The Impact of Education on Tobacco Use and Alcohol Consumption in the Dominican Republic: A Social Gradient Perspective

By Michelle Jimenez de Tavarez and Flavia Cristina Drumond Andrade.

Published by The International Journal of Health, Wellness and Society

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Education represents a permanent indicator of socio-economic status and may explain smoking and drinking behaviors. We assessed the relationship between educational attainment, tobacco use, alcohol consumption, and concurrent use among adults in the Dominican Republic (DR), and explored differentials by gender and residential location. We analyzed data from 59,565 Dominicans, aged 15 to 59 years, collected by the Demographic and Health Surveys (DHS) in 2007. Descriptive statistics and logistic regression were calculated. Regression models included gender and residential location. High educational attainment decreased the likelihood of smoking (OR=0.22, 95%CI 0.19-0.26) compared to no education (p<0.001), but increased the likelihood of consuming alcohol (OR=3.08, 95%CI 2.75-3.45; p<0.001). Higher education was protective for concurrent use (OR=0.63, 95%CI 0.51-0.77; p<0.001). Women were less likely than men to smoke (OR=0.64, 95%CI 0.59- 0.68) and to consume alcohol (OR=0.30, 95%CI 0.28-0.31). Compared to the general population, individuals at the sugar cane plantations were more likely to smoke (OR=1.23, 95%CI 1.08-1.41; p<0.001). In conclusion, there was a social gradient in tobacco use that mainly affects men and bateyes residents. The alcohol-related social gradient was reversed, but still affected men more than women. Gender specific, social class targeted interventions are needed to reduce tobacco and alcohol use in the DR.

Keywords: Educational Attainment, Tobacco Use, Alcohol Consumption

The International Journal of Health, Wellness and Society, Volume 3, Issue 1, pp.11-23. Article: Print (Spiral Bound). Article: Electronic (PDF File; 448.856KB).

Dr Michelle Jimenez de Tavarez

Graduate Student, Department of Kinesiology and Community Health, University of Illinois, Champaign, Illinois, USA

I am a Medical Doctor from the Dominican Republic (DR) with an specialty in Internal Medicine. Currently, I am a PhD candidate in Community Health with a concentration in health disparities at the University of Illinois. I worked as a Physician for about 7 years in the DR, providing health care and community service to the Dominican population. I also used to work as lecturer for the College of Medicine of a major university in Santiago City for several years. My research mainly focuses on health disparities in risk factors related to chronic diseases and HIV among Latinos, particularly Dominicans. I have worked with metabolic risk in Mexican young adults and tobacco use and alcohol consumption among Dominicans. I am currently working on gender disparities on HIV risk shaped by socioeconomic and cultural factors in the DR, which is going to be my doctoral dissertation research. After completing my PhD, I am returning to my home country to develop an academic career as a faculty who teaches, conducts research and develops community-based interventions.

Dr. Flavia Cristina Drumond Andrade

Assistant Professor, Department of Kinesiology and Community Health, University of Illinois, Champaign, Illinois, USA

Flavia Andrade is an Assistant Professor of Kinesiology and Community Health. She received her Ph.D in Sociology with a specialization in demography and an M.S. in Population Health at the University of Wisconsin-Madison in 2006. From 2006 to 2007 she was a postdoctoral fellow at the Harris School of Public Policy Studies at the University of Chicago. Dr. Andrade is Brazilian and she received a B.A. in Economics and an M.A. in Demography from Federal University of Minas Gerais/Brazil. Dr. Andrade's professional interests include demography, population health, aging and the life course, research methods and statistics, socioeconomic disparities in health, and sociology of family. Her research focuses on demography and population health. Dr. Andrade's current research examines the interactions among aging, disability, obesity, and diabetes mellitus. She is also interested how socioeconomic inequalities over the life course influence later life outcomes, in particular, health outcomes. Her interest in aging and the life course also extends to the analysis of living arrangements of elderly individuals.