Social Isolation and Social Connectedness As Predictors of Alcohol Use Among Adolescents: Examining the Moderating Effects of Gender, Race and Ethnicity

Background and Purpose: Alcohol use is a public health issue linked to a number of adverse health and social outcomes. Miller et al (2006) show that underage drinking results in large costs to society. They estimate a total cost of $61.9 billion when considering medical costs (5.4 billion), work loss and other resource costs (14.9 billion), and $41.6 billion in lost quality of life. In spite of legal restrictions, and education and prevention efforts, alcohol remains the most commonly used drug among adolescents (Centers for Disease Control, 2015).

Researchers are increasingly aware of the need to study social isolation among young people, especially among marginalized and other high-risk populations.  Social work’s grand challenge focusing on social isolation notes the links between social isolation and a number of health outcomes such as psychological distress and risky behaviors, including drinking. At the same time, social connectedness, has been shown to operate as a protective factor for maladaptive behaviors in adolescence. Although there is a rich literature on risk and protective factors related to adolescent problem behaviors, less is known about how gender, race, and ethnicity can moderate these factors.

The purpose of this paper is to: (1) test the hypothesis that social isolation and social connectedness are factors related to alcohol use among a national representative sample of adolescents ages 12 to 17, and (2) to examine the extent to which gender, and race, and ethnicity moderate these relationships.

Methods: A sample of respondents aged 12 through 17 (n=13,772) were extracted from the 2017 National Survey on Drug Use and Health (NSDUH); a national probability sample of Americans aged 12 or older. The dependent variable, alcohol use, was defined as any alcohol use in the past 30 days. The independent variables were gender (male/female), race/ethnicity (White, Black, Hispanic) social isolation (no one to talk with about a serious problem), and social connectedness (participation in activities). Hierarchical, binary logistic regression was used to test the hypotheses in this study.  On the first step, alcohol use was regressed on the independent variables. On the second step, the multiplicative interaction terms of gender and social isolation and gender and social connectedness as well as the race/ethnicity interaction terms were examined. All of the analyses were conducted on weighted data.

Findings: The findings from the main effects analysis showed statistical significance for all of the variables with the exception of being Hispanic. Females were 12% more likely to use alcohol then males (OR=.88). Whites were more likely to drink (OR=1.47), Blacks less likely (OR=.66), social isolation (OR=1.74) and social connectedness (OR=.75). The gender – social connectedness and the race – social connectedness interaction analyses were statistically significant indicating the presence of moderation effects.

Implications: The findings have implications for working proactively to assess alcohol use among youth and to pay particular attention to potential racial/ethnic and gender differences and to take those differences into account in the development and implementation of future research efforts as well as prevention and intervention efforts for youth.