Differential impact of the economic recession on alcohol use among white British adults, 2004-2010.
BACKGROUND
Unlike other west European countries, there is a long-term trend of rising alcohol consumption and mortality in England. Whether drinking will rise or fall during the current recession is widely debated. We examined how the recession affected alcohol use in adults in England using individual-level data.


METHODS
We analysed a nationally representative sample of non-institutionalized white persons aged 20-60 years from seven waves of the Health Survey for England, 2004-2010 (n = 36 525), to assess trends in alcohol use and frequency before, during and after the recession and in association with unemployment, correcting for possible changes in sample composition and socio-demographic confounders. The primary analysis compared 2006/7 with 2008/9, following the official onset of the UK recession in early 2008.


RESULTS
During England's recession, there was a significant decrease in frequent drinking defined as drinking four or more days in the past week (27.1% in 2006 to 23.9% in 2009, P < 0.001), the number of units of alcohol imbibed on the heaviest drinking day (P < 0.01) and the number of days that individuals reported drinking over the past seven days (P < 0.01). However, among current drinkers who were unemployed there was a significantly elevated risk of binge drinking in 2009 and 2010 (odds ratio = 1.64, 95% confidence interval: 1.22-2.19, P = 0.001) that was not previously observed in 2004-2008 (1.03, 0.76-1.41; test for effect heterogeneity: P = 0.036).


CONCLUSIONS
England's recession was associated with less hazardous drinking among the population overall, but with rises in binge drinking among a smaller high-risk group of unemployed drinkers.
1 University of Pennsylvania, Philadelphia, PA, USA mharhay@mail.med.upenn.edu.
Michael O
MO
Harhay
2 Department of International Health, Boston University School of Public Health, Boston, MA, USA.
Jacob
J
Bor
3 Department of Medicine, Stanford Prevention Research Center, Stanford University, Palo Alto, CA, USA4 Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Sanjay
S
Basu
4 Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Martin
M
McKee
5 Department of Epidemiology and Public Health, UCL (University College London), London, UK.
Jennifer S
JS
Mindell
5 Department of Epidemiology and Public Health, UCL (University College London), London, UK.
Nicola J
NJ
Shelton
4 Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK6 Department of Sociology, University of Oxford, Oxford, UK.
David
D
Stuckler
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D057172:Economic Recession; D004739:England / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult