Academic journal article Alcohol Research: Current Reviews

Associations between Socioeconomic Factors and Alcohol Outcomes

Academic journal article Alcohol Research: Current Reviews

Associations between Socioeconomic Factors and Alcohol Outcomes

Article excerpt

Socioeconomic status (SES) is one of the many factors influencing a person's alcohol use and related outcomes. Findings have indicated that people with higher SES may consume similar or greater amounts of alcohol compared with people with lower SES, although the latter group seems to bear a disproportionate burden of negative alcohol-related consequences. These associations are further complicated by a variety of moderating factors, such as race, ethnicity and gender. Thus, among individuals with lower SES, members of further marginalized communities, such as racial and ethnic minorities and homeless individuals, experience greater alcohol-related consequences. Future studies are needed to more fully explore the underlying mechanisms of the relationship between SES and alcohol outcomes. This knowledge should be applied toward the development of multilevel interventions that address not only individual-level risks but also economic disparities that have precipitated and maintained a disproportionate level of alcohol-related consequences among more marginalized and vulnerable populations.

Key words: Alcohol consumption; alcohol-related problems; alcohol-related consequences; special populations; socioeconomic status; socioeconomic factors; economic disparities; racial minority; ethnic minority; homeless

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According to the World Health Organization (2014), alcohol consumption is responsible for approximately 5.9 percent of deaths worldwide and a global loss of 139 million disability-adjusted life-years. The alcohol-related disease burden is precipitated in part by acute intoxication, which decreases reaction time, perception and motor skills, and inhibitions and is thereby associated with an increased risk for traffic accidents, self-inflicted injuries, suicide, falls, drownings, alcohol poisoning, and interpersonal violence. Longer-term effects of alcohol consumption also contribute to the disease burden by way of various medical conditions (e.g., cancer, cardiovascular disease, and liver cirrhosis) and psychiatric disorders (e.g., depression and alcohol use disorder [AUD]). Given the strong positive association between alcohol use and negative alcohol-related consequences, it is important to understand social determinants of these alcohol outcomes.

The quantity and frequency of a person's alcohol use, the resulting negative alcohol-related consequences (also known as alcohol-related problems), and his or her risk of AUD are determined by a variety of influences. These include higher-level chrono- and macrolevel factors, such as historical time and geopolitical context, as well as meso-, micro-, and individual-level factors, such as community context, family/peer influences, biological predisposition, effects of prenatal alcohol exposure, psychological factors, and sociodemographic features (e.g., gender, age, race, ethnicity, culture, religious affiliation, and socioeconomic status [SES]) (Edwards 2000; Gately 2008). These factors, which operate within various systems and levels, interact and transact over time to determine alcohol-related outcomes, such as drinking patterns and negative alcohol-related consequences (Gruenewald et al. 2014; Holder 1998).

This article focuses on one particular aspect of this complex set of systems, namely the relationship between SES- including income/economic factors, educational level, employment status, and housing status-and alcohol-related outcomes. It synthesizes data primarily obtained from English-language systematic reviews and meta-analyses that were based on studies conducted in the past decade involving adult populations (for a summary of these reviews and meta-analyses, see table 1). In some cases, these analyses were limited to studies from only one country, whereas other analyses were cross-national. In any case, caution must be used when interpreting these findings, because the cultural and political contexts in which these phenomena occur can differ widely. …

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