How Do Register-Based Studies Contribute to Our Understanding of Alcohol’s Harms to Family Members? A Scoping Review of Relevant Literature
Abstract
Objective
This review maps the research literature on register-based studies of alcohol’s harms to family members and identifies areas for future research.
Method
Using a scoping review methodology, the PubMed/MEDLINE, EMBASE, and PsycINFO databases were searched in August 2019 with keywords to identify studies that included register-based outcome sources, a family relationship, and an exposure to heavy alcohol use. In total, 5,961 records were screened, 403 full-text articles were assessed for eligibility, and 91 studies were included in the final review.
Results
Register-based research on alcohol’s harms to family members has largely drawn on hospital records to identify heavy alcohol users and has primarily focused on children of heavy alcohol users; 79 of the included studies solely investigated harms to children, whereas 2 focused on partners and 10 on multiple first-degree or unspecified relatives. Register-based studies show that children of heavy alcohol users are at a higher risk for mental disorders, disease and injury hospitalizations, infant and child mortality, criminality, poor employment and educational outcomes, abuse/neglect, and placement in residential/foster care, among other negative outcomes.
Conclusions
A substantial body of register-based research shows that children of parents with the most severe alcohol problems are at an increased risk for numerous adverse experiences. Register-based studies have investigated diverse, yet precisely defined outcomes, using large samples followed over long periods, and have examined the contribution of genetic, biological, and environmental factors. The understanding of alcohol’s harms to families could be enhanced by further register-based research on other household family members of heavy alcohol users.
Research in context
This review relied on studies of hospital and other centralized records, so-called register-based studies. These provide a fuller picture of the harm a family member’s alcohol use can cause children than studies using self-reported measures.
Children in households with heavy alcohol use was found to experience a range of poor outcomes, called “alcohol’s harms to others.” These included,
- mental health disorders in childhood and/or adolescence,
- infant/child mortality,
- being convicted of a crime later on in life,
- lower academic achievement,
- experience abuse and/or neglect,
- have an out-of-home placement (e.g., foster care), and
- an elevated risk for hospitalizations for physical illness and injury.
The study suggests that register based studies are an important tool to protect those most at risk from household alcohol use.
[T]he article by Brummer and associates points toward a wider scope in which register data sets can contribute to documenting, investigating, and prevention planning for harms from others’ alcohol use,” wrote Dr. Anne-Marie Laslett, from the Centre for Alcohol Policy Research in Australia, in an accompanying review, as per MedicalXpress.
Mining them will improve our understanding of how AHTO [alcohol’s harms to others] can be reduced.”
Dr. Anne-Marie Laslett, Centre for Alcohol Policy Research in Australia
