IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i11p6025-d568379.html
   My bibliography  Save this article

Beyond Behaviour: How Health Inequality Theory Can Enhance Our Understanding of the ‘Alcohol-Harm Paradox’

Author

Listed:
  • Jennifer Boyd

    (School of Health and Related Research, The University of Sheffield, S1 4DA Sheffield, UK)

  • Clare Bambra

    (Population Heath Sciences Institute, Faculty of Medical Sciences, Newcastle University, NE2 4HH Newcastle upon Tyne, UK)

  • Robin C. Purshouse

    (Department of Automatic Control and Systems Engineering, The University of Sheffield, S1 3JD Sheffield, UK)

  • John Holmes

    (School of Health and Related Research, The University of Sheffield, S1 4DA Sheffield, UK)

Abstract

There are large socioeconomic inequalities in alcohol-related harm. The alcohol harm paradox (AHP) is the consistent finding that lower socioeconomic groups consume the same or less as higher socioeconomic groups yet experience greater rates of harm. To date, alcohol researchers have predominantly taken an individualised behavioural approach to understand the AHP. This paper calls for a new approach which draws on theories of health inequality, specifically the social determinants of health, fundamental cause theory, political economy of health and eco-social models. These theories consist of several interwoven causal mechanisms, including genetic inheritance, the role of social networks, the unequal availability of wealth and other resources, the psychosocial experience of lower socioeconomic position, and the accumulation of these experiences over time. To date, research exploring the causes of the AHP has often lacked clear theoretical underpinning. Drawing on these theoretical approaches in alcohol research would not only address this gap but would also result in a structured effort to identify the causes of the AHP. Given the present lack of clear evidence in favour of any specific theory, it is difficult to conclude whether one theory should take primacy in future research efforts. However, drawing on any of these theories would shift how we think about the causes of the paradox, from health behaviour in isolation to the wider context of complex interacting mechanisms between individuals and their environment. Meanwhile, computer simulations have the potential to test the competing theoretical perspectives, both in the abstract and empirically via synthesis of the disparate existing evidence base. Overall, making greater use of existing theoretical frameworks in alcohol epidemiology would offer novel insights into the AHP and generate knowledge of how to intervene to mitigate inequalities in alcohol-related harm.

