Examining cultural background and the protective effect of marriage on alcohol use disorder in Sweden
(2024) In International Journal of Social Psychiatry- Abstract
Background: Little is known about whether the protective effect of marriage on alcohol use disorder (AUD) varies by cultural background. Aims: Using Swedish national data, we examined whether marriage is associated with a stronger reduction in AUD risk among Swedes of a Swedish background (i.e. those with two Swedish-born parents) compared to Swedes with a foreign background (i.e. one or two foreign-born parents) and whether the protective effect of marriage depends on whether the spouse has a Swedish or foreign background. Method: Among those born in Sweden 1960 to 1990 (3,093,439; 49% female), associations between cultural background and AUD registration during marriage were estimated with Cox models. Analyses of intra- and... (More)
Background: Little is known about whether the protective effect of marriage on alcohol use disorder (AUD) varies by cultural background. Aims: Using Swedish national data, we examined whether marriage is associated with a stronger reduction in AUD risk among Swedes of a Swedish background (i.e. those with two Swedish-born parents) compared to Swedes with a foreign background (i.e. one or two foreign-born parents) and whether the protective effect of marriage depends on whether the spouse has a Swedish or foreign background. Method: Among those born in Sweden 1960 to 1990 (3,093,439; 49% female), associations between cultural background and AUD registration during marriage were estimated with Cox models. Analyses of intra- and intermarriage on AUD registration were examined with Cox models and limited to groups of focal individuals for which there was sufficient statistical power, which included Swedes with two Swedish-born parents, two Finnish-born parents, or bicultural background (one Swedish and one foreign-born parent). Models were sex stratified. Results: Marriage was associated with reductions in AUD risk among those with Swedish and with foreign backgrounds, though less protective for males of Finnish versus Swedish background as indicated by a significant interaction between marital status and parental region of birth, HR = 0.80, 95% CI [0.71, 0.90]. Marriage was also less protective for those with a bicultural versus Swedish background, HRmales = 0.87, 95% CI [0.81, 0.92] and HRfemales = 0.88, 95% CI [0.81, 0.97]. Among those of Swedish background, marriage to a spouse with a foreign versus Swedish background was associated with increased risk of AUD, HRmales = 1.26, 95% CI [1.19, 1.34] and HRfemales = 1.20, 95% CI [1.10, 1.31]. This risk was diminished when family-level confounders (genes, rearing environment) were controlled for. Conclusions: The protective effect of marriage depends on cultural background, with some evidence that increased risks associated with a spouse’s foreign background are confounded by family-level factors.
(Less)
- author
- Salvatore, Jessica E. ; Larsson Lönn, Sara LU ; Chartier, Karen G. ; Sundquist, Jan LU ; Kendler, Kenneth S. LU and Sundquist, Kristina LU
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- alcohol use disorder, cultural background, Marriage
- in
- International Journal of Social Psychiatry
- publisher
- SAGE Publications
- external identifiers
-
- scopus:85207132833
- pmid:39435759
- ISSN
- 0020-7640
- DOI
- 10.1177/00207640241288211
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © The Author(s) 2024.
- id
- 97e247e3-26af-4526-9954-a775db87118e
- date added to LUP
- 2024-12-17 11:39:26
- date last changed
- 2025-07-16 04:30:03
@article{97e247e3-26af-4526-9954-a775db87118e,
abstract = {{<p>Background: Little is known about whether the protective effect of marriage on alcohol use disorder (AUD) varies by cultural background. Aims: Using Swedish national data, we examined whether marriage is associated with a stronger reduction in AUD risk among Swedes of a Swedish background (i.e. those with two Swedish-born parents) compared to Swedes with a foreign background (i.e. one or two foreign-born parents) and whether the protective effect of marriage depends on whether the spouse has a Swedish or foreign background. Method: Among those born in Sweden 1960 to 1990 (3,093,439; 49% female), associations between cultural background and AUD registration during marriage were estimated with Cox models. Analyses of intra- and intermarriage on AUD registration were examined with Cox models and limited to groups of focal individuals for which there was sufficient statistical power, which included Swedes with two Swedish-born parents, two Finnish-born parents, or bicultural background (one Swedish and one foreign-born parent). Models were sex stratified. Results: Marriage was associated with reductions in AUD risk among those with Swedish and with foreign backgrounds, though less protective for males of Finnish versus Swedish background as indicated by a significant interaction between marital status and parental region of birth, HR = 0.80, 95% CI [0.71, 0.90]. Marriage was also less protective for those with a bicultural versus Swedish background, HR<sub>males</sub> = 0.87, 95% CI [0.81, 0.92] and HR<sub>females</sub> = 0.88, 95% CI [0.81, 0.97]. Among those of Swedish background, marriage to a spouse with a foreign versus Swedish background was associated with increased risk of AUD, HR<sub>males</sub> = 1.26, 95% CI [1.19, 1.34] and HR<sub>females</sub> = 1.20, 95% CI [1.10, 1.31]. This risk was diminished when family-level confounders (genes, rearing environment) were controlled for. Conclusions: The protective effect of marriage depends on cultural background, with some evidence that increased risks associated with a spouse’s foreign background are confounded by family-level factors.</p>}},
author = {{Salvatore, Jessica E. and Larsson Lönn, Sara and Chartier, Karen G. and Sundquist, Jan and Kendler, Kenneth S. and Sundquist, Kristina}},
issn = {{0020-7640}},
keywords = {{alcohol use disorder; cultural background; Marriage}},
language = {{eng}},
publisher = {{SAGE Publications}},
series = {{International Journal of Social Psychiatry}},
title = {{Examining cultural background and the protective effect of marriage on alcohol use disorder in Sweden}},
url = {{http://dx.doi.org/10.1177/00207640241288211}},
doi = {{10.1177/00207640241288211}},
year = {{2024}},
}