Gender Differences in Alcohol Use Disorder Trends from 2009-2019: An Intersectional Analysis.

Background: Trend estimates from national surveys over the last 20 years have suggested converging rates of alcohol use over time between adult men and women. However, limited research has utilized an intersectional lens to examine how sociodemographic characteristics influence gender differences in these trends.

Methods: The current study used data from the National Survey on Drug Use and Health (NSDUH) to examine whether gender intersected with race/ethnicity, age, education level, marital status, employment status, household income, and urbanicity on temporal trends (2009-2019) in alcohol use disorder (AUD). Logistic regression and linear trend analyses were conducted to examine interaction effects of sociodemographic variables and changes in rates of AUD over time in males and females.

Results: We observed decreasing rates of AUD over time in males and females, with larger declines in males (p=0.01; OR=0.96 in males vs. OR=0.98 in females). We identified subpopulations of females that demonstrated little or no reductions during this timeframe (2009-2019), which varied by race/ethnicity, age, marital status, employment, and income but not by education or urbanicity. In adults aged 49 years and younger (overall p=0.02; ages 18-25 OR=0.92 in males vs. 0.96 in females, ages 26-29 OR=0.97 in males vs. OR=0.99 in females), and in those employed (overall p=0.05; OR=0.96 in males vs. OR=0.99 in females), women demonstrated smaller declines in comparison to men. Additionally, women who reported that they were Black (p=0.006; OR=0.94 in males vs. OR=1 in females), single (p=0.009; OR=0.94 in males vs. 0.96 in females) or earning between $20,000 and $49,000 (p=0.012; OR=0.96 in males vs. 0.98 in females), had smaller or no declines in AUD in compared to men with the same demographic characteristic.

Conclusions: Our findings provide support for converging rates of AUD between genders and newly identify subpopulations of females that may be at heightened risk.