The association between alcohol drinking and self-reported mental and physical functioning: a prospective cohort study among City of Helsinki employees

OBJECTIVES: Alcohol drinking is associated with ill health but less is known about its contribution to overall functioning. We aimed to examine whether alcohol drinking predicts self-reported mental and physical functioning 5-7 years later. DESIGN: A prospective cohort study. SETTING: Helsinki, Finland. PARTICIPANTS: 40-year-old to 60-year-old employees of the City of Helsinki (5301 women and 1230 men) who participated in a postal survey in 2000–2002 and a follow-up survey in 2007. PRIMARY AND SECONDARY OUTCOME MEASURES: Mental and physical functioning measured by the Short Form 36 Health Survey. RESULTS: Alcohol drinking was differently associated with mental and physical functioning. Heavy average drinking, binge drinking and problem drinking were all associated with subsequent poor mental functioning except for heavy average drinking among men, whereas only problem drinking was associated with poor physical functioning. Also, non-drinking was associated with poor physical functioning. Problem drinking was the drinking habit showing most widespread and strongest associations with health functioning. The associations between problem drinking and poor mental functioning and with poor physical functioning among women remained after adjusting for baseline mental functioning, sociodemographic factors, working conditions and other health behaviours. CONCLUSIONS: Alcohol drinking is associated especially with poor mental functioning. Problem drinking was the drinking habit strongest associated with poor health functioning. The results call for early recognition and prevention of alcohol problems in order to improve health functioning among employees.