# The interplay of alcohol use symptoms and sociodemographic factors in the HELIUS study: A network perspective

## TL;DR

This study explores how alcohol use symptoms and sociodemographic factors interact in a diverse population, revealing how these relationships vary by sex and ethnicity.

## Contribution

The study combines network and epidemiological approaches while stratifying analyses by sex and ethnicity, offering a novel integrative perspective.

## Key findings

- Religion was uniquely and negatively linked to adverse alcohol use problems.
- Socioeconomic factors like education and employment were positively related to binge drinking but negatively to its adverse effects.
- Employment and education showed sex-specific negative relationships with alcohol use symptoms.

## Abstract

Research on alcohol use disorder has exclusively focused on either its symptom-level mechanisms–the network perspective or sociodemographic determinants–epidemiological research. Moreover, such research failed to stratify analyses for important person-level factors (e.g., sex or ethnicity). Here, we combine network and epidemiological research and stratify analyses by person-level factors.

Using Bayesian inference, we estimated (1) a logistic regression model predicting past-year alcohol consumption from various sociodemographic factors within a large, multiethnic, urban sample in the Netherlands (complete sample: N = 22,164), (2) a cross-sectional network model of alcohol use symptoms and sociodemographic factors among alcohol drinkers of the same sample (drinkers: N = 10,877), and (3) stratified networks at the sex- and ethnic- levels in the same drinkers subsample.

All of our examined sociodemographic factors predicted past-year alcohol consumption (in order of magnitude: religion, sex, education, employment, perceived ethnic discrimination, and age). Our Bayesian analysis of networks revealed three notable patterns. First, religion was uniquely and negatively related to adverse alcohol use problems (such as having an injury due to drinking). Second, socioeconomic proxies (education and employment) were positively related to binge drinking, but negatively related to its adverse effects (such as ‘needing a drink in the morning’). Finally, employment and education were particularly negatively related to alcohol use symptoms within male and female networks, respectively.

Our results suggest that alcohol use symptoms are differentially related to sociodemographic factors and that these effects are moderated by sex and ethnicity. Our highlighted network links and Bayesian methodologies could prove useful for future research and prevention and intervention efforts on alcohol use disorders.Word count: 4198 words.

The online version contains supplementary material available at 10.1007/s00127-025-02954-9.