skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.


Title: Changes in drinking days among United States adults during the COVID‐19 pandemic
Abstract AimsTo examine changes in drinking behavior among United States (US) adults between March 10 and July 21, 2020, a critical period during the COVID‐19 pandemic. DesignLongitudinal, internet‐based panel survey. SettingThe Understanding America Study (UAS), a nationally representative panel of US adults age 18 or older. ParticipantsA total of 4298 US adults who reported alcohol use. MeasurementsChanges in number of reported drinking days from March 11, 2020 through July 21, 2020 in the overall sample and stratified by sex, age, race/ethnicity, household structure, poverty status, and census region. FindingsCompared with March 11, the number of drinking days per week was significantly higher on April 1 by an average of 0.36 days (95% CI = 0.30, 0.43), on May 1 by an average of 0.55 days (95% CI = 0.47, 0.63), on June 1 by an average of 0.41 days (95% CI = 0.33, 0.49), and on July 1 by an average of 0.39 days (95% CI = 0.31, 0.48). Males, White participants, and older adults reported sustained increases in drinking days, whereas female participants and individuals living under the federal poverty line had attenuated drinking days in the latter part of the study period. ConclusionsBetween March and mid‐July 2020, adults in the United States reported increases in the number of drinking days, with sustained increases observed among males, White participants, and older adults.  more » « less
Award ID(s):
2028683
PAR ID:
10368218
Author(s) / Creator(s):
 ;  ;  ;  ;  ;  ;  ;  ;  ;  ;  
Publisher / Repository:
Wiley-Blackwell
Date Published:
Journal Name:
Addiction
Volume:
117
Issue:
2
ISSN:
0965-2140
Format(s):
Medium: X Size: p. 331-340
Size(s):
p. 331-340
Sponsoring Org:
National Science Foundation
More Like this
  1. null (Ed.)
    Abstract Background Cross-sectional studies have found that the coronavirus disease 2019 (COVID-19) pandemic has negatively affected population-level mental health. Longitudinal studies are necessary to examine trajectories of change in mental health over time and identify sociodemographic groups at risk for persistent distress. Purpose To examine the trajectories of mental distress between March 10 and August 4, 2020, a key period during the COVID-19 pandemic. Methods Participants included 6,901 adults from the nationally representative Understanding America Study, surveyed at baseline between March 10 and 31, 2020, with nine follow-up assessments between April 1 and August 4, 2020. Mixed-effects logistic regression was used to examine the association between date and self-reported mental distress (measured with the four-item Patient Health Questionnaire) among U.S. adults overall and among sociodemographic subgroups defined by sex, age, race/ethnicity, household structure, federal poverty line, and census region. Results Compared to March 11, the odds of mental distress among U.S. adults overall were 1.84 (95% confidence interval [CI] = 1.65–2.07) times higher on April 1 and 1.92 (95% CI = 1.62–2.28) times higher on May 1; by August 1, the odds of mental distress had returned to levels comparable to March 11 (odds ratio [OR] = 0.80, 95% CI = 0.66–0.96). Females experienced a sharper increase in mental distress between March and May compared to males (females: OR = 2.29, 95% CI = 1.85–2.82; males: OR = 1.53, 95% CI = 1.15–2.02). Conclusions These findings highlight the trajectory of mental health symptoms during an unprecedented pandemic, including the identification of populations at risk for sustained mental distress. 
