The role of social determinants in alcohol consumption and cardiovascular health

The “J”-shaped relationship between alcohol consumption and cardiovascular health is recognised as potentially influenced by residual confounders. A study aimed to clarify what role social determinants play in the relationship.
Using NHANES data from 2005-2018, this study analysed 30,648 participants to assess how eight social determinants (employment, income, food security, education, healthcare access, insurance, housing stability, and marital status) influence the relationship between alcohol consumption and cardiovascular disease (CVD). Moderate drinking reduces CVD risk (HR: 0.741, 95%CI: 0.661, 0.831), while heavy drinking increases it (HR: 1.025, 95%CI: 1.004, 1.095). Structural equation modeling revealed that moderate alcohol consumption was associated with improved social determinants, which accounted for about 50% of the cardiovascular protective effect. In contrast, heavy drinking was associated with poorer social determinants, resulting in negative effects that masked the cardiovascular protective effects.
This study quantifies the role of social and health factors in the relationship between alcohol consumption and CVD. Despite identifying the direct cardiovascular protective effects of alcohol consumption, global health initiatives should continue to advocate for reduced heavy drinking, given the significant risks involved.
Source: Liu, M., Pan, Y., Wang, Z., Wang, J., Shi, Y., Chu, J. (2024) The role of social determinants in alcohol consumption and cardiovascular health: The Pathways Study. Nutr Metabol Cardio Dis,