The risk of alcohol abuse and dependence in adulthood: the association with educational level

In this analysis of prospectively gathered data, the authors sought to estimate the degree to which risk of alcohol abuse and dependence might be elevated among adults who attended but did not complete high school and among those who attended college without earning a degree. Study subjects were selected in 1980-1984 by taking probability samples of adult household residents at five sites of the Epidemiologic Catchment Area Program: New Haven, Connecticut; Baltimore, Maryland; St. Louis, Missouri; Durham-Piedmont, North Carolina; and Los Angeles, California. At baseline, participants completed standardized interviews that measured sociodemographic variables and assessed whether they had met diagnostic criteria for currently or formerly active alcohol abuse-dependence syndromes. The interviews were readministered 1 year later to identify incident cases among the 13,673 participants. After subjects were sorted into risk sets by age and residence census tract and after persons with a prior history of alcohol abuse or dependence were excluded, there were in 156 risk sets 160 incident cases and 526 subjects at risk for future occurrence of alcohol syndromes. Compared with adults who had earned a college degree, those who had attended high school without completion were at increased risk (relative risk (RR) = 6.23, 95 percent confidence interval (CI) 2.41-16.09) as were adults who had attended college without earning a degree (RR = 3.25, 95 percent CI 1.36-7.76). In contrast, risk of alcohol disorders among adults with a high school diploma but no college was not reliably greater than the level of risk for those with a college degree (RR = 1.88, 95 percent CI 0.79-4.47).