Prevalence and associations of psychological distress and alcohol use across ethnic groups using eight cross-sectional surveys in England

Objectives: Differences in patterns of alcohol and mental health across ethnic groups are not well-understood. Using multiple secondary datasets, this study aimed to examine the i) prevalence and associations of alcohol use and binge-drinking across ethnic groups, ii) associations of alcohol use and binge-drinking with psychological distress across ethnic groups, and iii) pooled prevalence and associations for i) and ii) across multiple data sources. Design: A secondary analysis of eight representative surveys in England was conducted. Alcohol use was assessed using validated measures and categorised as i) non-, ii) low-risk, iii) increased-risk, and iv) binge-drinker. Psychological distress was assessed using validated measures. Ethnicity was categorised using the most specific categories available. Multinomial and logistic regression models were conducted to establish associations of alcohol use and psychological distress across ethnic groups. A meta-analysis was conducted to establish pooled associations of alcohol use and psychological distress across ethnic groups. Results: Across datasets, minority ethnic groups were more likely to be non-drinkers, and less likely to be increased-risk or binge-drinkers, compared to White British groups. Among ethnic groups experiencing psychological distress, White British groups were more likely to be a non-drinker, Indian groups were more likely to be an increased-risk drinker, and Black African groups and White British groups were more likely to be binge-drinkers, compared to those of the same ethnicity but without psychological distress. Conclusion: There were differences in the level of alcohol use between specific ethnic groups, such as Indian and Pakistani groups, despite these groups often being combined. Ethnic groups with the overall highest levels of drinking did not have the higher odds of increased-risk drinking when individuals experienced psychological distress.