1. Socioeconomic status, alcohol use and the mediating role of social support and neighbourhood disadvantage among individuals meeting criteria for a mental health problem: a cross-sectional study

It has been established that alcohol use is higher among individuals with a mental health problem (MHP), and that MHPs are more common among lower socioeconomic status (SES) groups. Less is known about how SES is associated with alcohol within those with a MHP. This study aimed to develop latent profiles of SES of individuals with a MHP and examine associations of SES groups with alcohol use.

A secondary analysis of the 2014 Adult Psychiatric Morbidity Survey was conducted among individuals with a MHP (N=1,463). Indicators of SES(e.g. occupational class) were used to develop latent profiles of SES. Alcohol use was measured using the Alcohol Use Disorder Identification Test and categorised as; non-drinker, low-risk(reference), hazardous or harmful drinker. Multinomial logistic regression models were conducted to examine associations of SES profiles with alcohol use. Odds ratios(OR) and 95% confidence intervals(CI) determined significance.

A four-class model of SES was best-fitting, including: 'Economically inactive, social renters', 'routine/intermediate occupations, mixed owner/renters', 'retired, homeowners', and 'professional occupations, homeowners'. Compared to 'professional occupations, homeowners', non-drinking was more common among 'economically inactive, social renters'(OR=4.98,95%CI=3.03-8.21). Compared to 'professional occupations, homeowners', 'retired, homeowners' were less likely to be a hazardous drinker(OR=0.48,95%CI-0.27-0.85). No associations with harmful drinking were found.

A range of SES profiles were identified in this population with MHPs. Compared to higher SES groups, those of lower SES were more likely to be non-drinkers while retired populations were less likely to be hazardous drinkers. The alcohol harms paradox was not supported when examined among individuals with MHPs.