Occupational
A prospective cohort study on workplace discrimination and risk of alcohol abuse in U.S. workers Jian Li* Jian Li Liwei Chen
Objective: Although growing evidence has suggested that discrimination is a risk factor for alcohol misuse, most previous studies focused on general unspecific discrimination and research on workplace discrimination is sparse. To our best knowledge, there are only 3 cross-sectional studies, all from the U.S., indicating strong associations of workplace discrimination with negative alcohol drinking behaviors. This study aimed to provide the first instance of research evidence examining the prospective association of workplace discrimination with the risk of alcohol abuse.
Methods: Using data from the Midlife in the United States (MIDUS), 1102 workers who had no alcohol abuse at baseline and were followed up to 9 years were included. Workplace discrimination at baseline was measured using a validated 6-item instrument and categorized into three levels by tertile, while alcohol abuse at both baseline and follow-up was assessed using a modified 4-item Michigan Alcoholism Screening Test (MAST). Multivariable Poisson regression was performed to estimate the associations.
Results: The incident alcohol abuse at follow-up was 4.08%. Workers who experienced high exposure to workplace discrimination had a higher risk of alcohol abuse (adjusted RR and 95% CI = 3.15 [1.16, 8.52]) compared to those with low exposure, adjusting for age, sex, race, marital status, education, household income, smoking, leisure-time physical activity, alcohol drinking frequency, and major depressive episode at baseline. A trend analysis showed an exposure-response manner. Further adjustment for other psychosocial work factor (i.e., job strain) did not change the strength of association.
Conclusion: We found workplace discrimination was prospectively associated with a higher risk of alcohol abuse among U.S. workers. Given the impact of alcoholism on disease burden, policy attention regarding interventions addressing discrimination at work is warranted.