For White drinkers (see Table 4 ), there was an interaction of FH with area-level religious adherence in relation to high-risk drinking. Contrasts showed the interaction was present for those with an affected first-degree relative (adjusted Wald test: F(1,20449) = 5.30, p = .021). The average marginal effect of first-degree FH (compared to negative FH) on high-risk drinking was stronger at low levels of religious adherence in the county, and this effect became weaker as county-level religious adherence increased (Fig. 5 ). Stated another way, the risk of having one (or more) first-degree relatives with alcohol problems was exacerbated in areas with low religiosity and buffered in areas with high religiosity (Fig. 6 ). Average marginal effects for respondents with only extended family or with high FH density (compared to negative FH), were not as strongly attenuated as county-level religious adherence increased.Table 4Select coefficients from reduced models stratified by race/ethnicity.White DrinkersHigh-risk Drinking(wtd N = 8,109)Dependence(wtd N = 8,527)OR95% CIOR95% CIAUD in extended family only1.370**(1.082–1.736)2.138**(1.310–3.490)AUD in 1st degree1.814***(1.437–2.289)2.861***(1.722–4.756)AUD in 1st degree and extended1.582**(1.200–2.086)5.506***(3.416–8.877)Liquor/convenience stores per mi21.027+(0.999–1.055)1.008(0.963–1.056)Religious adherence in county1.000(0.999–1.001)1.001(0.999–1.002)Extended family X
