Alcohol use and alcohol-related harms: Exploring risk and protective factors among young people living in urban disadvantage

Abstract

The aim of the research is to explore the potential risk and protective factors associated with alcohol use, binge drinking and harmful consequences of alcohol use, under the broad domains of health-related quality of life, among young people living in urban disadvantage. Furthermore, to estimate the scale and scope of alcohol-related harms to children and young people presenting with acute conditions, wholly or partially attributable to their personal consumption of alcohol, as evidenced by emergency department (ED) presentations from two acute urban hospitals, located on one site, retrospectively for an 11-year period (2009-2019). The research design was a concurrent multiple methods, convergent parallel design, whereby a quantitative approach was dominant, with a qualitative aspect nested within. Firstly, a cross-sectional survey was conducted on 15?17-year-olds from six educationally disadvantaged schools and two youth training centres, in a highly deprived region in Dublin. Self-reported data were collected on alcohol behaviours, alcohol motivations, alcohol consequences/harms, health-related quality of life domains, leisure time activities and depression levels. Secondly, anonymised secondary data were extracted from the hospital data management systems of two urban hospitals, located on one site. Filters were applied using key alcohol search words and terms to relevant data capture fields, spanning both paediatric and adult emergency department presentations of children and young people aged 12?18-years old. The key findings were obtained from both descriptive and inferential modelling, comprising binary logistic regression and moderation analysis. The binary logistic regression models identified the significant predictors of alcohol use, binge drinking, harmful consequences and depression levels. Moderation analysis identified a relationship between the predictor variable alcohol use and the outcome variable harmful consequences through the influence of a third continuous moderator variable school environment. This study contributes to the existing data that support the premise that living in urban disadvantage demonstrates a higher prevalence of drinking behaviours among young people, compared to national and European data across predominantly middle to higher socio-economic communities, but indicated a lower frequency of alcohol consumption (fewer occasions). This compares to higher frequency (more occasions) among more affluent young people (Pedersen and Bakken, 2016). Potential risk factors were clearly associated to socially orientated motivations, socially orientated behaviours (peer support) and a lack of structured leisure time activities, among disadvantaged young people. Higher perceived social and peer support was a potential risk factor reporting the increased likelihood of alcohol use, binge drinking and suffering harmful consequences. Potential protective factors were clearly associated with positive school environment in decreasing the likelihood of alcohol use and binge drinking. Positive leisure time activities like reading books for enjoyment decreased the likelihood of alcohol use and binge drinking, while participating in structured leisure time evening activities and actively participating in sport potentially decreased the likelihood of depression. Acute alcohol-related harms were identified across two vulnerable age groups, both presenting with exclusive alcohol-related harm. In addition, this study calls attention to other deficits in health-related quality of life domains and depression experienced by disadvantaged young people.