How does the prevalence of alcohol use and associations with psychological distress differ across ethnic groups in England: A cross-sectional analysis of eight national surveys

Purpose Differences in patterns of alcohol and mental health across ethnic groups are not well-understood. Using multiple secondary datasets and across ethnic groups, this study aimed to examine the prevalence and associations of i)alcohol use and binge-drinking, ii)alcohol use and binge-drinking with psychological distress, and iii)pooled prevalence and associations for i)and ii)across multiple data sources. Methods A secondary analysis of eight representative surveys in England was conducted ( N =  112,831). Alcohol was assessed using validated measures and categorised as i)non-,ii)low-risk,iii)increased-risk, and iv)binge-drinker. Psychological distress was assessed using validated measures. Ethnicity was categorised using the most specific categories available. Multinomial and logistic regression models were conducted to address aims one and two. A meta-analysis was conducted to address aim three. Results Minority ethnic groups were more likely to be non-drinkers, and less likely to be increased-risk or binge-drinkers, compared to White British groups. Among those experiencing psychological distress, White British groups were more likely to be a non-drinker (OR = 1.46,95%CI = 1.34–1.59), Indian groups were more likely to be an increased-risk drinker (OR = 1.43,95%CI = 1.05–1.96), Black African and White British groups were more likely to be binge-drinkers (OR = 1.98,95%CI = 1.00-3.92;OR = 1.14, 95%CI = 1.08–1.20), compared to those of the same ethnicity but without psychological distress. Conclusion There were differences in the level of alcohol use between specific ethnic groups despite minority ethnic groups often being combined. Ethnic groups with the overall highest levels of drinking did not have the higher odds of increased-risk drinking when individuals experienced psychological distress. There is a need to better understand the reasons for drinking among minority ethnic groups experiencing psychological distress.