Patterns of alcohol use among people with and without disabilities: a secondary analysis of 29 Multiple Indicator Cluster Surveys from Low- and Middle-Income Countries.

BACKGROUND

Limited disability-disaggregated alcohol data in low- and middle-income countries (LMICs) hinders progress towards Sustainable Development Goal (SDG) 3.5, which focuses on strengthening the prevention and treatment of substance abuse, including narcotic drug abuse and harmful alcohol use.

OBJECTIVES

To compare patterns of alcohol use between people with and without disabilities, while also examining variation across functional domains associated with disability and adjusting for socio-economic and environmental determinants of drinking behaviour.

METHODS

We analysed Multiple Indicator Cluster Surveys from 29 LMICs. We estimated the adjusted prevalence ratios (aPR) for alcohol-related outcomes comparing adults with and without disabilities by sex and for each country, using modified Poisson regression. Meta-analyses were performed to pool country-specific estimates for each outcome.

RESULTS

Our analyses included 353,305 adults, including 18,532 adults with disabilities. Women with disabilities had a higher prevalence of lifetime alcohol use (aPR: 1.12; 95% confidence interval [CI]: 1.05-1.19), current alcohol use (aPR: 1.11; 95% CI: 1.01-1.22), and alcohol use before age 15 (aPR: 1.31; 95% CI: 1.16-1.48) compared with women without disabilities. Men with disabilities experienced only a higher prevalence of lifetime alcohol use (aPR: 1.07; 95% CI: 1.05-1.19). People with difficulty in vision, self-care, walking, or remembering or concentrating domains experienced greater inequities in alcohol-related outcomes compared with people without disabilities.

CONCLUSIONS

Women with disabilities were more likely to report alcohol use. Among men, alcohol use was high and frequent regardless of disability status. These findings highlight the need to develop health policies that explicitly incorporate a disability component to advance progress toward the SDGs in LMICs.