The Relationship Between Drinking Pattern, Social Capital, and Area-Deprivation: Findings From the Health Survey for England.

Abstract

The purpose of this study was to establish the relationships between heavy episodic and drinking frequency with area-deprivation and social capital in England. Using the Health Survey for England 2002-2006, a nationally representative crosssectional survey (N = 54,422), multilevel logistic regression models with individuals nested within primary sampling units were carried out, stratified by sex, on (a) drinkers versus nondrinkers, (b) heavy episodic drinking versus drinking less (on the heaviest drinking day), and (c) fewer than 2 drink-free days versus at least 2 drink-free days. Key exposures were individual social capital variables (social trust, active civic participation, social support, neighborhood perception). Models adjusted for age, area-deprivation, economic activity, education, ethnicity, longstanding illness, marital status, and children in the household. Lack of social support (men: OR = 0.69, 95% CI [0.60, 0.79]; women: OR = 0.77, 95% CI [0.69, 0.86]) and no civic participation (men: OR = 0.75, 95% CI [0.67, 0.83]; women: OR = 0.73, 95% CI [0.68, 0.78]) decreased the odds of being a drinker versus a nondrinker. Among men, low social trust increased (OR = 1.16, 95% CI [1.04, 1.30]) and no civic participation decreased (OR = 0.81, 95% CI [0.74, 0.89]) the odds of heavy episodic drinking; among women, good overall neighborhood perception decreased the odds (OR = 0.91, 95% CI [0.86, 0.97]). Lack of social support (men: OR = 1.25, 95% CI [1.14, 1.36]; women: OR = 1.20, 95% CI [1.02, 1.40]) and no civic participation (men: OR = 1.25, 95% CI [1.14, 1.36]; women: OR = 1.37, 95% CI [1.25, 1.51]) increased the odds of having fewer than 2 drink-free days. Men and women living in the most deprived areas were less likely to drink, more likely to engage in heavy episodic drinking, and more likely to have at least 2 alcohol-free days, after social capital variables were adjusted for. Social capital is associated with drinking alcohol, and low forms is associated with heavy episodic and frequent drinking. Interventions to reduce heavy episodic consumption should be targeted at those with low social capital and those living in deprived areas where heavy drinking is normalized. Drink-free days recommended in guidelines could be further targeted at those lacking social support.