic></td><td>%</td><td><italic>p</italic></td><td><italic>n</italic></td><td>%</td><td><italic>n</italic></td><td>%</td><td><italic>p</italic></td></tr><tr><td>Total</td><td char=".">2925</td><td>–</td><td char=".">318</td><td char=".">13.5</td><td /><td char=".">1073</td><td>–</td><td char=".">91</td><td char=".">12.4</td><td /></tr><tr><td><bold>Gender</bold></td></tr><tr><td> Men</td><td char=".">634</td><td char=".">27.0</td><td char=".">71</td><td char=".">22.5</td><td char=".">.181</td><td char=".">217</td><td char=".">29.5</td><td char=".">28</td><td char=".">30.8</td><td char=".">.922</td></tr><tr><td>Women</td><td char=".">1685</td><td char=".">71.7</td><td char=".">241</td><td char=".">76.3</td><td /><td char=".">504</td><td char=".">68.6</td><td char=".">61</td><td char=".">67.0</td><td /></tr><tr><td> Other (including transgender/nonbinary)</td><td char=".">30</td><td char=".">1.3</td><td char=".">4</td><td char=".">1.3</td><td /><td char=".">14</td><td char=".">1.9</td><td char=".">2</td><td char=".">2.2</td><td /></tr><tr><td>Ethno-racial group membership</td></tr><tr><td> NonLatinx White</td><td char=".">570</td><td char=".">24.3</td><td char=".">122</td><td char=".">42.5</td><td char="."><.001</td><td char=".">160</td><td char=".">21.7</td><td char=".">36</td><td char=".">39.6</td><td char="."><.001</td></tr><tr><td> NonLatinx Black</td><td char=".">288</td><td char=".">12.3</td><td char=".">44</td><td char=".">15.3</td><td char=".">105</td><td char=".">14.3</td><td char=".">13</td><td char=".">14.3</td></tr><tr><td> NonLatinx Asian</td><td char=".">469</td><td char=".">20.0</td><td char=".">23</td><td char=".">8.0</td><td char=".">168</td><td char=".">22.8</td><td char=".">5</td><td char=".">5.5</td></tr><tr><td> Latinx</td><td char=".">925</td><td char=".">39.5</td><td char=".">92</td><td char=".">32.1</td><td char=".">272</td><td char=".">37.0</td><td char=".">33</td><td char=".">36.3</td></tr><tr><td> Other</td><td char=".">90</td><td char=".">3.8</td><td char=".">6</td><td char=".">2.0</td><td char=".">31</td><td char=".">4.2</td><td char=".">4</td><td char=".">4.4</td></tr><tr><td><bold>Socio-economic status</bold></td></tr><tr><td> High</td><td char=".">711</td><td char=".">37.3</td><td char=".">127</td><td char=".">45.7</td><td char="."><.001</td><td char=".">182</td><td char=".">35.4</td><td char=".">43</td><td char=".">60.6</td><td char="."><.001</td></tr><tr><td> Low</td><td char=".">1196</td><td char=".">62.7</td><td char=".">151</td><td char=".">54.3</td><td char=".">332</td><td char=".">64.6</td><td char=".">28</td><td char=".">39.4</td></tr><tr><td>Stress level</td></tr><tr><td> Low (<5 stressors)</td><td char=".">1384</td><td char=".">47.4</td><td char=".">117</td><td char=".">36.8</td><td char="."><.001</td><td char=".">653</td><td char=".">60.9</td><td char=".">41</td><td char=".">45.1</td><td char=".">.016</td></tr><tr><td> High (5+ stressors)</td><td char=".">1534</td><td char=".">52.6</td><td char=".">201</td><td char=".">63.2</td><td char=".">420</td><td char=".">39.1</td><td char=".">50</td><td char=".">54.9</td></tr><tr><td><bold>Probable diagnosis</bold></td></tr><tr><td> Depression</td><td char=".">1177</td><td char=".">49.8</td><td char=".">189</td><td char=".">59.4</td><td char="."><.001</td><td char=".">282</td><td char=".">38.3</td><td char=".">40</td><td char=".">44.9</td><td char=".">.173</td></tr><tr><td> Anxiety</td><td char=".">951</td><td char=".">40.3</td><td char=".">174</td><td char=".">54.7</td><td char="."><.001</td><td char=".">226</td><td char=".">30.7</td><td char=".">43</td><td char=".">48.3</td><td char=".">.001</td></tr></tbody></table> </ephtml> </p> <p>Table 2 displays logistic regression results documenting the odds of increased alcohol consumption by specific stressor type, by stress level, and by probable diagnoses. All logistic regressions controlled for sociodemographic factors including ethno-racial group membership, SES, gender, and age. None of these covariates yielded significant results and therefore these results are not displayed in the table. High levels of stress were associated with higher odds of increased alcohol use in both April, and July. In April, the following stressor types were significantly associated with higher odds of increased alcohol use: seeing friends in person less, seeing family in person less, death of someone close to you due to COVID-19, feeling alone, not being able to get food due to shortages, not being able to get supplies due to shortages, losing a job, having financial problems, and having difficulty paying rent. In July, only three stressor types were associated with higher odds of increased alcohol use: family or relationship problems, feeling alone, and having financial problems. Probable diagnoses of depression and anxiety were associated with higher odds of drinking more at both time points.