    more » « less
  2. ImportancePersistence of COVID-19 symptoms beyond 2 months, or long COVID, is increasingly recognized as a common sequela of acute infection. ObjectivesTo estimate the prevalence of and sociodemographic factors associated with long COVID and to identify whether the predominant variant at the time of infection and prior vaccination status are associated with differential risk. Design, Setting, and ParticipantsThis cross-sectional study comprised 8 waves of a nonprobability internet survey conducted between February 5, 2021, and July 6, 2022, among individuals aged 18 years or older, inclusive of all 50 states and the District of Columbia. Main Outcomes and MeasuresLong COVID, defined as reporting continued COVID-19 symptoms beyond 2 months after the initial month of symptoms, among individuals with self-reported positive results of a polymerase chain reaction test or antigen test. ResultsThe 16 091 survey respondents reporting test-confirmed COVID-19 illness at least 2 months prior had a mean age of 40.5 (15.2) years; 10 075 (62.6%) were women, and 6016 (37.4%) were men; 817 (5.1%) were Asian, 1826 (11.3%) were Black, 1546 (9.6%) were Hispanic, and 11 425 (71.0%) were White. From this cohort, 2359 individuals (14.7%) reported continued COVID-19 symptoms more than 2 months after acute illness. Reweighted to reflect national sociodemographic distributions, these individuals represented 13.9% of those who had tested positive for COVID-19, or 1.7% of US adults. In logistic regression models, older age per decade above 40 years (adjusted odds ratio [OR], 1.15; 95% CI, 1.12-1.19) and female gender (adjusted OR, 1.91; 95% CI, 1.73-2.13) were associated with greater risk of persistence of long COVID; individuals with a graduate education vs high school or less (adjusted OR, 0.67; 95% CI, 0.56-0.79) and urban vs rural residence (adjusted OR, 0.74; 95% CI, 0.64-0.86) were less likely to report persistence of long COVID. Compared with ancestral COVID-19, infection during periods when the Epsilon variant (OR, 0.81; 95% CI, 0.69-0.95) or the Omicron variant (OR, 0.77; 95% CI, 0.64-0.92) predominated in the US was associated with diminished likelihood of long COVID. Completion of the primary vaccine series prior to acute illness was associated with diminished risk for long COVID (OR, 0.72; 95% CI, 0.60-0.86). Conclusions and RelevanceThis study suggests that long COVID is prevalent and associated with female gender and older age, while risk may be diminished by completion of primary vaccination series prior to infection. 
    more » « less
  3. ImportanceTrust in physicians and hospitals has been associated with achieving public health goals, but the increasing politicization of public health policies during the COVID-19 pandemic may have adversely affected such trust. ObjectiveTo characterize changes in US adults’ trust in physicians and hospitals over the course of the COVID-19 pandemic and the association between this trust and health-related behaviors. Design, Setting, and ParticipantsThis survey study uses data from 24 waves of a nonprobability internet survey conducted between April 1, 2020, and January 31, 2024, among 443 455 unique respondents aged 18 years or older residing in the US, with state-level representative quotas for race and ethnicity, age, and gender. Main Outcome and MeasureSelf-report of trust in physicians and hospitals; self-report of SARS-CoV-2 and influenza vaccination and booster status. Survey-weighted regression models were applied to examine associations between sociodemographic features and trust and between trust and health behaviors. ResultsThe combined data included 582 634 responses across 24 survey waves, reflecting 443 455 unique respondents. The unweighted mean (SD) age was 43.3 (16.6) years; 288 186 respondents (65.0%) reported female gender; 21 957 (5.0%) identified as Asian American, 49 428 (11.1%) as Black, 38 423 (8.7%) as Hispanic, 3138 (0.7%) as Native American, 5598 (1.3%) as Pacific Islander, 315 278 (71.1%) as White, and 9633 (2.2%) as other race and ethnicity (those who selected “Other” from a checklist). Overall, the proportion of adults reporting a lot of trust for physicians and hospitals decreased from 71.5% (95% CI, 70.7%-72.2%) in April 2020 to 40.1% (95% CI, 39.4%-40.7%) in January 2024. In regression models, features associated with lower trust as of spring and summer 2023 included being 25 to 64 years of age, female gender, lower educational level, lower income, Black race, and living in a rural setting. These associations persisted even after controlling for partisanship. In turn, greater trust was associated with greater likelihood of vaccination for SARS-CoV-2 (adjusted odds ratio [OR], 4.94; 95 CI, 4.21-5.80) or influenza (adjusted OR, 5.09; 95 CI, 3.93-6.59) and receiving a SARS-CoV-2 booster (adjusted OR, 3.62; 95 CI, 2.99-4.38). Conclusions and RelevanceThis survey study of US adults suggests that trust in physicians and hospitals decreased during the COVID-19 pandemic. As lower levels of trust were associated with lesser likelihood of pursuing vaccination, restoring trust may represent a public health imperative. 
