Understanding the Role of Inequality in Creating and Sustaining the Alcohol Harm Paradox using Agent-Based Modelling

This PhD applies a different perspective and novel methods to attempt to understand a complex health phenomenon, the Alcohol Harm Paradox (AHP). This is the consistent finding that poorer people experience greater risk of alcohol harm despite drinking the same or less as richer people. Thus far a variable-centric approach focused on testing the relationships between health behaviours and harm has dominated research on the AHP. This thesis shifts to a mechanism-based approach rooted in the theories of health inequality to understand how the determinants of health inequality; from the actions and interactions of individuals to the impact of society, contribute to the AHP. Simulation methods, specifically agent-based models, are implemented to test the explanatory value of health inequality theory in creating and sustaining the AHP.