Toggle Main Menu Toggle Search

Open Access padlockePrints

Deconstructing the Alcohol Harm Paradox: A Population Based Survey of Adults in England

Lookup NU author(s): Professor Eileen Kaner

Downloads


Licence

This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

BackgroundThe Alcohol Harm Paradox refers to observations that lower socioeconomic status (SES) groups consume less alcohol but experience more alcohol-related problems. However, SES is a complex concept and its observed relationship to social problems often depends on how it is measured and the demographic groups studied. Thus this study assessed socioeconomic patterning of alcohol consumption and related harm using multiple measures of SES and examined moderation of this patterning by gender and age.MethodData were used from the Alcohol Toolkit Study between March and September 2015 on 31,878 adults (16+) living in England. Participants completed the AUDIT which includes alcohol consumption, harm and dependence modules. SES was measured via qualifications, employment, home and car ownership, income and social-grade, plus a composite of these measures. The composite score was coded such that higher scores reflected greater social-disadvantage.ResultsWe observed the Alcohol Harm Paradox for the composite SES measure, with a linear negative relationship between SES and AUDIT-Consumption scores (beta = -0.036, p<0.001) and a positive relationship between lower SES and AUDIT-Harm (beta = 0.022, p<0.001) and AUDIT-Dependence (beta = 0.024, p<0.001) scores. Individual measures of SES displayed different, and non-linear, relationships with AUDIT modules. For example, social-grade and income had a u-shaped relationship with AUDIT-Consumption scores while education had an inverse u-shaped relationship. Almost all measures displayed an exponential relationship with AUDIT-Dependence and AUDIT-Harm scores. We identified moderating effects from age and gender, with AUDIT-Dependence scores increasing more steeply with lower SES in men and both AUDIT-Harm and AUDIT-Dependence scores increasing more steeply with lower SES in younger age groups.ConclusionDifferent SES measures appear to influence whether the Alcohol Harm Paradox is observed as a linear trend across SES groups or a phenomenon associated particularly with the most disadvantaged. The paradox also appears more concentrated in men and younger age groups.


Publication metadata

Author(s): Beard E, Brown J, West R, Angus C, Brennan A, Holmes J, Kaner E, Meier P, Michie S

Publication type: Article

Publication status: Published

Journal: PLoS One

Year: 2016

Volume: 11

Issue: 9

Online publication date: 28/09/2016

Acceptance date: 23/07/2016

Date deposited: 03/01/2017

ISSN (print): 1932-6203

Publisher: Public Library of Science

URL: http://dx.doi.org/10.1371/journal.pone.0160666

DOI: 10.1371/journal.pone.0160666


Altmetrics

Altmetrics provided by Altmetric


Actions

Find at Newcastle University icon    Link to this publication


Share