Suggested Citation

  • Jennifer Boyd & Clare Bambra & Robin C. Purshouse & John Holmes, 2021. "Beyond Behaviour: How Health Inequality Theory Can Enhance Our Understanding of the ‘Alcohol-Harm Paradox’," IJERPH, MDPI, vol. 18(11), pages 1-12, June.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:6025-:d:568379
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/11/6025/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/11/6025/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Tuong Manh Vu & Charlotte Probst & Alexandra Nielsen & Hao Bai & Petra S. Meier & Charlotte Buckley & Mark Strong & Alan Brennan & Robin Purhouse, 2020. "A Software Architecture for Mechanism-Based Social Systems Modelling in Agent-Based Simulation Models," Journal of Artificial Societies and Social Simulation, Journal of Artificial Societies and Social Simulation, vol. 23(3), pages 1-1.
    2. Rubin, Marcie S. & Clouston, Sean & Link, Bruce G., 2014. "A fundamental cause approach to the study of disparities in lung cancer and pancreatic cancer mortality in the United States," Social Science & Medicine, Elsevier, vol. 100(C), pages 54-61.
    3. Eirik Degerud & Inger Ariansen & Eivind Ystrom & Sidsel Graff-Iversen & Gudrun Høiseth & Jørg Mørland & George Davey Smith & Øyvind Næss, 2018. "Life course socioeconomic position, alcohol drinking patterns in midlife, and cardiovascular mortality: Analysis of Norwegian population-based health surveys," PLOS Medicine, Public Library of Science, vol. 15(1), pages 1-20, January.
    4. Smith, G.D. & Wentworth, D. & Neaton, J.D. & Stamler, R. & Stamler, J., 1996. "Socioeconomic differentials in mortality risk among men screened for the multiple risk factor intervention trial: II. Black men," American Journal of Public Health, American Public Health Association, vol. 86(4), pages 497-504.
    5. Krieger, Nancy, 1994. "Epidemiology and the web of causation: Has anyone seen the spider?," Social Science & Medicine, Elsevier, vol. 39(7), pages 887-903, October.
    6. Smith, G.D. & Neaton, J.D. & Wentworth, D. & Stamler, R. & Stamler, J., 1996. "Socioeconomic differentials in mortality risk among men screened for the multiple risk factor intervention trial: I. White men," American Journal of Public Health, American Public Health Association, vol. 86(4), pages 486-496.
    7. Niko Speybroeck & Carine Van Malderen & Sam Harper & Birgit Müller & Brecht Devleesschauwer, 2013. "Simulation Models for Socioeconomic Inequalities in Health: A Systematic Review," IJERPH, MDPI, vol. 10(11), pages 1-31, November.
    8. Bambra, Clare & Smith, Katherine E. & Pearce, Jamie, 2019. "Scaling up: The politics of health and place," Social Science & Medicine, Elsevier, vol. 232(C), pages 36-42.
    9. Dahlgren, Göran & Whitehead, Margaret, 1991. "Policies and strategies to promote social equity in health. Background document to WHO - Strategy paper for Europe," Arbetsrapport 2007:14, Institute for Futures Studies.
    10. Karriker-Jaffe, K.J. & Roberts, S.C.M. & Bond, J., 2013. "Income inequality, alcohol use, and alcohol-related problems," American Journal of Public Health, American Public Health Association, vol. 103(4), pages 649-656.
    11. Beckfield, Jason & Bambra, Clare, 2016. "Shorter lives in stingier states: Social policy shortcomings help explain the US mortality disadvantage," Social Science & Medicine, Elsevier, vol. 171(C), pages 30-38.
    12. Vineis, Paolo & Delpierre, Cyrille & Castagné, Raphaële & Fiorito, Giovanni & McCrory, Cathal & Kivimaki, Mika & Stringhini, Silvia & Carmeli, Cristian & Kelly-Irving, Michelle, 2020. "Health inequalities: Embodied evidence across biological layers," Social Science & Medicine, Elsevier, vol. 246(C).
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jennifer Boyd & Rebekah Wilson & Corinna Elsenbroich & Alison Heppenstall & Petra Meier, 2022. "Agent-Based Modelling of Health Inequalities following the Complexity Turn in Public Health: A Systematic Review," IJERPH, MDPI, vol. 19(24), pages 1-16, December.
    2. Abd Alghani Khamis & Siti Zuliana Salleh & Mohd Sayuti Ab Karim & Noor Ashikin Mohd Rom & Shamini Janasekaran & Aida Idris & Rusdi Bin Abd Rashid, 2022. "Alcohol Consumption Patterns: A Systematic Review of Demographic and Sociocultural Influencing Factors," IJERPH, MDPI, vol. 19(13), pages 1-17, July.
    3. Abd Alghani Khamis & Aida Idris & Abdallah Abdellatif & Noor Ashikin Mohd Rom & Taha Khamis & Mohd Sayuti Ab Karim & Shamini Janasekaran & Rusdi Bin Abd Rashid, 2023. "Development and Performance Evaluation of an IoT-Integrated Breath Analyzer," IJERPH, MDPI, vol. 20(2), pages 1-26, January.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Laurent Chenet & David Leon & Martin Mckee & Serguei Vassin, 1998. "Deaths from Alcohol and Violence in Moscow: Socio-economic Determinants," European Journal of Population, Springer;European Association for Population Studies, vol. 14(1), pages 19-37, March.
