This research report identified and reviewed the current research literature about the impacts on children of heavy parental alcohol use.
Research on alcohol-related harm has historically focused primarily on the negative effects of alcohol consumption on the individual drinker. As a result the wider social costs of alcohol use on children and families (the ‘externalities’ – costs which do not accrue to the drinker) have not been examined thoroughly, particularly within the New Zealand context. Where the impacts of familial alcohol use have been investigated it has often been in the alcohol problem treatment field. The impact of heavy parental or caregiver alcohol use on children and young people is a social issue that urgently requires further research and public debate.
In 2005 a survey carried out by the Centre for Social & Health Outcomes Research & Evaluation (SHORE) in the Auckland region interviewed young people aged 12-17 years and one of their parents/caregivers. The survey found that between 4 and 5 percent of households had at least one parent/caregiver who is a heavy drinker. This figure alone suggests that the issue of the impact of heavy use of alcohol by a parent or caregiver on young people’s health and wellbeing requires substantive further consideration.
The research literature however has a number of gaps. Firstly, there is a large gap in New Zealand research on the impact of heavy drinking on children and families. We do not have a good estimate of how many children are likely to be living in households in New Zealand with one or more relative who is a heavy drinker. Little is known of the impacts of heavy drinking behaviour on children’s and adolescents’ physical and mental health, behaviour, educational performance and alcohol use in Māori and Pacific families, despite disproportionate heavy use as evidenced by drinking surveys. Some implications can be drawn from the literature on the history of indigenous drinking practices as well as the studies on the effects of drinking on children in low-income families. However, given that many Māori and Pacific families are already experiencing socio-economic disadvantage, it might be expected that the poverty cycle and negative impacts on children would be exacerbated by the addition of parental alcohol abuse problems. Further research is needed to understand the specific dynamics and impacts on children in Māori and Pacific families.
In general, many studies have found that parental alcohol problems are associated with a range of negative outcomes in children and adolescents, including poorer physical and psychological health, educational and behavioural deficits, and an increased rate of subsequent alcohol problems. While most of the studies included were rated as weak due to methodological problems (such as selection bias, allocation bias, failure to control for confounders, lack of binding and attrition), there was consistency across the studies and they demonstrated impacts on the offspring of heavier drinkers.
This report was prepared for the Families Commission Blue Skies Fund by Melissa Girling, John Huakau, Sally Casswell & Kim Conway.
Purpose
This review aims to identify and review the current research literature about the impacts of heavy parental alcohol use on children.
Objectives
1. To undertake a systematic review of previous international and national research on the impacts of heavy parental alcohol use on children.
2. To identify gaps where further research is needed.
Methodology
Published literature
Relevant research literature concerning the impact of heavy parental use of alcohol on children was identified by searching the biomedical and social science databases for primary published research material. A total of eight databases (MEDLINE, Web of Science, SSCI, EBM Reviews, ETOH, PubMed, PsychInfo and CINAHL) were searched for publications from 1990 to 2005.2 In order to capture all relevant studies, the search terms remained broad. These were: ’parent/s or caregiver‘, plus ’child, children, adolescent, teenager, boys, girls, or youth’, plus ’drinking, alcoholism, or alcohol dependence or substance abuse‘ in the title or abstract. A total of 784 published studies were initially identified from the search criteria.
Grey literature
A number of alcohol and drug-related databases were identified from the ETOH database to search for grey literature (defined as research literature not published in peer-reviewed journals or books). These were the Cork Database, Alcohol Studies Database, Alcohol Advisory Council of New Zealand (ALAC) library database, Alcohol and Drug Council of Australia and the Canadian Centre on Substance Abuse. These databases are not set up for sophisticated searching, therefore searches included the following road terms: adult COA; children of alcoholics; family and parental drinking.
Key Results
In general, many studies have found that parental alcohol problems are associated with a range of negative outcomes in children and adolescents, including poorer physical and psychological health, educational and behavioural deficits, and an increased rate of subsequent alcohol problems. While most of the studies were rated as weak due to methodological problems (such as selection bias, allocation bias, failure to control for confounders, lack of binding and attrition), there was consistency across the studies and they demonstrated impacts on the offspring of heavier drinkers.
The research literature in general supports these conclusions:
1) Relationships exist between heavy drinking parents/caregivers and risk for higher hospital admission rates and higher rates of injuries and poisoning rates for children and adolescents. Also, Foetal Alcohol Syndrome (FAS) and Foetal Alcohol Effects (FAE) for children in utero.
2) Relationships exist between heavy drinking parents/caregivers and risk for eating disorders (for females), anxiety, mood disorders, depression, conduct disorders, aggression, disruptive behaviour disorders, attention deficit/hyperactivity, delinquency and psychiatric disorders for children and adolescents.
3) Relationships exist between poorer educational achievement of children and adolescents of heavy drinking parents/families that are likely due to the poor level of family functioning and social environment.
4) Relationships exist between heavy drinking parents/caregivers and the subsequent heavy alcohol use and related problems in adolescence.
5) Important mechanisms involved in the impact on children of heavy drinking parents/caregivers include: parental conflict; violence against children; parental absence; living standards; and parental control/supervision.
6) There is a need for longitudinal and qualitative research, both locally and internationally. Studies on the general population are lacking (and there is very limited research and information on impacts within Māori and Pacific families in New Zealand).