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Level of education and alcohol abuse and dependence in adulthood: a further inquiry.

R M Crum, J E Helzer and J C Anthony

School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Md. 21205.

OBJECTIVES. Prospectively gathered data were used to reexamine and to strengthen previously described observations about education and the risk of alcohol abuse and dependence. The hypothesis was that individuals who dropped out of high school and those who entered college but failed to get a college degree might be at increased risk for an alcohol disorder. METHODS. Study subjects were selected between 1980 and 1984 by taking probability samples of roughly 3000 adult household residents at each of the five Epidemiologic Catchment Area Program survey sites. To assess the occurrence of psychiatric conditions, staff administered the Diagnostic Interview Schedule soon after sampling and again at follow-up, roughly 1 year later. RESULTS. Individuals who had dropped out of high school were 6.34 times more likely to develop alcohol abuse or dependence than were individuals with a college degree. For those who had entered college but failed to achieve a degree, the estimated relative risk was 3.01. To extend these analyses, estimates for annual incidence were calculated, and an exploratory evaluation of interaction is presented. CONCLUSIONS. If these findings can be replicated, they should help identify subgroups at higher risk for the development of alcohol disorders.

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