Income inequality and alcohol attributable harm in Australia

Abstract

Background: There is little research on the relationship between key socioeconomic variables and alcohol related harms in Australia. The aim of this research was to examine the relationship between income inequality and the rates of alcohol-attributable hospitalisation and death at a local-area level in Australia.

Individual and household‐level socioeconomic position is associated with harmful alcohol consumption behaviours among adults

“…Cultural shifts in women's roles and increased social tolerance of women consuming alcohol and consuming it to excessive levels may contribute to these reverse socioeconomic trends seen between men and women. In Australia and internationally, an increased ‘masculinisation’ of alcohol consumption has been observed in the past two decades, with convergence of women's drinking prevalence and harmful consumption behaviours to levels seen among men 2,7,8,32 . This may reflect broader societal shifts that have occurred in this time, with women becoming less bound to traditional expectations, more assertive in their needs and being more involved in the workforce 32 .…”

“…Australian studies examining the association between socioeconomic position (SEP) and alcohol consumption have been limited in a number of ways. These have only examined a narrow focus of alcohol consumption behaviours such as abstinence 7 and alcohol dependence, 8 but have not investigated alcohol consumption behaviours that relate to short‐ and long‐term health consequences. Patterns of drinking associated with short‐ and long‐term harms are likely to differ markedly, and may vary by SEP.…”

“…Furthermore, in light of emerging research that is emphasising the importance of socioeconomic characteristics of residential areas on residents’ health behaviours, 8,9 no known Australian study to date has examined if the socioeconomic characteristics of areas are independently associated with residents’ alcohol consumption behaviours. Indeed, area‐level data in Australia have shown that socioeconomically‐disadvantaged areas have higher rates of death for conditions that have been associated with harmful alcohol consumption than advantaged areas 8,10 . This is of significance as alcohol‐control strategies in Australia have increasingly become ‘place‐based’ 2 .…”

Income Inequality, Alcohol Use, and Alcohol-Related Problems

“…2,13,14 Among these is a small literature on alcohol that suggests that income inequality is associated with increased frequency of alcohol consumption, 13 volume of alcohol consumed, 14,15 drinking to drunkenness, 14 and death due to chronic alcohol-attributable illnesses. 16 Results are not unequivocal, however. Findings for alcoholic cirrhosis are mixed, with one study finding a positive association for men but not women 15 and others finding no association.…”

“…17,18 Another study documented a curvilinear relationship with alcohol-related hospitalization, suggesting an initial decline in hospitalizations followed by a rapid rise as inequality increases. 16 Finally, one study found that state-level income inequality was negatively associated with women’s alcohol dependence, but not after adjustment for state beer taxes. 19 …”