Abstract
BackgroundStudies show that alcohol consumption appears to have a disproportionate impact on people of low socioeconomic status. Further exploration of the relationship between alcohol consumption, socioeconomic status and the development of chronic alcohol-attributable diseases is therefore important to inform the development of effective public health programmes.MethodsWe used systematic review methodology to identify published studies of the association between socioeconomic factors and mortality and morbidity for alcohol-attributable conditions. To attempt to quantify differences in the impact of alcohol consumption for each condition, stratified by SES, we (i) investigated the relationship between SES and risk of mortality or morbidity for each alcohol-attributable condition, and (ii) where, feasible explored alcohol consumption as a mediating or interacting variable in this relationship.ResultsWe identified differing relationships between a range of alcohol-attributable conditions and socioeconomic indicators. Pooled analyses showed that low, relative to high socioeconomic status, was associated with an increased risk of head and neck cancer and stroke, and in individual studies, with hypertension and liver disease. Conversely, risk of female breast cancer tended to be associated with higher socioeconomic status. These findings were attenuated but held when adjusted for a number of known risk factors and other potential confounding factors. A key finding was the lack of studies that have explored the interaction between alcohol-attributable disease, socioeconomic status and alcohol use.ConclusionsDespite some limitations to our review, we have described relationships between socioeconomic status and a range of alcohol-attributable conditions, and explored the mediating and interacting effects of alcohol consumption where feasible. However, further research is needed to better characterise the relationship between socioeconomic status alcohol consumption and alcohol-attributable disease risk so as to gain a greater understanding of the mechanisms and pathways that influence the differential risk in harm between people of low and high socioeconomic status.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1720-7) contains supplementary material, which is available to authorized users.
Highlights
Studies show that alcohol consumption appears to have a disproportionate impact on people of low socioeconomic status
Measures of alcohol use varied across the included studies: studies [15,16,17,19,20,25,28,29,31,34,41] reported number of drinks or glasses consumed in a day or week; studies
While in practice we found that relatively few studies presented a sufficient level of information to enable a joint analysis of socioeconomic status (SES) and alcohol consumption, we acknowledge that the limitations of our search strategy and inclusion criteria may in part have contributed to the lack of study identification
Summary
Studies show that alcohol consumption appears to have a disproportionate impact on people of low socioeconomic status. While many studies have found that the burden of alcohol-related mortality and morbidity falls most heavily on people of low SES [2,3,4,5,6,7], actual alcohol consumption patterns tend to show a deviation from the traditional pattern observed with risky health behaviours. This gives rise to a paradox whereby disadvantaged populations that apparently have the same, or a lower level, of alcohol consumption suffer greater alcohol-related harm than more affluent populations. Further exploration of the relationship between alcohol consumption, SES and the development of alcohol-attributable diseases, is important in order to understand the contribution they make to the disproportionate impact that alcohol consumption appears to have on those of low SES and to inform the development of effective public health programmes
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
