Highly educated people drink more, yet they face fewer alcohol-related health problems

Men drink more than women, and older individuals drink more often than younger ones. And most of us only drink on weekends.

This is revealed in a new study from the Norwegian Institute of Public Health (NIPH) (link in Norwegian).

The study also shows that people with higher education drink more often than those with lower education.

This is a bit of a paradox, according to the researchers, because highly educated individuals usually lead healthier lives than those with less education, with one exception – alcohol consumption.

Why is this the case?

Wealthy people have better health

People with so-called high socioeconomic status, meaning higher education and income, are healthier than those with low socioeconomic status. They eat healthier food and exercise more.

For example, highly educated individuals live longer than those who have only completed primary school. They also receive more assistance in the healthcare system.

A new study from Statistics Norway (link in Norwegian) shows that young people and individuals with higher education and income spend much more time in nature and engage in outdoor activities than single parents and people with low education and income.

So why do people with high socioeconomic status drink so much alcohol?

Do not view the use of alcohol as a problem

Everyone knows that too much alcohol is not good for us. The new Nordic dietary guidelines go as far as to recommend zero alcohol.

This is because alcohol has several different sides, Swedish researchers tell Svenska Dagbladet (link in Swedish). This also applies to Swedes, according to a new report from the Swedish Council for Information on Alcohol and Other Drugs.

Even though alcohol is dangerous, like smoking and poor diet, it also has some social elements that people experience as very positive. Individuals with higher education are often thought to be in social situations where alcohol is more prevalent.

So, it has to do with the social culture, if we are to believe the researchers.

“In the wealthy areas of Oslo, people are probably focused on exercise and a healthy lifestyle. They don't smoke, but many don't see the use of alcohol as a big problem,” addiction researcher and professor Willy Pedersen told forskning.no in this 2015 article about youth in Oslo’s western districts drinking more than those in the eastern districts.

Drink in a less harmful way

Even though highly educated people drink more and more often, they generally suffer less harm from it than people with lower education. This is shown by both the Swedish report and the Norwegian NIPH report.

Jonas Landberg is the study director at Stockholm University’s Department of Public Health Sciences. He points out that international research shows that high-income earners and the well-educated drink in a less harmful way.

“Those who are well-off handle the harmful effects of alcohol better,” he tells Svenska Dagbladet (link in Swedish)

“Alcohol-related mortality is three to four times higher for the less educated than the highly educated even though they consume the same amount of alcohol,” he says.

Drink less, but more often

Elin Kristin Bye, a researcher at NIPH and one of the authors of the new NIPH report, discusses this phenomenon.

She refers to this paradox as the ‘Alcohol Harm Paradox’. It suggests that even though those with high socioeconomic status drink as much or more than those with low socioeconomic status, alcohol-related harms are more common among those with low status.

“One of the reasons might be that those with low socioeconomic status have a riskier drinking pattern,” she says.

This means they drink a lot at one time, and they often drink liquors.

Another reason could be that more people with low socioeconomic status live alone, meaning there is often no one to point out that they are drinking too much. They therefore experience no informal social control, according to Bye.

General health also plays a role.

“In this group, many have poorer health to begin with,” Bye says.

There are more smokers and overweight individuals in this group, which increases the risk of diseases.

Jonas Landberg from Stockholm University points to another significant aspect: Those with high socioeconomic status seem to be better at quitting harmful habits, such as drinking and smoking, before they suffer serious harm or illness. They can more easily access help and the care they need to break free from risky behaviours, he says.

What constitutes alcohol-related harm?

Alcohol-related harms can be both acute and long-term.

For example, they can include physical injuries from accidents, violence, or traffic incidents occurring under the influence of alcohol.

And, of course, alcohol poisoning.

The long-term harms that arise from more regular use or abuse can include liver failure, cardiovascular diseases, and premature brain ageing.

References:

Guttormsson, U. Självrapporterade alkoholvanor i Sverige 2004–2022 (Self-reported Alcohol Habits in Sweden 2004–2022), CAN report, 2023.

Rossow, I.M. Oversikt over Alkohol i Norge: Et folkehelseperspektiv på alcohol (Overview of Alcohol in Norway: A Public Health Perspective on Alcohol), Report from the Norwegian Institute of Public Health, 2023.

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Translated by Alette Bjordal Gjellesvik

Read the Norwegian version of this article on forskning.no