Understanding the alcohol harm paradox This research was published by Alcohol Research UK before the merger of Alcohol Concern and Alcohol Research UK. Key findings There is good evidence that people with low individual or neighbourhood socioeconomic status (SES) show a greater susceptibility to the harmful effects of alcohol, but a lack of evidence means that it is not possible to conclude what mechanisms and pathways might underlie this difference in risk. Lower SES is associated with an almost two fold greater risk of alcohol related death compared with individuals in higher SES classifications. Relative to high SES, low SES is associated with an increased risk of head and neck cancers, strokes, hypertension, liver disease and pre-term birth. These findings are independent of a number of other known risk factors for these conditions such as diet and smoking. Although people in different SES groups do not differ in the unit amount and frequency of alcohol drunk across the week, there are important differences in ‘binge drinking’, beverage choice, and patterns of heavy drinking. There is underreporting of alcohol use in general population surveys of alcohol use, and this differs by alcohol risk rather than SES. The use of alternative survey methodologies captures a greater amount of population alcohol use. This also leads to more people being classified as at increasing and higher risk from their alcohol use. Read the full research on the Alcohol Research UK website. Read about the Alcohol Concern / Alcohol Research UK merger.