</p> <p>Table 2. Odds of increased alcohol consumption in April and July by specific stressors, cumulative stress, and probable psychiatric diagnosis.</p> <p> <ephtml> <table><thead><tr><td>Variable</td><td>April</td><td>July</td></tr></thead><tbody valign="top"><tr><td>OR</td><td char=".">95% CI</td><td>OR</td><td char=".">95% CI</td></tr><tr><td><bold>Stressors</bold></td></tr><tr><td> Seeing friends in person less</td><td char=".">2.6**</td><td char=".">1.4–4.9</td><td char=".">0.9</td><td char=".">0.4–1.9</td></tr><tr><td> Seeing family in person less</td><td char=".">1.8**</td><td char=".">1.3–2.7</td><td char=".">1.4</td><td char=".">0.6–2.8</td></tr><tr><td> Death of someone close to you due to coronavirus or COVID-19</td><td char=".">1.5**</td><td char=".">1.1–2.1</td><td char=".">1.4</td><td char=".">0.7–2.5</td></tr><tr><td> Family or relationship problems (for example, with your spouse or kids)</td><td char=".">1.2</td><td char=".">0.9–1.6</td><td char=".">2.1**</td><td char=".">1.2–3.7</td></tr><tr><td> Challenges finding childcare for your kids</td><td char=".">1.5</td><td char=".">0.8–2.7</td><td char=".">0.6</td><td char=".">0.2–1.7</td></tr><tr><td> Feeling alone</td><td char=".">1.5**</td><td char=".">1.2–2.0</td><td char=".">2.0*</td><td char=".">1.1–3.5</td></tr><tr><td> Not being able to get food due to shortages</td><td char=".">1.6**</td><td char=".">1.2–2.1</td><td char=".">0.7</td><td char=".">0.2–1.5</td></tr><tr><td> Not being able to get supplies due to shortages</td><td char=".">1.4*</td><td char=".">1.1–1.8</td><td char=".">1.5</td><td char=".">0.8–2.7</td></tr><tr><td> Losing a job</td><td char=".">2.3***</td><td char=".">1.7–3.1</td><td char=".">1.5</td><td char=".">0.8–2.8</td></tr><tr><td> A member of your household losing a job</td><td char=".">1.0</td><td char=".">0.7–1.3</td><td char=".">1.4</td><td char=".">0.8–2.5</td></tr><tr><td> Having financial problems</td><td char=".">1.5**</td><td char=".">1.1–2.0</td><td char=".">2.4**</td><td char=".">2.3–4.2</td></tr><tr><td> Having difficulty paying rent</td><td char=".">1.6**</td><td char=".">1.2–2.1</td><td char=".">1.7</td><td char=".">0.9–3.1</td></tr><tr><td> Being forced to leave campus</td><td char=".">1.3</td><td char=".">0.9–1.7</td><td char=".">1.2</td><td char=".">0.6–2.4</td></tr><tr><td><bold>Stress level</bold></td></tr><tr><td> Low (<5 stressors) (Ref.)</td><td>–</td><td>–</td><td>–</td><td>–</td></tr><tr><td> High (5+ stressors)</td><td char=".">1.8***</td><td char=".">1.4–2.4</td><td char=".">2.2**</td><td char=".">1.3–3.9</td></tr><tr><td>Probable diagnosis</td></tr><tr><td> Depression</td><td char=".">1.9***</td><td char=".">1.5–2.6</td><td char=".">1.9*</td><td char=".">1.0–3.3</td></tr><tr><td> Anxiety</td><td char=".">2.0***</td><td char=".">1.6–2.7</td><td char=".">2.6**</td><td char=".">1.5–4.6</td></tr></tbody></table> </ephtml> </p> <p>1 <emph>Note</emph>. April sample, <emph>N</emph> = 2925, was collected from April 8, 2020 to May 2, 2020. July sample, <emph>N</emph> = 1073, was collected from July 9, 2020 to July 31, 2020. Probable depression was calculated using the clinical cutoff scores on the Patient Health Questionnaire-9 (PHQ-9) (≥10) and probable anxiety was calculated using the clinical cutoff scores of the Generalized Anxiety Disorder-7 (GAD-7) (≥10). The above analyses controlled for ethno-racial group membership, age, gender, and SES.</p> <hd id="AN0176405449-13">Discussion</hd> <p>This study was the first of which we are aware to assess the correlates of increased alcohol use at two time points during the COVID-19 pandemic. We documented three key findings. First, a statistically significant relationship between cumulative stress and alcohol use was present in both April and July 2020, with higher stress exposure associated with higher odds of increased use at both time points. Second, more stressors were associated with increased alcohol use in April than were associated with increased alcohol use in July. Third, probable diagnoses of depression and anxiety were significantly associated with higher odds of increased alcohol consumption at both time points.</p> <p>There is a wealth of research documenting the association between cumulative stress and alcohol use in adulthood.[[<reflink idref="bib31" id="ref34">31</reflink>], [<reflink idref="bib33" id="ref35">33</reflink>]] Consistent with this work, our results demonstrate that in the initial weeks of the COVID-19 pandemic in NYC, a time when schools and workplaces were closing and rates of COVID-19 transmission and mortality were high, almost all stressors were associated with an increased odds of greater alcohol use. However, three months later, in July, only three stressors remained associated with increased alcohol use: family or relationship problems, feeling alone, and financial problems.