The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63873

Basile Chaix, PhD and Pierre Chauvin, MD, PhD, DSc. Research team on social determinants of health and utilization of care, National Institute of Health and Medical Research, INSERM U444, Faculté Saint-Antoine, 27 rue Chaligny, Paris Cedex 12, 75571, France, 33144738443, chaix@u444.jussieu.fr

Introduction: We investigated the effect of the level of consumerism, expressed as the gross domestic product (GDP) per capita in the broad area of residence, on the risks of smoking and drinking. Methods: Using a representative sample of the French population, multilevel logistic models allowed us to examine the effect of the GDP on such health-related behavior. Results: After adjustment for potential confounders, we found no GDP effect on the odds of being a moderate smoker. Conversely, the risk of being a highly-dependent smoker as opposed to a moderate consumer or an abstainer increased with the area-level GDP per capita (OR: 1.13, 95% CI: 1.04–1.23 for an increment of one standard deviation). A similar pattern was found for alcohol consumption: the odds of being a moderate consumer were not related to the GDP per capita, but a positive effect of the GDP on the odds of being an alcohol-dependent drinker as opposed to a moderate consumer or an abstainer was found among women (OR: 1.14, 95% CI: 1.02–1.28). The gap between the sexes with respect to alcohol-dependency therefore appeared to be narrower when the GDP per capita was high. Conclusions: Beyond the well-documented socioeconomic effects operating at both the individual and the local neighbourhood levels, our study suggests that broader areas of residence, through their level of economic development, may also have an independent impact on health-related behavior. It is therefore relevant to take into account the level of consumerism in the broad area of residence when targeting health-promotion programs.

Learning Objectives:

• At the conclusion of the session, the participants in this session will be able to:
• 3. Recognize that there were more heavy smokers, and more heavy drinkers among women in areas with a high gross domestic product per capita.
  6. Describe how the level of consumerism in a given area may be the causal pathway through which the gross domestic product per capita influences health-risk behavior.
  9. Articulate such a contextual effect operating at the level of the broad area of residence with more local contextual effects which have been reported in the literature.

Keywords: Substance Abuse, Risk Factors

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.