title: Clusters within a general adult population of alcohol abstainers.
abstract: BACKGROUND
  Our previous study found that alcohol abstainers use acute services more and preventative services less than safe level drinkers. The observed relationships between four categories of alcohol consumption and service use were J-shaped for acute services and inverted J-shaped for preventive services. The aim of this paper was to further investigate these relationships.
  
  
  METHODS
  The design was a health and lifestyle survey of 41 000 randomly-sampled adults in SE England. The response rate was 60%. Distinctive subgroups within the alcohol abstainer group were investigated using cluster analysis, based on socio-demographic and health status variables. Odds ratios for services use for the abstainer clusters, and three alcohol consumption groups were estimated from a logistic regression model which included age, social class, ethnic group, employment status, household composition, whether the respondent was a carer, smoking habit, use of private health insurance, and health status.
  
  
  RESULTS
  Two clusters were formed for both males and females. Cluster 1 comprised, on average, older, frailer, and more disabled people. Cluster 2 comprised younger, healthier people, a greater proportion of whom belonged to ethnic minority groups. Cluster 2 had similar rates of use of Accident & Emergency, GP, optician, and dental services compared with safe level drinkers. Cluster 1's rates differed from those of both Cluster 2 and safe level drinkers in almost all instances.
  
  
  CONCLUSIONS
  The J- and inverted J-shaped relationships between alcohol consumption and service use are partly explained by a subgroup of abstainers who are older, of less good health, and who use hospital, clinic, and domiciliary healthcare services much more than safe level drinkers.
authors.affiliation: Centre for Health Services Studies, University of Kent at Canterbury, Kent, UK. colin.cryer@hhc.umds.ac.uk
authors.forename: P C
authors.initials: PC
authors.lastname: Cryer
authors.forename: J
authors.initials: J
authors.lastname: Saunders
authors.forename: L M
authors.initials: LM
authors.lastname: Jenkins
authors.forename: H
authors.initials: H
authors.lastname: Neale
authors.forename: A C
authors.initials: AC
authors.lastname: Cook
authors.forename: T J
authors.initials: TJ
authors.lastname: Peters
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D016009:Chi-Square Distribution; D016000:Cluster Analysis; D003710:Demography; D004739:England; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D013695:Temperance