OBJECTIVE: Register-based studies analyze existing population registers consisting of individual-level data, which have been systematically collected and regularly updated on a complete target population. This review maps the research literature on register-based studies of alcohol's harms to family members and identifies areas for future research. Using a scoping review methodology, studies that included register-based outcome sources, a family relationship, and an exposure to heavy drinking. 91 studies were included in the final review.

RESULTS: Register-based research on alcohol's harms to family members has largely drawn on hospital records to identify heavy drinkers and has primarily focused on children of heavy drinkers; 79 of the included studies solely investigated harms to children, whereas 2 focused on partners and 10 on multiple first-degree or unspecified relatives. Register-based studies show that children of heavy drinkers are at a higher risk for mental disorders, disease and injury hospitalizations, infant and child mortality, criminality, poor employment and educational outcomes, abuse/neglect, and placement in residential/foster care, among other negative outcomes.

CONCLUSIONS: A substantial body of register-based research shows that children of parents with the most severe alcohol problems are at an increased risk for numerous adverse experiences. Register-based studies have investigated diverse, yet precisely defined outcomes, using large samples followed over long periods, and have examined the contribution of genetic, biological, and environmental factors. Our understanding of alcohol's harms to families could be enhanced by further register-based research on other household family members of heavy drinkers.

[See also, Commentary: Using registry data to better understand alcohol's harm to others]