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Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention
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Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 30 November 2025 | Viewed by 6603

Special Issue Editor

Prof. Dr. Katie Haighton

E-Mail Website
Guest Editor
Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE7 7XA, UK
Interests: translational public health research; alcohol screening and brief intervemtion; making every contact count; development and evaluation of complex interventions

Special Issue Information

Dear Colleagues, 

Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been disadvantaged by their social or economic status, geographic location, or environment. Many populations experience health disparities, including, but not limited to, people from some racial and ethnic minority groups, people with disabilities, women, people who are LGBTQI+ (lesbian, gay, bisexual, transgender, queer, intersex, or other), older people, and children. The alcohol harm paradox is the consistent research finding that disadvantaged populations suffer greater rates of alcohol-related hospitalizations and deaths, even though they often consume less alcohol than the more advantaged. 

Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. This Special Issue will focus on understanding alcohol use in disadvantaged populations and the role of inequalities in driving alcohol harms. It will also welcome research examining policy, practice, and interventions that might impact disadvantaged populations, reducing harms where they are often most acute. 

Prof. Dr. Katie Haighton
Guest Editor

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Keywords

  • alcohol
  • disadvantaged
  • marginalized
  • equity
  • inequality
  • minority
  • disability
  • women
  • LGBTQI+
  • older people
  • children

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Published Papers (5 papers)

