The Causes and risk factors section reported that people in professional jobs and on higher incomes are more likely to be drinking at ‘increasing risk’ levels. Data from the Hackney resident health and wellbeing survey are consistent with these findings, showing that high risk drinking (based on calculated AUDIT-C scores) is less common among adults living in the most deprived areas locally – 19% in those living in the most deprived areas compared with 27% overall.

National evidence suggests that, despite lower alcohol consumption levels compared with those living in more affluent areas, people living in the most deprived areas are: 1

  • 2–3 times more likely to die, in part, as a result of alcohol
  • 3–5 times more likely to die of an alcohol-specific cause
  • 2–5 times more likely to be admitted to hospital because of an alcohol-use disorder.

The reasons for these patterns are complex, but research shows that while people in lower socio-economic groups drink on fewer occasions, they consume more per occasion.  This suggests that the greater alcohol-related mortality risk observed in lower socio-economic groups may, in part, be explained by higher levels of intoxication per occasion. 2

Even at similar levels of alcohol consumption, deprived communities experience more alcohol-related harms than affluent areas. This ‘alcohol harm paradox’ has been variously attributed to higher alcohol-related worklessness in deprived communities, poorer resilience and healthcare provision, and a higher prevalence of binge drinking. Moreover, alcohol-related ill health is exacerbated by excessive drinking in combination with other harmful behaviours that are more prevalent in deprived communities – such as smoking, inactivity and poor diet. 3There is also some evidence that the alcohol harm paradox seen among adults is also present for children and young people living in the most deprived communities. 4


  1. NICE , “LGB6 Alcohol,” 2012. [Online]. Available: [Accessed 15 August 2016].
  2. Ally et al , “Developing a social practice-based typology,” 2016. [Online]. Available: . [Accessed 15 August 2016].
  3. Bellis et al , Understanding the alcohol harm paradox, Liverpool: Centre for Public Health, Liverpool John Moores University, 2015.
  4. Public Health England, “Alcohol consumption and harm among under 18 year olds,” 2016. [Online]. Available: [Accessed 15 August 2016].