Addressing inequities in alcohol consumption and related harms

December 2015
Roche A, Kostadinov V, Fischer J, Nicholas R, O'Rourke K, Pidd K, Trifonoff A (2015). Addressing inequities in alcohol consumption and related harms. Health Promotion International 2015 Sep;30 Suppl 2:ii20-ii35. doi: 10.1093/heapro/dav030.

To-date little Australian research has addressed the relationships between social determinants, inequities, and alcohol consumption and related harms. This study reviewed how social inequities may influence alcohol consumption and alcohol-related health outcomes in Australia. It found that people living in lower socio-economic circumstances experienced more harm than those who are better off after consuming the same amount of alcohol. To-date, the inequitable distribution of alcohol-related harm has not been addressed in Australia’s alcohol-related interventions and policies.

Strategies for reducing inequities associated with alcohol use and related harms were identified using the VicHealth framework for health equity ‘Fair Foundations’ as an organising schema. Fair Foundations posits that social contexts influence individuals’ social position and in turn their health and well-being via three ‘layers of influence’: (i) socioeconomic, political and cultural context; (ii) daily living conditions and (iii) individual health-related factors. While not always an optimal fit, Fair Foundations provided a useful schema by which to begin to examine this complex area.

Findings from the review also suggest that current mechanisms may have an unintended impact by exacerbating harms experienced by marginalised groups. The review identified the most promising alcohol-related approaches for promoting health equity as well as the interventions which may worsen inequities. It also highlighted the need for further research on the best methods for reducing inequities in alcohol consumption and related harms.

This study was funded by VicHealth.

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