</p> <p>There are several explanations for why these three stressors, in particular, may have remained significantly associated with alcohol use. First, the impact of quarantining and increased time at home for families and relationships became, for many, increasingly difficult, particularly for students confined to their home in multi-family households. Increased exposure to familial conflict and tension has been shown to relate to increased alcohol use.[[<reflink idref="bib34" id="ref36">34</reflink>], [<reflink idref="bib36" id="ref37">36</reflink>]] Second, there is significant literature documenting the risk of alcohol use among those who report feeling alone.[[<reflink idref="bib38" id="ref38">38</reflink>], [<reflink idref="bib40" id="ref39">40</reflink>]] Third, the importance of financial stress on increased alcohol use in both April and July highlights the continued economic insecurity that lower-income college students in New York City are facing as well as the impact of this continued economic insecurity on increased alcohol use, and by extension, on alcohol-related health outcomes.[[<reflink idref="bib41" id="ref40">41</reflink>], [<reflink idref="bib43" id="ref41">43</reflink>]]</p> <p>Despite the overall relationship between economic insecurity and alcohol use, our demographic results indicate that higher SES students endorsed greater percentages of increased alcohol use in July, as compared to April, when lower SES students endorsed greater percentages of increased alcohol use. Such results may relate to broad contextual shifts from Spring to Summer 2020 for populations of different socioeconomic levels. April was characterized by intense lockdown measures and high rates of transmission. The initial shock associated with the onset of the pandemic in New York City, combined with the greater economic burdens that are faced by lower-SES communities may have together contributed to higher endorsements of increased alcohol use. However, ongoing increases in eligibility for federal assistance programs that occurred in late Spring and early Summer, such as increases in unemployment and rent relief programs, may have alleviated some of the widespread burdens faced by lower-SES populations.[<reflink idref="bib44" id="ref42">44</reflink>],[<reflink idref="bib45" id="ref43">45</reflink>] Given the cost of alcohol purchases and use, such increases in consumption may have thus been greater among those that could afford to increase their purchasing of alcohol. Nevertheless, as discussed above, those who faced marked economic insecurity across our entire sample, had higher odds of increased alcohol use.</p> <p>The third key finding in this study, the relationship between alcohol use and probable depression and anxiety, is consistent with a wealth of research documenting the relationship between mental health and alcohol use, particularly for university students.[[<reflink idref="bib46" id="ref44">46</reflink>], [<reflink idref="bib48" id="ref45">48</reflink>]] The COVID-19 pandemic has contributed to increases in depression and anxiety symptoms, and the present findings highlight the persistent relationship between such symptoms and increased alcohol use, despite decreases and changes in stressor exposure.[<reflink idref="bib13" id="ref46">13</reflink>],[<reflink idref="bib17" id="ref47">17</reflink>],[<reflink idref="bib49" id="ref48">49</reflink>] Such persistence highlights the particular psychological burden faced by lower-income student populations during the pandemic.[<reflink idref="bib14" id="ref49">14</reflink>] The observation that psychological distress is accompanied by increased alcohol use, suggests an additional link between poor psychological and physical health outcomes.[<reflink idref="bib50" id="ref50">50</reflink>],[<reflink idref="bib51" id="ref51">51</reflink>]</p> <p>The present study has several limitations. First, although we assessed data at two time points, the participants were not the same, and therefore we conducted two cross-sectional analyses. Nevertheless, as an initial examination of correlates of increased alcohol use at two time points during the COVID-19 pandemic this study provides compelling evidence for how the correlates of alcohol use shifted over time as the pandemic evolved. Second, as is common in post-disaster research, we did not assess the amount of increased alcohol consumption, and did not control for baseline usage.