Longitudinal trajectories of binge and heavy drinking pattern among World Trade Center Health Registry enrollees, 2006–2021: A dual trajectory modeling approach

Abstract

Background

This study examined drinking trajectories among World Trade Center Health Registry enrollees and evaluated potential risk factors.

Methods

A longitudinal study analyzing binge and heavy drinking trajectories over 15 years, involving 18,332 enrollees aged 18 or older on 9/11/2001, with 62.7 % identifying as male. Group-based trajectory modeling explored binge drinking and heavy drinking trajectories. Multinomial logistic regression was used to assess risk factors (9/11-exposure, rescue/recovery worker, 9/11-related post-traumatic stress disorder (PTSD), lack of social support) associated with these drinking trajectories. Dual trajectory analysis estimated the conditional probabilities between binge and heavy drinking group memberships. Trajectory models stratified by age group and sex, separately, were also examined.

Findings

Four trajectories described binge (very-low-stable (72.5 %), moderate-increasing (6.9 %), high-decreasing (11.8 %), and very-high-decreasing (8.8 %)) and heavy (very-low-stable (82.9 %), low-increasing (6.0 %), high-decreasing (5.9 %), and high-increasing (5.1 %)) drinking over time. In dual trajectory analyses, most binge drinking trajectories overlapped with similar heavy drinking trajectories. Individuals aged 36–64, non-Hispanic White, or experienced 9/11-related PTSD were more likely to follow the other binge drinking trajectories and the initially “high-” heavy drinking trajectories than their respective very-low-stable trajectories; females were more likely to follow “increasing” heavy drinking trajectories, while males were more likely to follow high or increasing binge trajectories. Compared to younger enrollees (36–54, 55–69 years of age), a higher proportion of those aged 70 +  were in low-stable binge and heavy drinking trajectory groups.

Conclusions

The observed trajectory groups and factors associated with longitudinal patterns of excessive drinking may assist with developing targeted interventions like behavioral counseling.