Harms to children from the financial effects of others' drinking.

BACKGROUND: Many children live with parents who drink and experience little impact, but risky or heavy drinking by caregivers can result in a range of harms to children. Alcohol-related financial harms which directly impact children's needs in general populations have been seldom studied. OBJECTIVE: The study aims to identify the prevalence and correlates of financial harms from others' drinking affecting children's needs in nine lower- and middle-income (LMICs) and high-income countries (HICs). METHODS: Participants (n = 7,669) from Brazil, Chile, Ireland, Lao PDR, Nigeria, Sri Lanka, Thailand, USA and Viet Nam were aged 18-64 years and living with children. Logistic regression and meta-analyses explored differences in financial harm affecting children among LMICs and HICs, adjusting for gender, education, rurality and drinking pattern. RESULTS: In around one-tenth to a third of households in the nine countries, children lived with people who drank riskily. Less than 1% to 8% of respondents reported that their children's needs had not been met because of financial harm from others' drinking. Women reported significantly greater harm to children due to the financial effects of others' drinking than men in the USA, Nigeria and Viet Nam. When the participant reported drinking riskily, and particularly when families included someone who drank heavily, increased odds of financial harm from others' drinking affecting children were identified. CONCLUSION: That children's needs were not met due to financial harm from others' drinking was reported by three percent (<1 to 8%) of caregivers across the nine countries, representing a problem for large numbers of children, particularly in the low and middle-income countries studied. When a person's drinking was reported to be heavy or harmful within the family, the risk that children's needs were affected by the financial impacts of others' drinking was significantly greater.

Socioeconomic inequalities in alcohol use and some related consequences from a household perspective in Vietnam.

INTRODUCTION AND AIMS: Alcohol-related harm reduction may target individuals, their households or communities. This study investigates the prevalence of and socioeconomic inequalities in alcohol use and alcohol-related consequences (injury, accident, property loss and interpersonal violence) at the family-level. DESIGNS AND METHODS: A cross-sectional survey of 2394 households was conducted in eight provinces from six socioeconomic regions and two metropolitan cities in Vietnam. Family-level alcohol use and injury were computed from individual data, while other measures were on a household basis. Unstandardised and indirectly standardised concentration index was used to measure degree of expenditure-based inequality in alcohol use and its consequences. RESULTS: Over the previous 12 months, 88.5% and 46.2% of households had at least one current-drinker and one heavy episodic drinking person, and in 41.7% the heavy episodic drinking person was the breadwinner. About 5.3% of households suffered alcohol-related injury, accident or property loss; 11.4% reported alcohol-related interpersonal violence. Poor and near-poor households suffered the double-burdens of both having heavy episodic drinking person and alcohol-related harm. A modest socioeconomic gradient was observed with all types of drinker, more concentrated among higher living-standard households, especially in urban areas. However, there was a persistent high-level inequality disadvantaging lower living-standard families, especially in rural areas, in suffering all measured alcohol-related harms. DISCUSSION AND CONCLUSIONS: Alcohol use and alcohol-related consequences are highly prevalent in Vietnam. Lower socioeconomic households, especially in rural areas, are important target groups for alcohol-related harm prevention and reduction interventions. The concentration index appeared to be a useful measure of inequalities in alcohol-related harms.

Harm from Known Others' Drinking by Relationship Proximity to the Harmful Drinker and Gender: A Meta-Analysis Across 10 Countries.

BACKGROUND: Drinking is a common activity with friends or at home but is associated with harms within both close and extended relationships. This study investigates associations between having a close proximity relationship with a harmful drinker and likelihood of experiencing harms from known others' drinking for men and women in 10 countries. METHODS: Data about alcohol's harms to others from national/regional surveys from 10 countries were used. Gender-stratified random-effects meta-analysis compared the likelihood of experiencing each, and at least 1, of 7 types of alcohol-related harm in the last 12 months, between those who identified someone in close proximity to them (a partner, family member, or household member) and those who identified someone from an extended relationship as the most harmful drinker (MHD) in their life in the last 12 months. RESULTS: Women were most likely to report a close male MHD, while men were most likely to report an extended male MHD. Relatedly, women with a close MHD were more likely than women with an extended MHD to report each type of harm, and 1 or more harms, from others' drinking. For men, having a close MHD was associated with increased odds of reporting some but not all types of harm from others' drinking and was not associated with increased odds of experiencing 1 or more harms. CONCLUSIONS: The experience of harm attributable to the drinking of others differs by gender. For preventing harm to women, the primary focus should be on heavy or harmful drinkers in close proximity relationships; for preventing harm to men, a broader approach is needed. This and further work investigating the dynamics among gender, victim-perpetrator relationships, alcohol, and harm to others will help to develop interventions to reduce alcohol-related harm to others which are specific to the contexts within which harms occur.