Socio-economic status and binge drinking in Israel Yehuda D. Neumark a, *, Giora Rahav b , Dena H. Jaffe a a Department of Social Medicine, Braun School of Public Health and Community Medicine, Hebrew University of Jerusalem-Hadassah, P.O. Box 12272, Jerusalem, Israel b Department of Sociology, Tel Aviv University, Tel Aviv, Israel Received 14 December 2001; accepted 30 July 2002 Abstract Modern Israeli society is comprised primarily of two nationality groups */Jews and Arabs, with disparate religious and cultural attitudes toward alcohol drinking. We recently described higher rates of past-month drinking among Jewish adults, although Arabs who drink were more likely to report binge drinking. The goal of the present study is to examine the relationship between binge drinking and socio-economic status (SES) among Arab and Jewish adults in Israel. Data from a 1995 nationally representative household survey on drug and alcohol use were analyzed. Participants included male and female Arabs (n /982) and Jews (n / 4972) aged 18  /40 living in Israel. SES was assessed using education, household income, and occupation. The prevalence of binge drinking was highest among Arab men (21.4%) followed by Jewish men (15.2%), Arab women (7.3%), and Jewish women (4.0%). Prevalence rates and odds ratios (ORs) from logistic models controlling for age, gender, marital status and religiosity show that increased household income and occupation are associated with increased binge drinking among Arabs (OR /2.0) and decreased binge drinking among Jews (OR $/0.6). Higher educational achievement was protective against binge drinking in both nationality groups. Varied results for income and occupation, and education indicate the need to examine the association between each SES indicator and alcohol consumption independently, especially in culturally diverse populations. # 2002 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Alcohol; Binge drinking; Israel; Arabs; Jews; Socio-economic status 1. Introduction Socio-economic status (SES) impacts on health risks and outcomes in an inverse manner, such that, for example, people of lower SES have higher rates of smoking, cardiovascular disease, and mortality (Eames et al., 1993; Thomson et al., 2001; Davey Smith et al., 1994; Kunst et al., 1995; Pomerleau et al., 1997; Jarvis and Wardle, 1999). The association with alcohol con- sumption is somewhat more complex. Population groups of higher SES tend to exhibit a higher prevalence of light to moderate drinking (Marmot et al., 1993; Sutton and Godfrey, 1995; Marmot, 1997; Makela, 1999), whereas lower SES groups are more likely to have elevated rates of drinking problems and alcohol dependency (Halldin, 1985; Crum et al., 1992; Midanik and Clark, 1995; Lynch et al., 1997; Kunz and Graham, 1998; van Oers et al., 1999), alcohol-related morbidity (Romelsjo and Lundberg, 1996) and mortality (Makela et al., 1997; Harrison and Gardiner, 1999; Norstrom and Romelsjo, 1999). Various theories have been posited to explain the inverse relationship between SES and risk behaviors, specifically alcohol consumption. Members of different SES groups may differ in their attitudes towards alcohol-related risk and self-efficacy (van Oers et al., 1999). Individuals of higher SES, for example, may be more aware of the consequences of their behaviors and therefore more likely to make healthier choices (Nor- strom and Romelsjo, 1999; Kenkel, 1991). Another possibility is cultural attitudes toward drinking that vary across social groups and religions (Heath, 1995; Greeley et al., 1980; Hawks and Bahr, 1992). The traditional Weberian concept of social class, as described in the literature, encompasses: class (e.g. economic wealth), status (e.g. prestige or relative rank * Corresponding author. Tel.:  /972-2-643-9103; fax:  /972-2-643- 1086 E-mail address: yneumark@md2.huji.ac.il (Y.D. Neumark). Drug and Alcohol Dependence 69 (2003) 15 /21 www.elsevier.com/locate/drugalcdep 03765-8716/02/$ - see front matter # 2002 Elsevier Science Ireland Ltd. All rights reserved. PII:S0376-8716(02)00248-X