People in deprived communities are many more times likely to suffer alcohol-related disease and death

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At the start of January, the UK Chief Medical Officers announcednew guidelines on low risk drinking. They recommend that, in order to reduce the lifetime risk of dying from an alcohol-related cause to less than 1%, men and women shouldn’t regularly consume more than 14 units of alcohol a week and should avoid drinking heavily on single occasions.

该公告促使有关健康风险的辩论calculated, communicated and interpreted: is a 1% mortality risk low or high, compared to other routine (or leisure) activities?

How should we balance short-term pleasure against potential long-term harm? Is the role of guidelines to inform consumers, to change behavior or to reset our measures of ‘risky’ drinking across the population?

These are all important questions. There is, however, a further question that matters in this context of detailed risk assessment: why is it that, despite drinking similar amounts on average, people in deprived communities are many more times likely to suffer alcohol-related disease and death than more affluent drinkers?

Why does alcohol cause more harm to the poor?

一位的es are startling. In Scotland it is estimated that alcohol-related death rates in the most deprived communities are six times higher than in the most affluent.

一位的es are startling. In Scotland it is estimated that alcohol-related death rates in the most deprived communities aresix times higher比最富裕的。偏斜只是slightly less pronouncedin England and Wales, and isseen throughoutthe developed world.

While some drinkers (including, perhaps, the ‘worried well’) may now be wondering whether they shouldponder cancer risks every time they pour a glass of wine，较少的人问为什么酒精健康危害如此不成比例地降低了穷人的比例，为什么风险似乎被社会经济因素严重扭曲，以及真正的全部含义是什么。

A new study inBMC Public Healthaddresses this question. Its findings touch on the possibility that the skew is – in part at least – to do with the相互作用of health-influencing behaviors.

更大的研究的一部分alcohol harm paradox‘, funded by Alcohol Research UK, the paper analyses data from a national survey and finds some potentially important associations between drinking, diet, smoking, exercise and deprivation.

在贫困的饮酒者中，饮酒更有可能与吸烟和饮食不佳相结合，这表明行为的组合扩大了与任何一项活动相关的健康风险。

The research also identifies higher levels of current and past ‘binge drinking’ among some deprived drinkers, which is known to weaken the protective effects of low consumption on, for example, ischaemic heart disease.

我们还需要知道什么？

We also know that poverty impacts on a range of health outcomes that overlap with partially alcohol-attributable conditions such as hypertension.

There remains, undoubtedly, much more work to do on this issue. We know, for instance, that surveys often suffer low response rates from very poor or marginalized individuals.

We also know that poverty impacts on a range of health outcomes that overlap with partially alcohol-attributable conditions such as高血压. This paper is one contribution to untangling those complex interactions.

Hopefully, the more research we carry out the closer we will come to understanding the ‘harm paradox’. As alcohol-related harms rise up the policy agenda, we need to keep asking why those risks seem different if you’re poor.