    more » « less
  4. ImportanceSince 2013, the American College of Cardiology (ACC) and American Heart Association (AHA) have recommended the pooled cohort equations (PCEs) for estimating the 10-year risk of atherosclerotic cardiovascular disease (ASCVD). An AHA scientific advisory group recently developed the Predicting Risk of cardiovascular disease EVENTs (PREVENT) equations, which incorporated kidney measures, removed race as an input, and improved calibration in contemporary populations. PREVENT is known to produce ASCVD risk predictions that are lower than those produced by the PCEs, but the potential clinical implications have not been quantified. ObjectiveTo estimate the number of US adults who would experience changes in risk categorization, treatment eligibility, or clinical outcomes when applying PREVENT equations to existing ACC and AHA guidelines. Design, Setting, and ParticipantsNationally representative cross-sectional sample of 7765 US adults aged 30 to 79 years who participated in the National Health and Nutrition Examination Surveys of 2011 to March 2020, which had response rates ranging from 47% to 70%. Main Outcomes and MeasuresDifferences in predicted 10-year ASCVD risk, ACC and AHA risk categorization, eligibility for statin or antihypertensive therapy, and projected occurrences of myocardial infarction or stroke. ResultsIn a nationally representative sample of 7765 US adults aged 30 to 79 years (median age, 53 years; 51.3% women), it was estimated that using PREVENT equations would reclassify approximately half of US adults to lower ACC and AHA risk categories (53.0% [95% CI, 51.2%-54.8%]) and very few US adults to higher risk categories (0.41% [95% CI, 0.25%-0.62%]). The number of US adults receiving or recommended for preventive treatment would decrease by an estimated 14.3 million (95% CI, 12.6 million-15.9 million) for statin therapy and 2.62 million (95% CI, 2.02 million-3.21 million) for antihypertensive therapy. The study estimated that, over 10 years, these decreases in treatment eligibility could result in 107 000 additional occurrences of myocardial infarction or stroke. Eligibility changes would affect twice as many men as women and a greater proportion of Black adults than White adults. Conclusion and RelevanceBy assigning lower ASCVD risk predictions, application of the PREVENT equations to existing treatment thresholds could reduce eligibility for statin and antihypertensive therapy among 15.8 million US adults. 
    more » « less
  5. ImportanceEfforts to understand the complex association between social media use and mental health have focused on depression, with little investigation of other forms of negative affect, such as irritability and anxiety. ObjectiveTo characterize the association between self-reported use of individual social media platforms and irritability among US adults. Design, Setting, and ParticipantsThis survey study analyzed data from 2 waves of the COVID States Project, a nonprobability web-based survey conducted between November 2, 2023, and January 8, 2024, and applied multiple linear regression models to estimate associations with irritability. Survey respondents were aged 18 years and older. ExposureSelf-reported social media use. Main Outcomes and MeasuresThe primary outcome was score on the Brief Irritability Test (range, 5-30), with higher scores indicating greater irritability. ResultsAcross the 2 survey waves, there were 42 597 unique participants, with mean (SD) age 46.0 (17.0) years; 24 919 (58.5%) identified as women, 17 222 (40.4%) as men, and 456 (1.1%) as nonbinary. In the full sample, 1216 (2.9%) identified as Asian American, 5939 (13.9%) as Black, 5322 (12.5%) as Hispanic, 624 (1.5%) as Native American, 515 (1.2%) as Pacific Islander, 28 354 (66.6%) as White, and 627 (1.5%) as other (ie, selecting the other option prompted the opportunity to provide a free-text self-description). In total, 33 325 (78.2%) of the survey respondents reported daily use of at least 1 social media platform, including 6037 (14.2%) using once a day, 16 678 (39.2%) using multiple times a day, and 10 610 (24.9%) using most of the day. Frequent use of social media was associated with significantly greater irritability in univariate regression models (for more than once a day vs never, 1.43 points [95% CI, 1.22-1.63 points]; for most of the day vs never, 3.37 points [95% CI, 3.15-3.60 points]) and adjusted models (for more than once a day, 0.38 points [95% CI, 0.18-0.58 points]; for most of the day, 1.55 points [95% CI, 1.32-1.78 points]). These associations persisted after incorporating measures of political engagement. Conclusions and RelevanceIn this survey study of 42 597 US adults, irritability represented another correlate of social media use that merits further characterization, in light of known associations with depression and suicidality. 
    more » « less