Workplace discrimination and risk of alcohol abuse: a prospective cohort study in the United States

OBJECTIVE: Prospective studies on the link between workplace discrimination and subsequent alcohol abuse remain markedly sparse. We aimed to address this gap and to expand the current evidence base by exploring i) the potential explanatory role of psychological stress and ii) gender differences. METHODS: We included 1097 workers from the Midlife in the United States (MIDUS) study without alcohol abuse at baseline (2004-2006) followed up in 2013-2014. Workplace discrimination at baseline was measured using a validated 6-item instrument and categorized into three levels by tertiles. Alcohol abuse at both baseline and follow-up was assessed using a modified 4-item Michigan Alcoholism Screening Test. We applied multivariable Poisson regression to estimate associations in terms of risk ratios (RRs) for and 95% confidence intervals (CIs). Multivariable RRs were additionally adjusted for a measure of psychological stress (i.e., Kessler 6 scale) and gender differences were examined by interaction terms. RESULTS: The risk of alcohol abuse was increased 2.6-fold in those reporting high workplace discrimination as compared to those with low levels (RR=2.60, 95% CI=1.10-6.15). Stress explained this association only marginally (i.e., RRs for high workplace discriminination were attenuated by 14.47%). Associations did not differ between women and men (i.e., p-values for all interaction terms were > 0.05) CONCLUSION: Our findings suggest that workplace discrimination is an important risk factor for alcohol abuse among US workers, highlighting the need for organizational interventions to address discrimination at the workplace.