Early life adversity and alcohol misuse in mid and later life: The moderating role of adult residential characteristics.

Alcohol misuse among mid- and later-life adults is a growing public health concern. Early life adversity (e.g., abuse, poverty) is a well-established risk factor for alcohol misuse in midlife and beyond. Neighborhood environments may also influence alcohol use and shape the extent to which early adversity contributes to misuse later in life, yet little is known about these relationships among midlife and older adults. Using a cross-sectional sample of 9759 adults aged 51+ from the Health and Retirement Study and a series of multilevel mixed effects logistic regression models, this study examined whether adult residential characteristics moderate the associations between three domains of childhood adversity and two problematic drinking outcomes (heavy episodic drinking and hazardous drinking). Findings showed that exposure to two or more risky parental (e.g., abuse) or any adolescent (e.g., trouble with police) behaviors increased the odds of hazardous drinking, while exposure to multiple childhood socioeconomic disadvantages (e.g., poor family finances) was associated with lower odds of hazardous drinking. Among residential characteristics, neighborhood social ties were associated with higher odds of both heavy episodic and hazardous drinking. Neighborhood affluence, however, was a protective factor for problematic drinking. Significant cross-level interactions indicated that residential context modifies associations between early life adversity and alcohol misuse. Notably, neighborhood social ties amplified the probability of heavy episodic drinking among individuals with childhood socioeconomic disadvantage. These findings highlight the complex and context-dependent nature of alcohol misuse risk in mid- and older-adulthood, and that residential characteristics may function as both protective and risk-enhancing factors.