Area-level socio-economic factors are significantly related to a population’s  health. This study investigates how school district-level factors affect the  initiation of alcohol drinking of Danish adolescents. 
A survey sample of 11 223 female and male pupils in the 7th grade from 447  schools across Denmark was analysed for the outcome variable drinking initiation  and a number of individual level predictors. Aggregated variables on school  district level were created from national registry data for education,  occupational level and household savings of residents, type of housing and land  use characteristics.
About 40% of all respondents  (45.8% males and 35.2% females) had ever drunk more than one glass of alcoholic  beverage. Mixed-effects logistic regression showed that significant individual  level predictors for drinking initiation were male gender, a lower performance  at school, perceived peer group drinking and the perceived daily drinking of the  father. On school district level, adolescents were more likely to initiate  alcohol consumption in school districts with higher farming land use and less  likely in those with higher proportion of private apartment buildings. Other  school district factors were not associated with drinking initiation when  controlled for individual level factors.
The  impact of socio-economic variables at school district level seems to be smaller  in the welfare state of Denmark than known for other countries. However,  residence in rural areas may be a direct disadvantage for youth, indicating a  need for region-specific prevention programmes. 

 
