A gender-focused multilevel analysis of how country, regional and individual level factors relate to harm from others’ drinking

Abstract

Background

The aim of this study was to examine how gender, age and education, regional prevalence of male and female risky drinking and country-level economic gender equality are associated with harms from other people’s drinking.

Methods

24,823 adults in 10 countries were surveyed about harms from drinking by people they know and strangers. Country-level economic gender equality and regional prevalence of risky drinking along with age and gender were entered as independent variables into three-level random intercept models predicting alcohol-related harm.

Findings

At the individual level, younger respondents were consistently more likely to report harms from others’ drinking, while, for women, higher education was associated with lower risk of harms from known drinkers but higher risk of harms from strangers. Regional rate of men’s risky drinking was associated with known and stranger harm, while regional-level women’s risky drinking was associated with harm from strangers. Gender equality was only associated with harms in models that did not include risky drinking.

Conclusions

Youth and regional levels of men’s drinking were consistently associated with harm from others attributable to alcohol. Policies that decrease the risky drinking of men would be likely to reduce harms attributable to the drinking of others.

Keywords:

• Alcohol
• harm to others
• gender

Acknowledgments

The data used in this paper are from the GENAHTO Project (Gender and Alcohol’s Harm to Others), supported by NIAAA Grant No. R01 AA023870 (Alcohol’s Harm to Others: Multinational Cultural Contexts and Policy Implications). GENAHTO is a collaborative international project affiliated with the Kettil Bruun Society for Social and Epidemiological Research on Alcohol and coordinated by research partners from the Alcohol Research Group/Public Health Institute (USA), University of North Dakota (USA), Aarhus University (Denmark), the Centre for Addiction and Mental Health (Canada), the Centre for Alcohol Policy Research at La Trobe University (Australia), and the Addiction Switzerland Research Institute (Switzerland). Five of the countries were part of a joint WHO-Thai-Health study on alcohol’s harm to others (India, Nigeria, Sri Lanka, Thailand, and Vietnam). The content is solely the responsibility of the authors and does not necessarily express the official opinions of the NIAAA or the NIH.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Lao PDR’s inclusion also was supported by Thai-Health, while Australia [NHMRC 1065610], New Zealand, Switzerland, and the USA separately funded and completed their own studies. Analyses of these data were supported in part by Research Grant no. R01 AA023870 from the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA)/National Institutes of Health (NIH), and the US survey data were supported by Research Grant no. R01 AA022791 from the NIAAA/NIH. S. C. is funded by a Discovery Early Career Researcher Award from the Australian Research Council [DE180100016]. R. R. receives funding from the Centre for Alcohol Policy Research is co-funded by the Foundation for Alcohol Research and Education, an independent, charitable organization working to prevent the harmful use of alcohol in Australia (http://www.fare.org.au). National Health and Medical Research Council; World Health Organization.