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The association between macro-level structural discrimination and alcohol outcomes: A systematic review
Sophie Bright1, Charlotte Buckley2, Daniel Holman3
1Sheffield Addictions Research Group, Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, UK.
Structural discrimination, like racism and sexism, impacts alcohol consumption and related harms, particularly for marginalized groups. More research is needed on intersectional discrimination and its long-term effects.
Area of Science:
- Public Health
- Sociology
- Epidemiology
Background:
- Alcohol consumption is a leading cause of death and disability, disproportionately affecting disadvantaged populations.
- While interpersonal discrimination's link to alcohol use is known, the impact of structural discrimination is less understood.
Purpose of the Study:
- To systematically review the association between macro-level structural discrimination and alcohol consumption or related health outcomes.
Main Methods:
- Systematic review of 25 studies from four databases and grey literature.
- Studies examined structural racism, sexism, heterosexism, and intersectional discrimination.
- Outcomes included alcohol consumption, harm, or both.
Main Results:
- Associations varied by discrimination type, measurement, alcohol outcome, and sociodemographic factors.
- Structural racism linked to higher consumption and harm, especially for Black and Hispanic populations.
- Increasing gender equality may increase women's drinking; greater sexism linked to risky drinking and mortality.
Conclusions:
- Structural discrimination, including racism, sexism, and heterosexism, is associated with alcohol consumption and harm.
- Differential effects by sociodemographic factors require further study.
- Future research should adopt intersectional and longitudinal approaches to understand structural discrimination's complex impact on alcohol-related health.
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