Why do poor people have more alcohol-related deaths than rich people?

Medic Conor Walsh has won an award for his essay on why lower socioeconomic groups suffer more alcohol-related harm, even though they drink less.

Sixth-year medical student Conor Walsh has come second in the Medical Council on Alcohol’s annual essay competition, with a paper examining why lower socioeconomic groups suffer more alcohol-related harm than wealthier people.

Posing the question ‘Why do poor people have more alcohol-related deaths than rich people?’, the topic of this year’s MCA Legacy Essay Competition asked entrants to examine an apparent paradox between alcohol consumption and related mortality.

It is widely reported that a low socioeconomic status is associated with lower or similar alcohol consumption compared to a high socioeconomic status—yet levels of alcohol-related mortality and morbidity are significantly higher in poorer populations.

“During my fifth year at medical school, I developed more of an interest in psychiatric medicine and thoroughly enjoyed working on a general adult psychiatric ward,” says Walsh.

“However, one area of psychiatry that I was unable to explore was substance abuse. I did some research and found this essay that would give me the opportunity to look into both substance abuse as well as health inequality.”

The MCA Legacy Essay Competition is run by the Medical Council on Alcohol, a charity who support health professionals of all specialities in reducing harm from drinking. The prize started in 1985 following a gift from the Frowen family who lost their son Micheal due to alcohol-related health issues.

Walsh’s paper examines how drinking patterns, lifestyle factors, access to healthcare and social context play a role in why poorer people suffer greater harmful health effects of alcohol, even with lower average consumption.

“The disproportionate effect of alcohol consumption affecting populations of low socioeconomic status is unusual, given the normally positive relationship between exposure and consequence,” he explains.

“In lower socioeconomic groups, alcohol use is more polarised, with higher levels of both abstinence and binge drinking. Binge drinking has more destructive effects and negates the apparent cardio-protective benefits of moderate drinking.

“There is also a multiplicative effect between alcohol and cigarette smoking. With mouth and throat cancer, for example, it has been found that its prevalence is seven times greater with tobacco use and six times greater with alcohol use—but thirty-eight times greater for those using both tobacco and alcohol.”

Walsh receives an invitation to the MCA Symposium in November and a pot of prize money. As a sixth-year student, Conor will shortly be going on his elective—a final placement which gives medical students the opportunity to experience healthcare in an unfamiliar country.

“I have decided to put the prize money towards my elective. Currently I am planning on going to the USA, before doing some travelling in Mexico, so any additional savings are very welcome.”

Read Walsh’s essay (Medical Council on Alcohol website)