Solving the “Alcohol Harm Paradox”

Alcohol is responsible for 5.1 % of the global burden of disease and injury (disability adjusted life years) and 3.3 million deaths worldwide. Soak that up for a second.

Now recognize that people in deprived communities have higher levels of alcohol-related ill health than people in non-deprived communities, despite drinking the same amounts of alcohol. This is what the health sciences community has referred to as the “alcohol harm paradox.”

There have been a few theories and postulations about this paradox, but finally a study has been done which ties up all the loose ends pretty conclusively. The results of the collaboration that included teams from Bangor University, Liverpool John Moores University and Alcohol Research UK have just been published on BioMed Central.

What the researchers learned is that alcohol consumption becomes a sort of “force multiplier” in poor communities. “Deprived” drinkers are more likely than their wealthier counterparts to drink alcohol as part of a suite of health challenging behaviors. These include smoking, excess weight gain poor diet, and not enough exercise. This additional bad behavior created a geometric increase in the risks of wholly (e.g. alcoholic liver disease) and partly (e.g. cancers) alcohol-related conditions.

Binge drinking was another activity tagged in deprived communities for which there was no equivalent corresponding behavior in affluent neighborhoods. This type of drinking increases the risks of injury and heart disease despite total alcohol consumption not differing from affluent counterparts. In other words, deprived people may drink the same quantity of alcohol over the same period of time as affluent people but were likely to do so in fewer sittings, and so were sustaining more alcohol-related injuries, as well as cardio problems, from these isolated “drinking bouts.” 

The paradox may be solved, but how do we fix the problem? Public health messages on how smoking, poor diet/exercise and binging escalate health risks associated with alcohol are needed, especially in deprived communities, as their absence will contribute to health inequalities.