evidence from a number of countries converges in that sense showing that the worstoff have higher rates of alcoholrelated problems and mortality than the betteroff najman et al hemstrom harrison and gardiner even for the same level of drinking makela and paljarvi grittner et al hence the gradient of inequities in alcohol related harm is not consistently in line with the gradient of inequalities in alcohol use lastly alcohol consumption may have larger societal impacts in addition to its health outcomes