Breaking the Cycle: New Study Reveals Scale of Household Substance Misuse Affecting Children in Wales
A new study using population-scale linked data from health, criminal justice, and children’s social care, uncovers the scale and factors associated with substance misuse within Welsh households.
The study, published in the International Journal of Population Data Science (IJPDS), was conducted with the SAIL Databank. The research shows that children living with adults who misuse alcohol or drugs experience significantly higher deprivation, poorer birth outcomes, and increased mental health issues, social care involvement, and exposure to suicide. The findings underscore an urgent need for early intervention and evidence-based policy to protect children and disrupt cycles of intergenerational harm.
Substance misuse – defined as repeated use of alcohol or drugs that causes harm – is a leading global cause of disability. While its effects on individuals are well known, this study highlights its broader impact on families and future generations. Children in affected households often face multiple, compounding challenges, including poverty, instability, and emotional trauma. In Wales, substance misuse has long been recognised as a major public health issue, with national frameworks such as the Well-being of Future Generations (Wales) Act 2015 and the Welsh Government’s Substance Misuse Delivery Plan emphasising prevention and long-term well-being. This research demonstrates how deeply these issues intersect across health, social care, and justice systems.
By linking records from general practice, hospitals, emergency departments, social care, substance misuse treatment services, and criminal justice, the researchers built a comprehensive picture of more than 1.8 million people in Wales between 2011 and 2019. They found that 11% of Welsh children (over 83,000) lived in a household where at least one adult had a documented substance misuse event. These children were more likely to be born preterm or with low birthweight and had higher rates of mental health issues and self-harm. Adults in these households had suicide prevalence nearly ten times higher than the rest of the population. Children were also far more likely to come into contact with social care or appear in substance-related criminal court cases, demonstrating how household substance misuse contributes to widening social inequalities.
Lead author Dr Hywel T Evans, Senior Data Scientist & User Support Lead at SAIL Databank, said, “This study was close to my heart, having friends and family affected by substance misuse. We were able to link the new Ministry of Justice data with 11 national datasets in SAIL to consider all adults in a household, then compare households with substance misuse to the rest of the population. These statistics provide an evidence base to inform policy and public service decision-makers of the scale and complexity of the issues associated with substance misuse in Wales, so that we can improve support.”
The findings highlight a compelling case for change: earlier identification of at-risk households, improved access to treatment for adults, and more coordinated support across sectors. By bringing together data from multiple services, this research offers one of the clearest pictures to date of how substance misuse affects entire households. Breaking the cycle requires an integrated, family-focused response that supports both adults and children in building healthier, more stable futures.
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Dr Hywel Turner Evans, Senior Data Scientist & User Support Lead, SAIL User & Data Support Services Team, Population Data Science, Swansea University, Wales, UK