title: Alcohol consumption and social inequality at the individual and country levels--results from an international study.
abstract: BACKGROUND
  International comparisons of social inequalities in alcohol use have not been extensively investigated. The purpose of this study was to examine the relationship of country-level characteristics and individual socio-economic status (SES) on individual alcohol consumption in 33 countries.
  
  
  METHODS
  Data on 101,525 men and women collected by cross-sectional surveys in 33 countries of the GENACIS study were used. Individual SES was measured by highest attained educational level. Alcohol use measures included drinking status and monthly risky single occasion drinking (RSOD). The relationship between individuals' education and drinking indicators was examined by meta-analysis. In a second step the individual level data and country data were combined and tested in multilevel models. As country level indicators we used the Purchasing Power Parity of the gross national income, the Gini coefficient and the Gender Gap Index.
  
  
  RESULTS
  For both genders and all countries higher individual SES was positively associated with drinking status. Also higher country level SES was associated with higher proportions of drinkers. Lower SES was associated with RSOD among men. Women of higher SES in low income countries were more often RSO drinkers than women of lower SES. The opposite was true in higher income countries.
  
  
  CONCLUSIONS
  For the most part, findings regarding SES and drinking in higher income countries were as expected. However, women of higher SES in low and middle income countries appear at higher risk of engaging in RSOD. This finding should be kept in mind when developing new policy and prevention initiatives.
authors.affiliation: Department for Biostatistics and Clinical Epidemiology, Charité - University Medicine, Berlin, Germany. ulrike.grittner@charite.de
authors.forename: Ulrike
authors.initials: U
authors.lastname: Grittner
authors.forename: Sandra
authors.initials: S
authors.lastname: Kuntsche
authors.forename: Gerhard
authors.initials: G
authors.lastname: Gmel
authors.forename: Kim
authors.initials: K
authors.lastname: Bloomfield
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult