| Alcohol consumption patterns |
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Increased binging episodes have a more harmful impact on the liver than gradual alcohol intake
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Lower income individuals more likely to choose spirits or beer over wine
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Higher alcohol outlet density in urban areas contributes to higher alcohol intake
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Strengthen alcohol policy
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Introduce pricing policies that make cheap, high-alcohol-content beverages less accessible
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Limit alcohol marketing, particularly in low-income areas and to vulnerable populations
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Reduce the concentration of alcohol outlets in disadvantaged neighbourhoods
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| Education |
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Reduce stigma and enhance awareness
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Educate about alcohol’s health risks, emphasizing liver disease, mental health, and chronic illnesses, e.g. US Surgeon General warning about alcohol and cancer risk
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Train healthcare providers to address stigma, and deliver equitable care tailored to diverse socioeconomic backgrounds
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Develop opportunities for education regarding treatment for alcohol use disorder and ALD
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| Healthcare access |
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Lower income groups, immigrants, and individuals living in densely populated urban areas are less likely to have health insurance or easy access to preventive health
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Limited access to healthcare leads to delayed diagnosis of ALD, leading to more severe illness and limited treatment options
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Limited access and lower health literacy make treatment adherence more challenging, reducing the likelihood of transplant listing
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Improve access to healthcare
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Implement routine screening for alcohol use and liver disease, especially in underserved areas
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Provide affordable access to addiction treatment programmes, counselling, and medications for AUD
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Expand access to mental health care
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Ensure timely referral to subspecialty care
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Leverage use of virtual visits or consults
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| Psychosocial stress and stigmatization |
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Chronic stress from unsafe living conditions, unstable housing, and/or financial insecurity may increase alcohol use as a coping mechanism
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Progression of ALD from mild to severe illness and compounding symptoms and comorbidities may lead to further drinking
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Reduce social determinants of poor health
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Address financial insecurity through job training, housing assistance, and income support to reduce stress-related alcohol use
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Improve housing access and living conditions
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Reduce food insecurity and food deserts
Community engagement
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Involve disadvantaged communities in designing and implementing interventions to ensure they are relevant and culturally appropriate
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Provide early interventions for children and teenagers in high-risk environments to prevent harmful drinking patterns from developing
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