Huge Study Links Risky Drinking with Low Social Support and Area of Residence

People who report having low social support are substantially more likely to experience heavy drinking and binge drinking than those who feel more supported, a large European study suggests. The researchers also found strong evidence that risky drinking is associated with areas of residence. Although alcohol use is known to be linked to social, economic, and demographic factors, the research is incomplete; it is not clear to what extent some of these factors, especially environmental conditions, predict dangerous drinking. Investigators in Spain designed a study that was unusual in exploring both heavy drinking and binge drinking and both individual and contextual (environmental) factors. The study, in Alcoholism: Clinical & Experimental Research, confirmed individual risk factors and highlighted certain environmental conditions that may help target interventions for those at risk.

In Spain, heavy drinking has decreased, and binge drinking has emerged as the greatest contributor to alcohol-related health harms. Investigators pulled data from the 2011-12 Spanish National Health Survey, all of which was collected at a single point in time. They identified samples of more than 20,000 people, and explored heavy drinking (in men, 40 grams of alcohol per day; in women, 24 grams) and binge drinking (in men, six or more drinks in 4-6 hours; in women, five or more). The data included individual characteristics, such as sex, age, education level, rural or urban residence, smoking history, and perceived social support. Researchers also looked at environmental variables relating to education, unemployment, and the percentage of local people working in the hospitality industry — a proxy for the density of bars and restaurants. They used statistical analysis to explore associations between risky drinking and factors believed to be relevant.

The data showed that individuals who perceived their social support as low were twice as likely to report heavy drinking, and almost twice as likely to report binge drinking, as were those with greater social support. This could be because social support is protective, because social isolation is stressful, and/or because risky drinking may harm relationships.

Other individual factors were relevant too. Heavy alcohol use and binge drinking were more commonly reported by men than women, and were relatively prevalent among higher earners; higher earnings may facilitate risky alcohol consumption. Binge drinking was also more common among young people; the risk declined with each birthday. Being a current or former smoker was a substantial risk factor, but educational achievement was not.

Contextual factors were also substantially associated with hazardous alcohol use, though differed by drinking pattern. Residents of areas with relatively high employment in the hospitality industry were more likely to report heavy drinking; this study could not discern whether they drank heavily because they had ready access to bars, or whether as heavy drinkers they chose to live near bars. Areas of higher unemployment had fewer self-reported heavy drinkers. Heavy drinking was not related to rural versus urban residence; binge drinking, in contrast, was more common among rural residents than urban. The analysis suggested that additional environmental factors not covered in this study were relevant.

The study has several limitations. The researchers recommend further research on the role of social support in alcohol use.

Individual and contextual factors associated with hazardous drinking in Spain: Evidence from a national population-based study. I. Galán, L. Simón, C. Rodriguez, Ortiz, T. López-Cuadrado, J. Merlo (pp xxx).