Low social status increases risk of health problems from alcohol problems

Men and women with lower income or education levels are more likely to develop medical conditions related to alcohol abuse compared to similar individuals with a higher socioeconomic status. Alexis Edwards of Virginia Commonwealth University, US, and colleagues report these findings in a new study published March 19^th in the open access journal PLOS Medicine.

The World Health Organization estimates that harmful alcohol use accounts for 5.1% of the global burden of disease and injury worldwide, and results in three million deaths each year. Excessive alcohol consumption can also take an economic toll. Previous studies have identified links between a person’s socioeconomic status and alcohol use, but currently it is unclear how an individual’s social class impacts their future risk of acquiring alcohol-related medical conditions, like alcoholic liver disease.

In the new study, researchers used a model that follows people over time to estimate their risk of developing medical conditions from alcohol abuse using two indicators for socioeconomic status: income and education level. The researchers analyzed data from more than 2.3 million individuals in a Swedish database to show that both men and women with a lower income or education level were more likely to develop these conditions. The associations held true, even when researchers controlled for other relevant factors, such as marital status, history of psychiatric illness and having a genetic predisposition to abuse alcohol.

The new findings are important for understanding which populations are most likely to suffer from medical conditions resulting from alcohol abuse, and contribute to a growing body of literature on health disparities that stem from socioeconomic factors. The researchers recommend that individuals with lower income or education levels might warrant additional screening by clinicians to evaluate their alcohol consumption and identify related conditions.

The authors add, “Among individuals with an alcohol use disorder, those with lower levels of education or lower incomes are at higher risk for developing an alcohol-related medical condition, such as cirrhosis or alcoholic cardiomyopathy. Additional screening and prevention efforts may be warranted to reduce health disparities.”

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In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004359

Citation: Edwards AC, Larsson Lönn S, Chartier KG, Lannoy S, Sundquist J, Kendler KS, et al. (2024) Socioeconomic position indicators and risk of alcohol-related medical conditions: A national cohort study from Sweden. PLoS Med 21(3): e1004359. https://doi.org/10.1371/journal.pmed.1004359

Author Countries: United States, Sweden

Funding: This project was supported by grant AA023534 from the US National Institutes of Health to KK and KS, and grants from the Swedish Research Council to JS (2020-01175) as well as ALF funding from Region Skåne awarded to KS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.