This rapid review examined evidence of the association between poverty and alcohol use. The research primarily focused on work undertaken in the UK and was commissioned by the Joseph Rowntree Foundation as part of their programme to develop Anti-Poverty Strategies for the UK. The purpose of the rapid review was to provide an evidence base that the Joseph Rowntree Foundation could use in developing their strategies, and to inform how alcohol misuse was addressed.
What struck me about this review was the section on stigma and marginalisation:
How people respond to others’ alcohol use exacerbates harm (World Health Organization, 2007). Alcohol dependence is a highly stigmatized health condition and as Room (2005) argues, “the use of alcohol [and drugs] is strongly moralized, and those transgressing moral norms are subject to stigma and social marginalization”. The relationship between alcohol dependence and stigma particularly manifests itself through the perception that those affected have personal control over their illness (Livingston et al., 2011). The WHO Expert Committee on Problems Related to Alcohol Consumption noted that “there a clear tendency for many cultures to marginalize particularly those who are both poor and habitually intoxicated, and that there are many pathways by which poverty can enable or exacerbate the stigmatization of intoxication” (World Health Organization, 2007). People who are poor or living in poverty may be less able to avoid or buffer the social consequences of their drinking unlike their more affluent counterparts. Police surveillance of ‘anti-social behaviour’ such as public drunkenness may also be heightened in poor communities. Thus in affluent societies, the WHO Expert Committee (World Health Organization, 2007) highlighted “that there is a very strong overlap between the most marginalized population and those defined as having serious alcohol problems”.