Special Issue "Social Determinants of Alcohol Use and Its Consequences"

Special Issue Editors

Dr. Charlotte Probst
E-Mail Website
Guest Editor
1. Heidelberg Institute of Global Health, Universitätsklinikum Heidelberg, 69120 Heidelberg, Germany
2. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
Interests: population health modeling; epidemiology of alcohol use and attributable burden of disease; social determinants of health; socioeconomic inequality
Dr. Shannon Lange
E-Mail Website
Guest Editor
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
Interests: population health modeling, epidemiology of suicidal thoughts and behaviors, alcohol-attributable harm, fetal alcohol spectrum disorder

Special Issue Information

Dear Colleagues,

Alcohol is an established risk factor for a wide range of outcomes, including numerous noncommunicable diseases and nearly all intentional and nonintentional injuries. With over 200 causally related conditions, alcohol use is known to cause around 3 million deaths and over 130 million disability-adjusted life years annually. What these high-level indicators fail to reflect are the health disparities that exist conditional on the social determinants of health, including sex, gender, socioeconomic status, and, in the broader sense, the social, political, and economic conditions in which people live. For instance, there is mounting evidence that the stagnation and following decline in life expectancy in the United States is linked to alcohol use, with individuals in the low socioeconomic strata carrying the largest part of the burden. To understand the full epidemiological picture of alcohol use and its consequences, the role and impact of the diverse social determinants and the inequalities related to them must be studied.

Not only do social determinants influence alcohol use directly, but there are also several examples where they influence the relationship between alcohol use and health outcomes. For example, the relationship between alcohol use and its various outcomes is more often than not found to differ by sex and gender, as is the case with suicide. Women with an alcohol use disorder have been found to have a two-fold higher risk of death by suicide than men with an alcohol use disorder. Furthermore, the risk relationships between alcohol use and health burden likely differ from one country context to another. However, currently, the bulk of evidence on such relationships is based on a fairly uniform group of western, high-income countries.

Moving forward, alcohol use and its consequences must be understood in the context of wider social and economic determinants, rather than considering it merely as individual health behavior. Accordingly, this Special Issue is intended to draw attention to the importance of social determinants of alcohol use and its consequences by providing a forum to publish this line of research.

Dr. Charlotte Probst
Dr. Shannon Lange
Guest Editors

Manuscript Submission Information

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Keywords

  • social determinants of health
  • alcohol use
  • alcohol use disorders
  • alcohol-attributable burden
  • health inequalities

Published Papers (1 paper)

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Review

Review
Beyond Behaviour: How Health Inequality Theory Can Enhance Our Understanding of the ‘Alcohol-Harm Paradox’
Int. J. Environ. Res. Public Health 2021, 18(11), 6025; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116025 - 03 Jun 2021
Viewed by 983
Abstract
There are large socioeconomic inequalities in alcohol-related harm. The alcohol harm paradox (AHP) is the consistent finding that lower socioeconomic groups consume the same or less as higher socioeconomic groups yet experience greater rates of harm. To date, alcohol researchers have predominantly taken [...] Read more.
There are large socioeconomic inequalities in alcohol-related harm. The alcohol harm paradox (AHP) is the consistent finding that lower socioeconomic groups consume the same or less as higher socioeconomic groups yet experience greater rates of harm. To date, alcohol researchers have predominantly taken an individualised behavioural approach to understand the AHP. This paper calls for a new approach which draws on theories of health inequality, specifically the social determinants of health, fundamental cause theory, political economy of health and eco-social models. These theories consist of several interwoven causal mechanisms, including genetic inheritance, the role of social networks, the unequal availability of wealth and other resources, the psychosocial experience of lower socioeconomic position, and the accumulation of these experiences over time. To date, research exploring the causes of the AHP has often lacked clear theoretical underpinning. Drawing on these theoretical approaches in alcohol research would not only address this gap but would also result in a structured effort to identify the causes of the AHP. Given the present lack of clear evidence in favour of any specific theory, it is difficult to conclude whether one theory should take primacy in future research efforts. However, drawing on any of these theories would shift how we think about the causes of the paradox, from health behaviour in isolation to the wider context of complex interacting mechanisms between individuals and their environment. Meanwhile, computer simulations have the potential to test the competing theoretical perspectives, both in the abstract and empirically via synthesis of the disparate existing evidence base. Overall, making greater use of existing theoretical frameworks in alcohol epidemiology would offer novel insights into the AHP and generate knowledge of how to intervene to mitigate inequalities in alcohol-related harm. Full article
(This article belongs to the Special Issue Social Determinants of Alcohol Use and Its Consequences)
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