Gender differences in socioeconomic inequality of alcohol‐attributable mortality: A systematic review and meta‐analysis

Probst, Charlotte; Roerecke, Michael; Behrendt, Silke; Rehm, Jürgen

doi:10.1111/dar.12184

Cited by 65 publications

(69 citation statements)

References 54 publications

(65 reference statements)

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“…This suggests higher rates of alcohol dependence among more deprived males. The moderating effect of sex on socio-economic gradients in alcohol-related harm was also observed in two other recent studies [40,41].…”

Section: Discussionsupporting

confidence: 71%

Understanding the alcohol harm paradox: an analysis of sex‐ and condition‐specific hospital admissions by socio‐economic group for alcohol‐associated conditions in England

et al. 2017

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Background and Aims In many countries, conflicting gradients in alcohol consumption and alcohol‐associated mortality have been observed. To understand this ‘alcohol harm paradox’ we analysed the socio‐economic gradient in alcohol‐associated hospital admissions to test whether it was greater in conditions which were: (1) chronic (associated with long‐term drinking) and partially alcohol‐attributable, (2) chronic and wholly alcohol‐attributable, (3) acute (associated with intoxication) and partially alcohol‐attributable and (4) acute and wholly alcohol‐attributable. Our aim was to clarify how (1) drinking patterns (e.g. intoxication linked to acute admissions or dependence linked to chronic conditions) and (2) non‐alcohol causes (e.g. smoking and poor diet which are risks for partially alcohol‐attributable conditions) contribute to the paradox. Design Regression analysis testing the modifying effects of condition‐group (1–4 above) and sex on the relationship between area‐based deprivation and admissions. Setting England, April 2010–March 2013. Participants A total of 9 239 629 English hospital admissions where a primary or secondary cause was one of 36 alcohol‐associated conditions. Measurements Admissions by condition and deciles of Index of Multiple Deprivation (IMD). Socio‐economic gradient measured as the relative index of inequality (RII, the slope of a linear regression of IMD on admissions adjusted for overall admission rate). Conditions were categorized by ICD‐10 code. Findings A socio‐economic gradient in hospitalizations was seen for all conditions, except partially attributable chronic conditions. The gradient was significantly steeper for conditions which were wholly attributable to alcohol and for acute conditions than for conditions partially alcohol‐attributable and for chronic conditions. Gradients were steeper for men than for women in cases of wholly alcohol attributable conditions. Conclusions There is a socio‐economic gradient in English hospital admission for most alcohol‐associated conditions. The greatest inequalities are in conditions associated with alcohol dependence, such as liver disease and mental and behavioural conditions, and in acute conditions, such as alcohol poisoning and assault. Socio‐economic differences in harmful drinking patterns (dependence and intoxication) may contribute to the ‘alcohol harm paradox’.

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Section: Discussionsupporting

confidence: 71%

Understanding the alcohol harm paradox: an analysis of sex‐ and condition‐specific hospital admissions by socio‐economic group for alcohol‐associated conditions in England

et al. 2017

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“…This review focused only on gender, however it is important to acknowledge that gender inequality intersects with other forms of inequality (including economic, racial, sexual orientation) in complex ways . These interactions can have important implications for alcohol‐related harms , and require a broader focus in both research and policy .…”

Section: Discussionmentioning

confidence: 99%

Gender differences in the impact of population-level alcohol policy interventions: evidence synthesis of systematic reviews

et al. 2016

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“…In a meta-analysis, occupation and income were significantly related to relative risk of alcohol-related mortality for women (and men) (Probst, Roerecke, Behrendt, & Rehm, 2015). In a recent review of SES and sexual minority stress, McGarrity (2014) noted that SES has typically been relegated to a control variable/covariate in research rather than considered in terms of its potential important association with health.…”

Section: Race Ses and Minority Stressmentioning

confidence: 99%

Pathways to Hazardous Drinking Among Racially and Socioeconomically Diverse Lesbian Women

Lewis

Mason

Winstead

et al. 2016

Psychology of Women Quarterly

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Lesbian women engage in more hazardous drinking than heterosexual women yet we know relatively little about what explains this disparity. In the present study, race, socioeconomic status, minority stress, general psychological processes and distress were examined as pathways to hazardous drinking among young (18-35 years) Black and non-Hispanic White lesbian women. We used the psychological mediation framework adaptation of minority stress theory and the reserve capacity model as theoretical underpinnings of the conceptual model in the current study. Self-identified lesbian participants (N= 867) completed a one-time online survey that assessed race, socioeconomic status, perceived sexual minority discrimination, proximal minority stress (concealment, internalized homophobia, lack of connection to lesbian community), rumination, social isolation, psychological distress, drinking to cope, and hazardous drinking. Cross-sectional results demonstrated that being Black was associated with hazardous drinking via sequential mediators of rumination, psychological distress, and drinking to cope. Socioeconomic status was associated with hazardous drinking via sequential mediators of sexual minority discrimination, proximal minority stress, rumination, social isolation, psychological distress, and drinking to cope. Understanding these pathways can aid researchers and clinicians studying and working with lesbians who are at risk for hazardous drinking.

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Gender differences in socioeconomic inequality of alcohol‐attributable mortality: A systematic review and meta‐analysis

Cited by 65 publications

References 54 publications

Understanding the alcohol harm paradox: an analysis of sex‐ and condition‐specific hospital admissions by socio‐economic group for alcohol‐associated conditions in England

Understanding the alcohol harm paradox: an analysis of sex‐ and condition‐specific hospital admissions by socio‐economic group for alcohol‐associated conditions in England

Gender differences in the impact of population-level alcohol policy interventions: evidence synthesis of systematic reviews

Pathways to Hazardous Drinking Among Racially and Socioeconomically Diverse Lesbian Women

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