    2. Megan Teychenne & Kylie Ball & Jo Salmon, 2012. "Educational Inequalities in Women’s Depressive Symptoms: The Mediating Role of Perceived Neighbourhood Characteristics," IJERPH, MDPI, vol. 9(12), pages 1-13, November.
    3. Ryan Petteway & Mahasin Mujahid & Amani Allen & Rachel Morello-Frosch, 2019. "Towards a People’s Social Epidemiology: Envisioning a More Inclusive and Equitable Future for Social Epi Research and Practice in the 21st Century," IJERPH, MDPI, vol. 16(20), pages 1-21, October.
    4. McGrath, Jennifer J. & Matthews, Karen A. & Brady, Sonya S., 2006. "Individual versus neighborhood socioeconomic status and race as predictors of adolescent ambulatory blood pressure and heart rate," Social Science & Medicine, Elsevier, vol. 63(6), pages 1442-1453, September.
    5. Levin, Kate A. & Leyland, Alastair H., 2006. "A comparison of health inequalities in urban and rural Scotland," Social Science & Medicine, Elsevier, vol. 62(6), pages 1457-1464, March.
    6. Lohan, Maria, 2007. "How might we understand men's health better? Integrating explanations from critical studies on men and inequalities in health," Social Science & Medicine, Elsevier, vol. 65(3), pages 493-504, August.
    7. L. Di Matteo & R. Di Matteo, 2005. "Does testing for prostate-specific antigen contribute to declining prostate cancer mortality?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(4), pages 298-308, December.
    8. Rainham, Daniel, 2007. "Do differences in health make a difference? A review for health policymakers," Health Policy, Elsevier, vol. 84(2-3), pages 123-132, December.
    9. Mr. Michael Sarel, 1997. "How Macroeconomic Factors Affect Income Distribution: The Cross-Country Evidence," IMF Working Papers 1997/152, International Monetary Fund.
    10. Kim, Jae-Hyun & Lee, Sang Gyu & Shin, Jaeyong & Park, Eun-Cheol, 2014. "Impact of the gap between socioeconomic stratum and subjective social class on depressive symptoms: Unique insights from a longitudinal analysis," Social Science & Medicine, Elsevier, vol. 120(C), pages 49-56.
    11. Craig, Neil, 2005. "Exploring the generalisability of the association between income inequality and self-assessed health," Social Science & Medicine, Elsevier, vol. 60(11), pages 2477-2488, June.
    12. Daniel Nettle, 2010. "Why Are There Social Gradients in Preventative Health Behavior? A Perspective from Behavioral Ecology," PLOS ONE, Public Library of Science, vol. 5(10), pages 1-6, October.
    13. Alvarez, Camila H. & Evans, Clare Rosenfeld, 2021. "Intersectional environmental justice and population health inequalities: A novel approach," Social Science & Medicine, Elsevier, vol. 269(C).
    14. Arusha, Anowara Rayhan & Biswas, Raaj Kishore, 2020. "Prevalence of stress, anxiety and depression due to examination in Bangladeshi youths: A pilot study," Children and Youth Services Review, Elsevier, vol. 116(C).
    15. Jordi Vallverdú, 2018. "Post Truth, Newspeak and Epidemiological Causality," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 2(1), pages 2267-2268, January.
    16. Intima Alrimawi & Michael Craig Watson & Carol Hall & Ahmad Rajeh Saifan, 2019. "Preventing Unintentional Injuries to Children Under 5 in Their Homes: Palestinian Mothers’ Perspectives," SAGE Open, , vol. 9(1), pages 21582440188, January.
    17. Myers, Douglas J. & Kriebel, David & Karasek, Robert & Punnett, Laura & Wegman, David H., 2007. "The social distribution of risk at work: Acute injuries and physical assaults among healthcare workers working in a long-term care facility," Social Science & Medicine, Elsevier, vol. 64(4), pages 794-806, February.
    18. Jayeun Kim & Kyuhyun Yoon, 2020. "Municipal Residence Level of Long-Term PM 10 Exposure Associated with Obesity among Young Adults in Seoul, Korea," IJERPH, MDPI, vol. 17(19), pages 1-13, September.
    19. Mariusz Duplaga, 2020. "The Use of Fitness Influencers’ Websites by Young Adult Women: A Cross-Sectional Study," IJERPH, MDPI, vol. 17(17), pages 1-19, September.
    20. Andreea-Oana IACOBUTA & Livia BACIU & Alina-Mariuca IONESCU & Gabriel Claudiu MURSA, 2015. "Socioeconomic Inequalities In Self-Perceived Health In Romania," Journal of Public Administration, Finance and Law, Alexandru Ioan Cuza University, Faculty of Economics and Business Administration, vol. 0(Special i), pages 209-224, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:6025-:d:568379. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.