The alcohol harm paradox. Poorer people drink the same or less than others but have more alcohol-related problems. Some people think that more drinking in a population leads to more alcohol-related problems. But that’s very a simplistic belief.

World-wide research shows that countries with higher drinking rates generally have fewer drinking problems. That’s in comparison to those countries where drinking is lower.¹

In addition, the paradox is a good example of this fact within countries. 

Researchers generally state social status in terms of socioeconomic status or SES. They calculate it by some combination of income, occupation, and/or education.²

The paradox is found around the world. It’s found in socialist, communist, and capitalist economies. In developed and developing countries. It’s found under dictators and freely elected leaders. In short, it’s everywhere. That fact makes it harder to understand.

Also the paradox is stronger in men and younger age groups.³ On the other hand, that fact might make it easier to explain.

I. Possible Reasons

There are a number of possible reasons for the paradox. They include these.³

1. 1. Drinking patterns differ. For instance, having two daily drinks (14 weekly) promotes good health⁵ and longer life.⁶ But having 14 drinks one night easily leads to many problems. So-called bingeing occurs more often among lower SES groups.
   2. Unhealthful behaviors. These include smoking, poor diet, “bingeing,” and fighting. Also excess weight, poor exercise, and dangerous jobs. These are more common among lower SES groups.
   3. Methods problems. These include such things as erroneous government statistics and inaccurate self-reports.

All of these could contribute to the paradox. If so, the exact degree now remains unknown.

Alcohol Harm Paradox

II. Resources

   Web

• • Harm Reduction for Alcohol Abuse.
  • Alcohol Abuse.
  • Harm Reduction for Drinking.

   Readings

• • Bellis, M. et al. The alcohol harm paradox. BMC Pub Health, 1-10. 
  • Lewer, D. et al. Unravelling the alcohol harm paradox. BMC Pub Health, art #599.

   Footnotes

1. 1. Peele, S. Utilizing cultural and behaviour of alcohol consumption and consequences. Alco Alco, 32(1), 51-64.
   2. Berzofsky, M. et al. Measuring Socioeconomic Status (SES). Wash: DOJ.
   3. Beard, E. et al. Alcohol Harm Paradox. PLoS One, 11(9), e0160666.
   4. Boyd, J. Beyond behaviors. SHAAP/SARN. 
   5. Alcohol and Health
   6. Drinkers Live Longer