Research paper
Harms to children from the financial effects of others’ drinking

https://doi.org/10.1016/j.drugpo.2021.103254Get rights and content

Abstract

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.

Section snippets

Background

Harm to children can result in any family where stresses and strains arise and supporting structures are overwhelmed. Garbarino's human ecology theory (Garbarino, 1977) describes this and underlines the importance of individuals and events as well as family and larger societal and structural factors in children's lives and their development. Heavy alcohol consumption at the family or community level can cause strain and lead to a range of problems including deprivation (Samarasinghe, 2009).

Objectives

This study aims to explore the prevalence of financial harms from others’ drinking affecting children's needs among families in six low-and middle-income countries and three high-income countries. Secondly the study asks which groups of caregivers in different countries and across countries are at greater risk of reporting financial harm to children due to others’ drinking.

Participants and setting

Nine countries (USA, Ireland, Chile, Brazil, Thailand, Sri Lanka, Nigeria, Viet Nam and Lao People's Democratic Republic (Lao PDR) – listed in order of decreasing gross national income (The World Bank, 2019; World Bank, 2017) – from the Gender and Alcohol's Harm to Others (GENAHTO) project (https://genahto.org/ Wilsnack, Greenfield & Bloomfield, 2018) collected data on whether children's needs were affected by the financial implications of others’ drinking. All participants were aged 18–64

Sample description

Table 1 presents the unweighted sample numbers, and except for Nigeria, all surveys under-represented men. Across the different countries, the weighted percentages were largely similar in terms of gender and age distribution, apart from the Brazilian sample, which was relatively younger and the Thai and Vietnamese samples which had a lower proportion of 18–29 year-olds than most of the other countries. Larger percentages of the samples from Ireland, Viet Nam and Sri Lanka were in the

Do the drinking patterns of parents and their financial consequences affect children's needs?

Turning to participants’ drinking patterns first, substantial proportions of parents reported drinking riskily in both HICs and LMICs. The Irish and Chilean figures, where a third of adults with children reported drinking riskily, are similar to figures found in other HIC studies, where 30% of parents in the UK (Manning et al., 2009) and 25% in the US (Grant, 2000) with children reported drinking in a risky way. The prevalence of risky drinking in LMICs ranged from 13% of parents in Sri Lanka

Conclusion

Small percentages of families in nine countries reported that the needs of children were affected by the financial effects of others’ drinking. In around one-tenth to a third of households in the nine countries we studied, children lived with people who drank more than five drinks on the one occasion monthly or more. While this may not necessarily be problematic, when the household included someone who drank riskily, and particularly when families included someone who drank in a harmful heavy

Ethics

Ethical approvals were obtained for the study protocol from the World Health Organization, in each country where the study was conducted and for the cross-national collation, storage and analysis of the combined database (La Trobe University Human Research Ethics Committee).

Declarations of Interest

No conflict declared.

Acknowledgements

The data used in this study are from the GENAHTO Project (Gender and Alcohol's Harm to Others), supported by U.S. National Institute on Alcohol Abuse and Alcoholism/National Institutes of Health (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

References (53)

  • P. Chand et al.

    Distressing behaviors of alcohol dependence patients: A study from India

    Asian Journal of Psychiatry

    (2010)
  • S. Dawe et al.

    Drug use in the family: Impacts and implications for children

    (2007)
  • J.B. Du Prel et al.

    Confidence interval or p-value? Part 4 of a series on evaluation of scientific publications

    Deutsches Artzeblatt International

    (2009)
  • Ezard

    Six rapid assessments of alcohol and other substance use in populations displaced by conflict

    Conflict & Health

    (2011)
  • M. Fernandez et al.

    Alcohol's harm to others: Its effects on personal well-being and health in Chile

  • D.J. Fisher

    Two-stage individual participant data meta-analysis and generalized forest plots

    Stata Journal

    (2015)
  • B. Freisthler et al.

    Alcohol use and harm to children by parents and other adults

    Child Maltreatment

    (2020)
  • J. Garbarino

    The human ecology of child maltreatment: A conceptual model for research

    Journal of Marriage and the Family

    (1977)
  • M.J. Gardner et al.

    Confidence intervals rather than p-values: Estimation rather than hypothesis testing

    British Medical Journal

    (1986)
  • Graham

    Do gender differences in the relationship between living with children and alcohol consumption vary by societal gender inequality?

    Drug and Alcohol Review

    (2020)
  • B.F. Grant

    Estimates of U.S. children exposed to alcohol abuse and dependence in the family

    American Journal of Public Health

    (2000)
  • D. Griggs et al.

    Sustainable development goals for people and planet

    Nature

    (2013)
  • U. Grittner et al.

    Social inequalities and gender differences in the experience of alcohol-related problems

    Alcohol and Alcoholism

    (2012)
  • H.T.M. Hanh et al.

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

    Drug and Alcohol Review

    (2019)
  • J. Harwin et al.

    Children affected by parental alcohol problems (ChAPAPs): A report on the research, policy, practice and service development relating to ChAPAPs across Europe. An ENCARE 5 project funded by the European Union

    (2010)
  • T. Huedo-Medina et al.

    Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Chip documents, 19

    (2006)

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