Abstract
Introduction
Early alcohol use has significant association with poor health outcomes. Individual risk factors around early alcohol use have been identified, but a holistic, data-driven investigation into health and household environmental factors on early alcohol use is yet to be undertaken.
Objectives
This study aims to investigate the relationship between preceding health events, household exposures and early alcohol use during adolescence using a two-stage data-driven approach.
Methods
In stage one, study population (N = 1,072) were derived from Millennium Cohort Study (MCS)
Wales (born between 2000-2002). MCS data were first linked with electronic-health records. Factors associated with early (<=eleven years) alcohol use were identified using feature selection and stepwise logistic regression. In stage two analogues risk factors from MCS were recreated for whole population (N = 59,231) of children (born between 1998-2002 in the Welsh Demographic Service Dataset) using routine data to predict the alcohol-related health events
in hospital or GP records.
Results
Significant risk factors from stage two included poor maternal mental (adjusted odds ratio [aOR] = 1.31) and physical health (aOR = 1.25), living with someone with alcohol-related problem (aOR = 2.16), single-adult household (aOR = 1.45), ever in deprivation (aOR = 1.66), child’s high hyperactivity (aOR = 3.57), and conduct disorder (aOR = 3.26). Children with health events, whose health needs are supported (e.g., are taken to the doctor), are at lower risk of early alcohol use.
Conclusion
Health events of the family members and the child can act as modifiable exposures and may therefore inform the development of prevention initiatives. Families with known alcohol problems, living in deprivation, experiencing child behavioural problems and those who are not taken to the doctor are at higher risk of early drinking behaviour and should be prioritised for early years support and intervention to target problem drinking in young people.
Early alcohol use has significant association with poor health outcomes. Individual risk factors around early alcohol use have been identified, but a holistic, data-driven investigation into health and household environmental factors on early alcohol use is yet to be undertaken.
Objectives
This study aims to investigate the relationship between preceding health events, household exposures and early alcohol use during adolescence using a two-stage data-driven approach.
Methods
In stage one, study population (N = 1,072) were derived from Millennium Cohort Study (MCS)
Wales (born between 2000-2002). MCS data were first linked with electronic-health records. Factors associated with early (<=eleven years) alcohol use were identified using feature selection and stepwise logistic regression. In stage two analogues risk factors from MCS were recreated for whole population (N = 59,231) of children (born between 1998-2002 in the Welsh Demographic Service Dataset) using routine data to predict the alcohol-related health events
in hospital or GP records.
Results
Significant risk factors from stage two included poor maternal mental (adjusted odds ratio [aOR] = 1.31) and physical health (aOR = 1.25), living with someone with alcohol-related problem (aOR = 2.16), single-adult household (aOR = 1.45), ever in deprivation (aOR = 1.66), child’s high hyperactivity (aOR = 3.57), and conduct disorder (aOR = 3.26). Children with health events, whose health needs are supported (e.g., are taken to the doctor), are at lower risk of early alcohol use.
Conclusion
Health events of the family members and the child can act as modifiable exposures and may therefore inform the development of prevention initiatives. Families with known alcohol problems, living in deprivation, experiencing child behavioural problems and those who are not taken to the doctor are at higher risk of early drinking behaviour and should be prioritised for early years support and intervention to target problem drinking in young people.
| Original language | English |
|---|---|
| Article number | 13 |
| Number of pages | 26 |
| Journal | International Journal of Population Data Science |
| Volume | 7 |
| Issue number | 1 |
| Early online date | 7 Jul 2022 |
| DOIs | |
| Publication status | Published - 7 Jul 2022 |
Bibliographical note
AcknowledgementsThis research has been carried out as part of the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyse anonymised data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). This work was also supported by and the National Centre for Population Health and Well-Being Research (NCPHWR). The research was supported by DECIPHer, a UKCRC Public Health Research Centre of Excellence, which receives funding from the British Heart Foundation, Cancer Research UK, Medical Research Council, the Welsh Government and the Wellcome Trust (WT087640MA), under the auspices of the UK Clinical Research Collaboration. This work was supported by Health Data Research UK which receives its funding from HDR UK Ltd (NIWA1) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Welcome Trust. The authors are grateful to the Centre for Longitudinal Studies, UCL Institute of Education and the UK Data Service. The co-operation of the participating Cohort families is also gratefully acknowledged. This work uses data provided by patients and collected by the NHS as part of their care and support. This study used anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. We would like to acknowledge all the data providers who enable SAIL to make anonymised data available for research. Compliance with ethical standards.
Funding
This work was supported by funds from the Economic and Social Research Council, the Medical Research Council and Alcohol Research UK to the ELAStiC Project (ES/L015471/1). The study funders had no involvement in the study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the paper for publication.
Keywords
- alcohol
- adolescent
- data linkage
- electronic health records (EHRS)
- cohort study
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