Substance Use
Trends in heavy episodic drinking in Canada by gender and socioeconomic position from 2000-2021: an age-period-cohort analysis Alessandra Andreacchi* Alessandra Andreacchi Erin Hobin Arjumand Siddiqi Brendan Smith
Background:
Age, period, and birth cohort (APC) modelling is vital for epidemiological surveillance, providing insights into changes in alcohol use over time. Exploring variation in APC models for alcohol use across sociodemographic groups helps contextualize the causes of temporal changes. This study examined APC trends in heavy episodic drinking (HED) in Canada by gender and socioeconomic position.
Methods:
An APC analysis of repeated cross-sectional data from the Canadian Community Health Surveys (2000-2021) was conducted using hierarchical cross-classified random effects logistic regression. HED, defined as binge drinking ≥monthly in the past 12 months, was examined in relation to gender and socioeconomic position measured by household income and education.
Results:
Population-level trends showed steeper HED decreases in adolescent (aged 12-17) and young adult (aged 18-29) men than women and increases in middle adult (aged 30-64) women. Gender-specific APC models revealed strong age and birth cohort effects. HED peaked in young adulthood and decreased with age. HED was greatest in the 1980-1989 cohort but decreased in the most recent 1990-2009 cohort, particularly in men. Higher household incomes demonstrated a positive gradient for HED across age, period, and cohort, while trends varied by education. Compared to lower education groups, people with ≥ a bachelor’s degree had the lowest HED in middle adulthood. HED among people with ≥ a bachelor’s degree was low in earlier cohorts, converging with other education groups in recent cohorts due to a greater HED increase, particularly in women.
Conclusion:
The gender gap in HED is converging in Canada; recent cohorts of young men are reducing HED, while high-risk cohorts of women are entering middle adulthood with increased HED linked to higher education. Gender and socioeconomic position should be considered in research to contextualize trends and in alcohol policies to assess potential differential reductions in HED.