Abstract

Purpose: Alcohol use can lead to serious health concerns and even death, but findings are inconsistent regarding whether consumption differs by where people live. The purpose of this study was to assess whether alcohol use differs by metropolitan status in young adult females ages 25-44 in the general population. Methods: This cross-sectional analysis used data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) for females ages 25-44 in California (N=271), Colorado (N=428), Florida (N=1,109), New York (N=1,456), and Texas (N=482). Ordered logistic regression analysis was used with combined state data to assess the relationship between alcohol use and metropolitan status while controlling for demographic and health-related factors. Results: Across states, over half of participants reported alcohol use (49-65%), with about one-fifth reporting excessive alcohol use (14-26%). Metropolitan status varied among urban (12-54%), suburban (24-51%), and rural (5- 42%) residents. The results of adjusted analysis indicated that metropolitan status, current smoking, and mental health status were significantly related to alcohol use. Conclusion: Overall, alcohol use differed by metropolitan status in female adults ages 25-44, with urban women reporting drinking more than their rural counterparts. In a primary care setting, providers may expect about half of young adult females to drink alcohol, less than half to have mental health issues, and few to be smokers. Providers need to be aware that current smokers and those with mental health issues are more likely to report alcohol use. Providers should continue to screen all women ages 25-44 for alcohol use, with special attention to those from urban areas. Because smoking and mental health status were related to alcohol use, providers should screen for all of these if any are present and provide education and referrals to substance abuse programs and mental health counseling as necessary.

Keywords: Alcohol Consumption; Women’s Health; Urban Population; Suburban Population; Rural Population; Mental Health; Tobacco Use