New research reveals that alcohol’s association with heart disease mortality differs across socioeconomic groups
A new study led by researchers at the Alcohol Research Group, a program of the Public Health Institute, is the first U.S. study to examine how a person’s socioeconomic status (SES) modifies the relationship between alcohol consumption and ischemic heart disease (IHD) mortality.
Cardiovascular diseases (CVDs) are the leading causes of death in the U.S., with IHD being a significant contributor. Past research has shown that individuals with lower SES are disproportionately more likely to suffer from heart disease compared to those with higher SES. However, alcohol’s contribution to socioeconomic inequalities in disease mortality has been largely unexplored.
Published in JAMA Open Network, the research team’s findings showed that drinking less than 20 grams of alcohol per day, approximately 1.5 standard drinks, was associated with a reduced risk of IHD mortality that was most pronounced among individuals with a high SES. In contrast, this association was notably weaker among persons with low SES.
Yachen Zhu, PhD
“Alcohol consumption is a health behavior that has long been recognized as a significant contributor to socioeconomic disparities in mortality, and our study highlights the ways drinking can play a significant role in widening inequities in cardiovascular health,” said lead study author and Biostatistician Yachen Zhu, PhD.
In other results, men with lower SES who drank more than 60 grams of alcohol per day, approximately 4.25 drinks, were shown to have the highest risk for IHD mortality.
Researchers speculated that the differences in mortality rates between people with high and low SES with similar drinking patterns could be explained by multiple sociopolitical and sociocultural factors, including limited access to healthcare and preventive services, living in neighborhoods with fewer opportunities for healthy lifestyle choices, and being more likely to experience chronic stress.
“Long-term stress can slowly undermine a person’s health and lead to heightened blood pressure, which significantly increases an individual’s susceptibility to cardiovascular diseases,” Zhu explained.
The study team recommends public health interventions take into account a person’s socioeconomic background when assessing the risks associated with their alcohol consumption and tailoring alcohol treatment to better support those in recovery across all sociodemographic groups.
Despite differences in risk across socioeconomic groups, there is no safe level of alcohol consumption.
“It’s critical to recognize that alcohol can pose significant health risks, and our study should be considered in the context of the numerous serious health harms associated with drinking – even at low levels,” Zhu added.
The study, “Differential associations of alcohol use with ischemic heart disease mortality by socioeconomic status in the US, 1997-2018” by Yachen Zhu, Laura Llamosas-Falcón, William Kerr, Klajdi Puka, Charlotte Probst, is available at: doi:10.1001/jamanetworkopen.2023.54270
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Support for this paper was provided by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) under award number R01AA028009 (Probst, C., PI) at the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
