Heavy and binge alcohol drinking and parenting status in the United States from 2006 to 2018: An analysis of nationally representative cross-sectional surveys

Abstract

Background

Binge and heavy drinking are preventable causes of mortality and morbidity. Alcohol consumption by women who parent is damaging to child health, and it is concerning that women in the United States in their reproductive years have experienced increased drinking over the past decade. Although media attention has focused on the drinking status of women who are child-rearing, it remains unclear whether binge and heavy drinking vary by parenting status and sex.

Methods and findings

We examined national trends in binge drinking, defined as 5 or more drinks in a single day for men and 4 or more drinks for women, and heavy drinking, defined as 60 or more days with binge episodes in a year. We used survey-weighted logistic regression from the 2006–2018 waves of the cross-sectional National Health Interview Survey (NHIS, N = 239,944 eligible respondents) to study time trends in drinking outcomes by sex, age, and parenting status. Binge drinking increased for both sexes in nearly all age groups, with the largest increase among women ages 30–44 without children (from 21% reporting binge drinking in 2006 to 42% in 2018); the exception was young men (ages 18–29) with children, among whom binge drinking declined. By 2012, the prevalence of binge drinking among young men with children (38.5%) declined to below that of young women without children (39.2%) and stayed lower thereafter. Despite widespread increases in binge drinking, heavy drinking declined or remained stable for all groups except older women (ages 45–55) without children (odds ratio [OR] for heavy drinking each year = 1.06, 95% CI 1.02–1.10) and women ages 30–44, regardless of parenting status. For binge drinking outcomes only, we saw evidence of interaction in drinking trends by parenting status, but this was shown to be confounded by sex and age. Men and women with children reported consistently lower levels of drinking than those without children. Rates of abstention mirrored trends in binge outcomes for both sexes, limiting concerns about invariance. Study limitations include self-reported data and measurement invariance in binge drinking cutoffs across study years.

Conclusions

This study demonstrated that trends in binge and heavy drinking over time were not differential by parenting status for women; rather, declines and increases over time were mainly attributable to sex and age. Women both with and without children are increasing binge and heavy drinking; men, regardless of parenting status, and women without children consumed more alcohol than women with children. Regardless of impact on child health, increased drinking rates in the past decade are concerning for adult morbidity and mortality: binge drinking has increased among both sexes, and heavy drinking has increased among older women. Men and women of all ages and parenting status should be screened for heavy alcohol use and referred to specialty care as appropriate.

Abstract

Sarah McKetta and colleagues investigate associations between alcohol drinking and parenting among adults in the United States.

Author summary

Why was this study done?

• Excessive alcohol use is a leading cause of death and disability.

• Excessive alcohol use has been increasing in the US, particularly among women during the ages when they are likely to be raising children.

• Media reporting has focused on drinking among women who parent (so-called mommy drinking) as particularly concerning; thus, we tested whether increases in drinking in recent years is particularly apparent among women who parent.

What did the researchers do and find?

• We studied trends in binge drinking and heavy drinking among adults ages 18–55 in a large, nationally representative data set (the National Health Interview Survey [NHIS], N = 239,944) from 2006 to 2018.

• We tested whether binge and heavy drinking were increasing, decreasing, or invariant among men and women according to parenting status and age.

• We found that binge drinking increased, and alcohol abstention decreased, for all groups except for young men (ages 18–29) with children; binge drinking increased for all women, regardless of parenting status.

• Heavy drinking generally decreased except among older women (ages 45–55) without children.

What do these findings mean?

• Concerns about increases in alcohol use among women with children should be qualified; all adult women are increasing drinking, and women without children have higher rates of drinking than women with children.

• Binge drinking increased for nearly all groups, though heavy drinking remained mostly stable.

• Physicians should be screening all adults—not just select groups of men and women—for alcohol use disorders and referring them to appropriate treatment.