The Alcohol Harm Paradox: Why the Poor Face More Risk

Deprived communities face higher rates of alcohol related deaths despite drinking the same amount as those in affluent communities


The poor might drink the same as the rich, but they face deadlier consequences because of it. A new study might explain why.

British researchers looked into this alcohol harm paradox and found that the way alcohol is consumed, even in similar amounts, and other lifestyle factors might be why the differences in death rates persist.

"Better awareness of how broader health behaviors exacerbate alcohol-related health harms is invaluable, but addressing the 'harm paradox' also means targeting the structural issues that can make healthier choices harder for people in deprived communities," James Nicholls, Director of Research and Policy Development at Alcohol Research UK, said in a press release.

In this study, conducted by various universities and Alcohol Research UK, researchers conducted a phone survey of 6,015 people in various areas across the UK for almost a year. The authors asked questions about drinking consumption, other health problems such as smoking and excess weight and underreported drinking outside of special occasions.

Nicholls and team found that those in deprived communities reported higher rates of smoking and obesity, along with different drinking patterns and types of alcohol than those in affluent communities. In affluent communities, for instance, about 67 percent of people reported other health issues along with their alcohol consumption, while 83 percent of people reported in poor communities.

"About 9% of increased risk drinkers surveyed in poorer communities also smoked, were overweight and had unhealthy lifestyles," co-author Mark Bellis, professor of Public Health at Bangor University in the UK, said in the release. "Together these combinations can create enormous stresses on people's bodies, overwhelming their ability to limit the health harms caused by alcohol."

Those in poor areas are also likely to drink more beer and liquor, as opposed to wine in affluent areas, while binge drinking when they do imbibe, as opposed to more days of moderate drinking during the week.

"Such behaviors can increase risks of injury and heart disease compared to people who drink the same total amount of alcohol but over more occasions," Bellis said.

According to Harvard University's School of Public Health, which was not involved in the study, wine in moderation could be healthy for the heart, and those who drink daily moderate amounts have a lower risk of heart attack, no matter the type of alcohol.

According to this study's authors, public health campaigns that explain the effects of alcohol and habits like binge drinking, smoking and unhealthy diets should be undertaken to lessen the alcohol paradox.

This study was published February 18 in the journal BMC Public Health.

Alcohol Research UK funded this study.

Researchers declared no conflicts of interest.