How does the prevalence of alcohol use and associations with psychological distress differ across ethnic groups in England: A cross-sectional analysis of eight national surveys

Purpose: Research on ethnic differences in alcohol use has relied on broad groupings, potentially obscuring patterns across specific ethnic groups. Single data sources often include few participants from minoritised ethnic groups, a meta-analytic approach across data sources can overcome this limitation. This study examined, by ethnicity, the prevalence of i) alcohol use and binge-drinking, and associations of ii) alcohol use and binge-drinking with psychological distress. Methods: A secondary analysis of eight representative surveys in England (N= 112,791) was conducted. Alcohol was assessed using validated measures and categorised as i) non- (AUDIT-C score of 0), ii) low-risk (AUDIT-C score of 1-5), iii) increased-risk (AUDIT-C score of 6 or more), and iv)binge-drinker. Binge-drinking analyses were restricted to drinkers only. Psychological distress was measured using validated scales. Ethnicity was categorised using the most specific available classifications. Regression models estimated prevalence and associations within each survey, followed by a meta-analytic pooling of results from four surveys. Results: Minority ethnic groups were more likely to be non-drinkers and less likely to be increased-risk or binge-drinkers compared with White British groups. The pooled association between psychological distress and non-drinking was significant for the White British group(OR=1.46,95%CI=1.34-1.59). The association between psychological distress and increased-risk drinking was significant for the Indian group (OR=1.43,95%CI=1.05-1.96). The association between psychological distress and binge-drinking was significant for White British groups (OR=1.14, 95%CI=1.08-1.20), compared to those of the same ethnicity without distress. Conclusion: Collapsing ethnicities into broad categories masks differences in patterns of alcohol use, for example, the difference between specific South Asian ethnic groups. Positive associations between alcohol use and psychological distress were identified for some minority ethnic groups, suggesting that alcohol may be used as a coping mechanism.