Individual- and area-level inequalities in alcohol-related disorders and emergency hospital admissions in Catalonia

Aims This study examines socioeconomic inequalities in alcohol-related emergency room (ER) visits in Catalonia, combining individual and area-level socioeconomic factors and comparing the results with the ones for all ER visits. Methods This population-based study retrospectively analyzed all 7 043 795 individuals aged 12 and older who received public healthcare in Catalonia in 2022 using sociodemographic, ER visits, and medical diagnoses data. Individuals were classified by individual-based and area-based socioeconomic levels (ISL and ASL, respectively). Binomial models assessed associations between ISL and ER visits, stratifying results by sex, age, and ASL. Alternative models were performed including interactions between both socioeconomic levels. Results In 2022, 22.2% of individuals visited ERs, of which 0.45% accounted for alcohol-related ER visits. Socioeconomic disparities were evident: individuals in the lowest ISL had an alcohol-related ER visit prevalence six times higher than the highest ISL. This pattern persisted across ASL, with more pronounced effects in wealthier regions. Age and sex influenced trends, with middle-aged males from low ISL groups showing the highest prevalence ratios. Interaction analysis revealed that the combined effect of low individual socioeconomic status and living in disadvantaged areas was smaller than would be expected if the effects were multiplicative. Conclusions Significant socioeconomic disparities in ER visits exist in Catalonia, with lower socioeconomic groups, especially at the individual level, experiencing higher rates of alcohol-related ER visits. These findings underscore the need to address socioeconomic inequalities in healthcare access, particularly concerning alcohol-related health outcomes, highlighting the need to further research ISL and ASL interactions.