[<reflink idref="bib9" id="ref52">9</reflink>],[<reflink idref="bib52" id="ref53">52</reflink>]</p> <p>In spite of the stated limitations, the present study highlights the importance of both cumulative and specific stressors on alcohol use among an urban public university population throughout the changing COVID-19 pandemic. The persistence of stressors related to social stress, perceived aloneness, and economic insecurity on alcohol use speaks to the importance of understanding the unique contribution of particular stressors when investigating increased alcohol consumption after traumatic events. These factors and the continued import of probable depression and anxiety emphasize the necessity for a multipronged approach that seeks to address economic, social, and psychological vulnerabilities among university students. Such interventions could protect against increased alcohol use, thereby protect against long-term detrimental health outcomes after large-scale traumatic events, and additionally help understand alcohol use within its social and economic context in order to reduce stigma around increases in consumption.</p> <hd id="AN0176405449-14">Conflict of interest disclosure</hd> <p>The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of America and received approval from the Institutional Review Board of CUNY.</p> <hd id="AN0176405449-15">Funding</hd> <p>No funding was used to support this research and/or the preparation of the manuscript.</p> <ref id="AN0176405449-16"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Calina D, Hartung T, Mardare I, et al. COVID-19 pandemic and alcohol consumption: Impacts and interconnections. Toxicol Rep. 2021; 8 : 529 – 535. doi: 10.1016/j.toxrep.2021.03.005.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref5" type="bt">2</bibl> <bibtext> Cerdá M, Tracy M, Galea S. A prospective population based study of changes in alcohol use and binge drinking after a mass traumatic event. 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Ettman and Sandro Galea</p> <p>Reported by Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref7"></nolink> <nolink nlid="nl2" bibid="bib11" firstref="ref8"></nolink> <nolink nlid="nl3" bibid="bib12" firstref="ref9"></nolink> <nolink nlid="nl4" bibid="bib13" firstref="ref10"></nolink> <nolink nlid="nl5" bibid="bib14" firstref="ref11"></nolink> <nolink nlid="nl6" bibid="bib15" firstref="ref12"></nolink> <nolink nlid="nl7" bibid="bib17" firstref="ref13"></nolink> <nolink nlid="nl8" bibid="bib18" firstref="ref14"></nolink> <nolink nlid="nl9" bibid="bib20" firstref="ref15"></nolink> <nolink nlid="nl10" bibid="bib21" firstref="ref17"></nolink> <nolink nlid="nl11" bibid="bib23" firstref="ref18"></nolink> <nolink nlid="nl12" bibid="bib24" firstref="ref19"></nolink> <nolink nlid="nl13" bibid="bib26" firstref="ref20"></nolink> <nolink nlid="nl14" bibid="bib27" firstref="ref21"></nolink> <nolink nlid="nl15" bibid="bib28" firstref="ref22"></nolink> <nolink nlid="nl16" bibid="bib29" firstref="ref26"></nolink> <nolink nlid="nl17" bibid="bib30" firstref="ref28"></nolink> <nolink nlid="nl18" bibid="bib31" firstref="ref34"></nolink> <nolink nlid="nl19" bibid="bib33" firstref="ref35"></nolink> <nolink nlid="nl20" bibid="bib34" firstref="ref36"></nolink> <nolink nlid="nl21" bibid="bib36" firstref="ref37"></nolink> <nolink nlid="nl22" bibid="bib38" firstref="ref38"></nolink> <nolink nlid="nl23" bibid="bib40" firstref="ref39"></nolink> <nolink nlid="nl24" bibid="bib41" firstref="ref40"></nolink> <nolink nlid="nl25" bibid="bib43" firstref="ref41"></nolink> <nolink nlid="nl26" bibid="bib44" firstref="ref42"></nolink> <nolink nlid="nl27" bibid="bib45" firstref="ref43"></nolink> <nolink nlid="nl28" bibid="bib46" firstref="ref44"></nolink> <nolink nlid="nl29" bibid="bib48" firstref="ref45"></nolink> <nolink nlid="nl30" bibid="bib49" firstref="ref48"></nolink> <nolink nlid="nl31" bibid="bib50" firstref="ref50"></nolink> <nolink nlid="nl32" bibid="bib51" firstref="ref51"></nolink> <nolink nlid="nl33" bibid="bib52" firstref="ref53"></nolink>
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  Data: Risk Factors for Increased Alcohol Consumption among Young Adults during COVID-19
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Sasha+Rudenstine%22">Sasha Rudenstine</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-7659-0874">0000-0002-7659-0874</externalLink>)<br /><searchLink fieldCode="AR" term="%22Talia+Schulder%22">Talia Schulder</searchLink><br /><searchLink fieldCode="AR" term="%22Krish+J%2E+Bhatt%22">Krish J. Bhatt</searchLink><br /><searchLink fieldCode="AR" term="%22Catherine+K%2E+Ettman%22">Catherine K. Ettman</searchLink><br /><searchLink fieldCode="AR" term="%22Sandro+Galea%22">Sandro Galea</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-7534-0945">0000-0002-7534-0945</externalLink>)
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  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2024 72(2):487-492.
