Risk and protective factors of drinking in a Mediterranean region. Results from the Catalan Health Survey (2018-2022)

Background: Alcohol consumption and its associated health and social consequences pose a significant public health challenge in the WHO European Region. In this context, social disparities in alcohol-related harm are subject to variations influenced by demographic factors, including socioeconomic status, education, gender, ethnicity, and place of residence. This study aims to describe the alcohol consumption patterns of the population in Catalonia and identify the risk and protective factors of the low and high-risk consumers, from an inequities and social health determinants perspective.

Methods: A cross-sectional study was conducted using data from the 2018-2022 waves of the Catalan Health Survey, which is a household-based and representative survey of the population in Catalonia. For the 15-64-year-old population (N=11.643), a bivariate analysis and multiple logistic models were developed to estimate the odds ratio and their 95% confidence intervals between high-risk and low-risk alcohol consumption, stratified by sex. The threshold for risky alcohol consumption was set at 28 standard drinks for males and 17 for females. Additionally, engaging in binge drinking once a month was classified as high-risk consumption. Sociodemographic, health, and lifestyle variables were explored considering confounding variables such as socioeconomic status and migration situation. 

Results: In the Catalan population, the prevalence of high-risk alcohol consumption was 8.31% in males and 2.95% in females, whereas the low-risk alcohol consumption was 66.34% in males and 59.93% in females. In both genders, high-risk alcohol consumption was associated with younger age, lower socioeconomic status, poorer well-being, and higher tobacco consumption. Social support was identified as a protective factor against high-risk alcohol consumption for males. 

Conclusion: The results of this study reveal that more than 65% of the Catalan population reported alcohol consumption in the last 12 months, while around 5% exhibited a high-risk drinking pattern, notably more prevalent among males than females. Moreover, individuals with high-risk patterns exhibit poorer health outcomes compared to those with lower risk. These findings emphasize the need for universal interventions to reduce alcohol consumption in the entire population and indicate preventive measures to mitigate harms associated with the high-risk subgroup of alcohol consumers.