Alcohol and inequality

James Nicholls | November 2018 | 8 minutes

On Monday 19 November, the first day of Alcohol Awareness Week 2018, Parliamentarians including Baroness Hayter and Fiona Bruce MP are meeting in Westminster for an All-Party Parliamentary Group on Alcohol Harm meeting to discuss the severe inequalities related to alcohol found across the UK.

Alcohol, as we all know, can cause harm across society. Heavy and dependent drinking costs thousands of lives every year, hundreds of thousands of hospital admissions, and much more less quantifiable but severe suffering. However, we also know that these consequences are not spread evenly across the population, and that other factors than simply how much people drink shape outcomes.

Most dramatically, we know that people living in deprived areas are many times more likely to experience health harms directly related to alcohol, despite average consumption in those areas often being lower than in more affluent neighbourhoods. Understanding this so-called ‘harm paradox’ is absolutely critical to reducing the suffering linked to alcohol. Fortunately, some excellent research has emerged, which helps make sense of what is going on. You can find out more in this factsheet.

The inequalities associated with alcohol spread much further than just the ‘harm paradox’, however. Not only are there disparities in the harms people experience, but also in access to support. Last year, we published research showing that around two-thirds of residential rehabilitation centres imposed arbitrary limits on access according to age. The problem of how to reconfigure services so that they are better able to support the needs of older drinkers seeking help is an increasingly pressing concern, highlighted in a recent major report from the Royal College of Psychiatrists, and in this blog for Alcohol Awareness Week by Drink Wise, Age Well.

There is a real lack of research and knowledge in the area of black and minority ethnic communities, and it is something that we feel needs much more work.

We also know that, while statistics show the majority of people with drinking problems are white, alcohol can be a serious issue among many black and minority ethnic communities. This can be made worse when alcohol problems are not widely discussed, where gender norms around alcohol differ, or where community services are simply not set up to address the needs of individuals from particular minority groups. There is a real lack of research and knowledge in this area, and it is something that we feel needs much more work.

In order to raise some of these critical issues, the All-Party Parliamentary Group on Alcohol Harm is today running a meeting on the question on alcohol and inequalities. Speakers will consider the ‘harm paradox’, age inequalities in support and advice, and the challenges of providing alcohol services for minority communities. It will also consider how interventions (such as minimum unit pricing, or brief advice in primary care) affect different communities, particularly whether such interventions tend to reduce or increase inequalities.

These are all vitally important questions for everyone interested in alcohol harm. Our population consists of diverse and varied communities, networks and individuals. We cannot assume that what works for one will work for all, or even that the consequences of drinking are identical across all social groups.

Alcohol harm is a complex problem, and it occurs in a complex society. We need to adopt this perspective if we want to make substantial and meaningful changes to the levels of harm that exist. Hopefully, the work of the APPG – and all those involved in considering alcohol from this perspective – will help in achieving that goal.

Find out more about the APPG, which we help to organise.