How does the social environment help to explain the relationships between deprivation, mental health, and alcohol use?

Alcohol use is one of the top five leading risk factors for death and loss of health in the UK, and consumption has social and economic consequences for individuals, communities, and society. There is a clear and persistent gradient in the risks of alcohol-related harm by socioeconomic status (SES) and deprivation, such that people with lower income, education or occupational status, or living in more deprived areas are more likely to die or suffer from a disease related to their alcohol use. However, this relationship is complicated, and despite similar levels of consumption, groups from lower socioeconomic backgrounds experience disproportionately higher levels of alcohol related harm. There is a lack of research in this area, but previous work has explored this paradox, and suggests that factors such as neighbourhood cohesion and social support, including bonding social capital (people that can be counted on such as family and friends), and community social capital (participation and links with neighbourhood groups and services) might be important.
Harms of alcohol in lower SES groups may result from alcohol being consumed in a more problematic way, for example, drinking to cope with poorer mental health in the absence of protective social capital and social support. In areas of higher deprivation, neighbourhood-based social capital may be protective against alcohol related harm. Furthermore, considering the links between deprivation, mental health, and alcohol harm, differences in social capital may moderate this relationship. So, for example, people who are able to draw upon high levels of social capital are less likely to use alcohol as a result of poorer mental health.
This PhD studentship will investigate how differences in the social environment and social relationships might help to explain the association between deprivation, mental health, and alcohol use. The successful student will explore whether neighbourhood characteristics, including cohesion and attachment to community influences the relationships between i) deprivation and patterns of alcohol use; and ii) mental health, wellbeing and patterns of alcohol use. This could inform future systemic and community led initiatives to address alcohol-related harm.
The supervisory team has complementary expertise in alcohol epidemiology (Prof Sumnall), qualitative research (Dr Tod) and systematic review (Ms Jones), and mental health research and statistical modelling (Dr Goodwin; University of Liverpool). The student will benefit from the multidisciplinary expertise of supervisors/advisors, as well as the training/support opportunities provided by cross Faculty/Institutional working.
The student will be required to develop the programme of work, but we think that a mixed methods approach might be most appropriate. Suggested linked-studies include:
• S1: A rapid review with a realist-informed perspective will be used to develop a theoretical framework on the links between deprivation, neighbourhood social capital, mental health, and alcohol use. The review will provide an understanding of the mechanisms, and under what contexts (i.e. neighbourhood and social factors) alcohol related health outcomes are generated. This review will generate a logic model to inform all stages of research, and be updated as new evidence emerges from the work.
• S2: Mapping of existing high quality and representative cross-sectional and longitudinal data sources (through the UK Data Service); followed by a secondary analysis of these data informed by the emerging theoretical framework. Analysis will specifically address the research hypotheses outlined above.
• S3: Theory-led qualitative work in the community investigating context in more detail. This activity will run partly in parallel to, and complement, S2. We propose a participatory or creative data collection methodology such as neighbourhood ethnography or other participatory techniques such as photovoice. This will provide also provide an opportunity to engage with community members and organisations (e.g. sports clubs) with a view to future work around co-production of health promotion and interventions.

This is an exciting and important area of work, with relevance for practice and policy. This is multidisciplinary research and presents opportunities to collaborate with professionals and partners outside of University settings. It is likely to appeal to students from a broad range of disciplines, including, but not limited to public health, psychology, sociology, and health sciences. It is important that the prospective student shares our values of respect towards people and communities who may affected by substance use, and shares our commitment to undertaking research that seeks to reduce health and social inequalities.