Project 458885

Studies show lower socioeconomic status (SES) groups experience greater alcohol-related illnesses and deaths compared to higher SES groups, even when consuming lower quantities of alcohol. Known as the "alcohol-harm paradox", this phenomenon is well documented in research but proposed explanations for these differences are complex, poorly understood, and have not fully explained differences in alcohol-related harms. Clarifying the mechanisms involved in creating the alcohol-harm paradox is essential to designing equitable alcohol policies. One policy to reduce alcohol-related harms is to restrict increases in alcohol availability. An improved understanding is urgently needed in jurisdictions where alcohol availability has increased, such as in Ontario, where sales were expanded to grocery stores and restaurant takeout. It is largely unknown how such deregulations in alcohol sales affect social inequities in alcohol harms, which are health differences that are considered to be preventable and unfair. The purpose of the proposed research is to explore potential mechanisms for the inequitable impact of alcohol harms on lower SES groups (i.e., the alcohol-harm paradox) and to examine whether policies that increase alcohol availability contribute to social inequities in alcohol harms in Canada. The recent alcohol deregulation in Ontario presents a critical opportunity to understand how population-level policies may influence health inequities. This research will fill key gaps in evidence as it is the first in Canada to disentangle the causal mechanisms driving the alcohol-harm paradox. The results will directly inform targeted alcohol policies and equity strategies to better support priority populations in Canada.