Using multi-level data to estimate the effect of social capital on hazardous alcohol consumption in the former Soviet Union

Hazardous alcohol consumption is a leading cause of mortality in the former Soviet Union (fSU), but little is known about the social factors associated with this behaviour. We set out to estimate the association between individual- and community-level social capital and hazardous alcohol consumption in the fSU. Data were obtained from Health in Times of Transition 2010, a household survey of nine fSU countries (n = 18 000 within 2027 communities). Individual-level indicators of social isolation, civic participation, help in a crisis and interpersonal trust were aggregated to the community level. Adjusting for demographic factors, the association of individual- and community-level indicators with problem drinking (CAGE) and episodic heavy drinking was estimated using a population average model for the analysis of multi-level data. Among men, individual social isolation [odds ratio (OR) = 1.20], community social isolation (OR = 1.18) and community civic participation (OR = 4.08) were associated with increased odds of CAGE. Community civic participation (OR = 2.91) increased the odds of episodic heavy drinking, while community interpersonal trust (OR = 0.89) decreased these odds. Among women, individual social isolation (OR = 1.30) and community civic participation (OR = 2.94) increased odds of CAGE. Our results provide evidence of the role of some elements of social capital in problem drinking in the fSU, and highlight the importance of community effects. The nature of civic organizations in the fSU, and the communities in which civic participation is high, should be further investigated to inform alcohol policy in the region.