Alcohol Harm Paradox: What It Is & Why It’s Important

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.

DON’T BE FOOLED! A beer has the same amount of pure alcohol as a glass of dinner wine or a shot of whiskey. It’s 6/10th of an ounce in each case.

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.Alcohol Harm Paradox

In addition, 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. Drinking patterns differ. For example, having two daily drinks (14 weekly) promotes good health5 and longer life.6 However, having 14 drinks one night easily leads to many problems. So-called bingeing occurs more often among lower SES groups.
    2. alcohol harm paradoxUnhealthful 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, however, the exact degree now remains unknown.

II. Resources: Alcohol Harm Paradox

Web Pages

Harm Reduction for Alcohol Abuse.

Alcohol Abuse.

Harm Reduction for Drinking.


Bellis, M. et al. The alcohol harm paradox. BMC Pub Health, 2016, 1-10. 

Lewer, D. et al. Unravelling the alcohol harm paradoxBMC Pub Health, 2016, art #599.


    1. Peele, S. Utilizing cultural and behaviour of alcohol consumption and consequences. Alco Alco, 1997, 32(1), 51-64.
    2. Berzofsky, M. et al. Measuring Socioeconomic Status (SES). Washington: Dept Justice, 2014.
    3. Beard, E. et al. Alcohol Harm Paradox. PLoS One, 2016, 11(9), e0160666.
    4. Boyd, J. Beyond behaviors. SHAAP/SARN Alcohol Occasional, 20 Jan 2021. 
    5. Alcohol and Health
    6. Drinkers Live Longer