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19 pages, 296 KiB  
Article
Building Connections and Striving to Build Better Futures: A Qualitative Interview Study of Alcohol Recovery Navigators’ Practice in the North East of England, UK
by Domna Salonen, Amy O’Donnell, Katherine Jackson, Sarah Hulse, James Crosbie, Ryan Swiers, Fiona Tasker, Gemma Muldowney, Anna Pickford, Floor Christie-de Jong, Eileen Kaner and Emma-Joy Holland
Int. J. Environ. Res. Public Health 2025, 22(1), 111; https://doi.org/10.3390/ijerph22010111 - 15 Jan 2025
Viewed by 791
Abstract
To address the holistic and continuity of care needs of people who attend North East hospitals frequently for alcohol-related reasons, Recovery Navigator (Navigator) roles were introduced into Alcohol Care Teams in six hospitals in the North East of England, UK, in 2022. The [...] Read more.
To address the holistic and continuity of care needs of people who attend North East hospitals frequently for alcohol-related reasons, Recovery Navigator (Navigator) roles were introduced into Alcohol Care Teams in six hospitals in the North East of England, UK, in 2022. The Navigators aimed to provide dedicated holistic support to patients experiencing alcohol harms, starting whilst in the hospital with the potential to continue this beyond discharge. This qualitative study explores the contributions that the Navigators make towards integrated alcohol care. Twenty-five semi-structured interviews were undertaken with 7 patients, 1 carer, and 17 staff. We used reflexive thematic analysis and applied the concept of continuity of care and Self-Determination Theory. The findings suggest that all of the participants value Navigators having dedicated time to work with patients to address their social needs, that patients benefit from having someone who provides relational support and is ‘gently persistent’, and that most of the Navigators have good relationships with community providers and have supported the transition of patients to these services. Staff recognise the challenges of holistic alcohol care in hospitals, and the support of the Alcohol Care Teams and Navigators is seen as invaluable. Navigators help to address gaps in the provision of holistic support for patients who experience significant health inequalities. Full article
(This article belongs to the Special Issue Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention)
12 pages, 268 KiB  
Article
Adopting a Holistic Approach to Alcohol Brief Interventions for Women in a Prison Setting in the UK: A Qualitative Exploration
by Jennifer Louise Ferguson
Int. J. Environ. Res. Public Health 2024, 21(12), 1671; https://doi.org/10.3390/ijerph21121671 - 14 Dec 2024
Viewed by 629
Abstract
Currently, women make up only 5% of the prison population, with 3604 women in prison in the UK compared to 74,981 men. Risky drinking is highly prevalent in both the male and female prison population, however, significantly more females drink in a risky [...] Read more.
Currently, women make up only 5% of the prison population, with 3604 women in prison in the UK compared to 74,981 men. Risky drinking is highly prevalent in both the male and female prison population, however, significantly more females drink in a risky way prior to prison (24% compared to 18% of men). In addition to risky drinking, those entering the criminal justice system (CJS), particularly women, are more likely to suffer from inequalities in society. Such inequalities can be linked to the pains of imprisonment for women. The overall research methods discussed in this paper are qualitative interviews. The interviews were designed after two systematic reviews exploring: the gendered pains of imprisonment and the feasibility and acceptability of women and alcohol brief interventions (ABI) were conducted. Interviews were conducted in an open prison setting, with both female residents and relevant staff and stakeholders. To date there is a dearth of evidence in relation to delivering ABI’s in prison, specifically with women. This research explored the feasibility and acceptability of delivering ABI to women in prison and found that when delivering ABI’s in a prison setting, by underpinning the research with criminological theory, could help women capitalise on the “teachable moment” necessary to induce behaviour change. The findings of the interviews found the intervention was both feasible and acceptable and identified five themes highlighting the women’s journey through prison chronologically to enable a more holistic ABI to be developed in future. Full article
(This article belongs to the Special Issue Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention)
13 pages, 321 KiB  
Article
What’s the Matter? Alcohol Use Risk Among Relatives of People with Mental Illness
by Suzanne A. McKeag, Gordon L. Flett and Joel O. Goldberg
Int. J. Environ. Res. Public Health 2024, 21(12), 1637; https://doi.org/10.3390/ijerph21121637 - 9 Dec 2024
Viewed by 897
Abstract
Family members who live with relatives with serious mental illness face unique mental health risks, which become worse with alcohol use and without social support. Research has highlighted the damaging effects of harmful substance use among people who feel like they do not [...] Read more.
Family members who live with relatives with serious mental illness face unique mental health risks, which become worse with alcohol use and without social support. Research has highlighted the damaging effects of harmful substance use among people who feel like they do not matter to others, but few studies have assessed links between mattering and alcohol use within marginalized populations. In the present study, a sample of family members who reside with a relative with mental illness completed an online survey. Using the AUDIT alcohol screening measure, participants were classified into a No–Low Risk Alcohol Use (n = 52) or a Hazardous Drinking (n = 28) group. Hazardous alcohol use was alarmingly high, reaching triple the rate of the general population and categorized at the most severe level of harm. Those who drank hazardously felt like they mattered less to others (p < 0.001), felt like they mattered less to their relative with mental illness (p = 0.035), had greater anti-mattering (e.g., they felt invisible and unheard) (p = 0.008), experienced more hopelessness (p < 0.001), felt less supported by significant others (p = 0.003), endorsed having more problems with mental health services (p = 0.017), had higher stigma (p < 0.001), and had lower psychological well-being (p < 0.001). Findings highlight under-recognized public health risks, implications for public health initiatives, and the need for tailored interventions that boost mattering and reduce harmful alcohol use in this vulnerable family member population. Full article
(This article belongs to the Special Issue Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention)
9 pages, 646 KiB  
Article
Alcohol Use among Young Women in Kampala City: Comparing Self-Reported Survey Data with Presence of Urinary Ethyl Glucuronide Metabolite
by Monica H. Swahn, Jane Palmier, Rachel Culbreth, Godfrey S. Bbosa, Charles Natuhamya, Gideon Matovu and Rogers Kasirye
Int. J. Environ. Res. Public Health 2024, 21(9), 1256; https://doi.org/10.3390/ijerph21091256 - 21 Sep 2024
Viewed by 2007
Abstract
This study sought to determine the level of concordance between self-reported alcohol use and the presence of its urinary ethyl glucuronide (EtG) metabolite in women living in urban Kampala. In 2023, we recruited 300 young women, ages 18 to 24 years, to participate [...] Read more.
This study sought to determine the level of concordance between self-reported alcohol use and the presence of its urinary ethyl glucuronide (EtG) metabolite in women living in urban Kampala. In 2023, we recruited 300 young women, ages 18 to 24 years, to participate in a prospective cohort study across three sites in urban Kampala (i.e., Banda, Bwaise, and Makindye) to examine the mechanistic pathways of mental illness. As part of the baseline assessment, participants were asked to complete a research assistant-administered survey and to provide a urine sample to screen for 16 different substances and/or their metabolites, including EtG. Overall, 58% (n = 174) reported to have ever consumed alcohol and 23% (n = 68) to have used it in the past month. Among the 300 women, 10% (n = 30) had EtG levels in their urine sample and of these, 40% (n = 12) reported to have never consumed alcohol, using a self-reported survey (p = 0.035). Recent alcohol use was relatively low among the women in this study. However, the discordance between self-reported alcohol use and the presence of EtG presents concerns about the accuracy of self-reported alcohol use. Additional research is needed to contextualize self-reported alcohol use, social desirability, and the implications for alcohol prevention and intervention strategies for young women in urban Kampala. Full article
(This article belongs to the Special Issue Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention)
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18 pages, 959 KiB  
Systematic Review
Domiciliary Carers’ Perspectives on Alcohol Use by Older Adults in Their Care: A Systematic Review and Thematic Synthesis of Qualitative Studies
by Catherine Haighton, Mel Steer and Beth Nichol
Int. J. Environ. Res. Public Health 2024, 21(10), 1324; https://doi.org/10.3390/ijerph21101324 - 6 Oct 2024
Viewed by 1635
Abstract
As global populations continue to age, alcohol consumption rises, and we strive to age in place, it is important to have an up-to-date understanding of domiciliary carers’ perspectives on older adults’ alcohol use in their care. Therefore, a systematic review and thematic synthesis [...] Read more.
As global populations continue to age, alcohol consumption rises, and we strive to age in place, it is important to have an up-to-date understanding of domiciliary carers’ perspectives on older adults’ alcohol use in their care. Therefore, a systematic review and thematic synthesis of qualitative studies of the unique challenges faced by domiciliary care workers in front line roles regarding older adults’ alcohol use was conducted (PROSPERO registration number: CRD42024516660). Eight databases were searched on 22 February 2024 for qualitative studies focusing on older adults’ (defined as aged 50 or over) alcohol consumption and domiciliary care. The Critical Appraisal Skills Programme checklist was utilised for quality appraisal. Twenty articles reporting 14 unique studies of mainly medium to low quality were included. Three overarching themes (and associated subthemes) were identified as follows: identification (alcohol problems are common, no assessment for alcohol problems, and additional overt signs of excessive alcohol use), management (to buy or not to buy that is the question, balancing rights and risks, monitor and report but do not intervene, maintaining the vicious circle, home as a barrier to accessing support and services, and more support needed from healthcare professionals), and training (lack of alcohol education). Domiciliary carers are well placed to make every contact count to target alcohol consumption but would benefit from support and resources for alcohol consumption identification and management. Clear guidance on how to manage alcohol consumption to harmoniously balance rights and risks is crucial, particularly when caring for older adults with cognitive difficulties. Full article
(This article belongs to the Special Issue Alcohol Use in Disadvantaged Populations: Health Equalities and Appropriate Intervention)
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