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  Label: Availability
  Group: Avail
  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
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  Label: Peer Reviewed
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– Name: Pages
  Label: Page Count
  Group: Src
  Data: 6
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
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  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Drinking%22">Drinking</searchLink><br /><searchLink fieldCode="DE" term="%22Correlation%22">Correlation</searchLink><br /><searchLink fieldCode="DE" term="%22Low+Income+Students%22">Low Income Students</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Pandemics%22">Pandemics</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Characteristics%22">Student Characteristics</searchLink><br /><searchLink fieldCode="DE" term="%22Stress+Variables%22">Stress Variables</searchLink><br /><searchLink fieldCode="DE" term="%22Incidence%22">Incidence</searchLink><br /><searchLink fieldCode="DE" term="%22Depression+%28Psychology%29%22">Depression (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22New+York+%28New+York%29%22">New York (New York)</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/07448481.2022.2040518
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0744-8481<br />1940-3208
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: This study explored correlates of increased alcohol use among a predominantly low-socioeconomic status student population at two time points during the COVID-19 pandemic. Participants: Participants were students enrolled in at least one course at a City University of New York (CUNY) campus. Methods: Demographic characteristics, stressor endorsements, probable diagnoses, and alcohol use endorsement, were collected via self-report surveys in April and July 2020. Frequencies and multivariable logistic regressions were computed to assess for prevalence and odds of increased alcohol consumption. Results: High cumulative stress was significantly related to increased alcohol use in both April and July 2020. A greater number of specific stressors was associated with increased alcohol use in April as compared to July. Probable diagnoses of depression and anxiety were associated with higher odds of alcohol consumption at both time points. Conclusion: Findings highlight the importance of stress and mental health on increases in alcohol use for public university students.
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  Data: As Provided
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  Label: Entry Date
  Group: Date
  Data: 2024
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1419726
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1419726
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/07448481.2022.2040518
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 6
        StartPage: 487
    Subjects:
      – SubjectFull: Drinking
        Type: general
      – SubjectFull: Correlation
        Type: general
      – SubjectFull: Low Income Students
        Type: general
      – SubjectFull: COVID-19
        Type: general
      – SubjectFull: Pandemics
        Type: general
      – SubjectFull: Student Characteristics
        Type: general
      – SubjectFull: Stress Variables
        Type: general
      – SubjectFull: Incidence
        Type: general
      – SubjectFull: Depression (Psychology)
        Type: general
      – SubjectFull: Anxiety
        Type: general
      – SubjectFull: College Students
        Type: general
      – SubjectFull: New York (New York)
        Type: general
    Titles:
      – TitleFull: Risk Factors for Increased Alcohol Consumption among Young Adults during COVID-19
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Sasha Rudenstine
      – PersonEntity:
          Name:
            NameFull: Talia Schulder
      – PersonEntity:
          Name:
            NameFull: Krish J. Bhatt
      – PersonEntity:
          Name:
            NameFull: Catherine K. Ettman
      – PersonEntity:
          Name:
            NameFull: Sandro Galea
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 0744-8481
            – Type: issn-electronic
              Value: 1940-3208
          Numbering:
            – Type: volume
              Value: 72
            – Type: issue
              Value: 2
          Titles:
            – TitleFull: Journal of American College Health
              Type: main
ResultId 1