My understanding is that the relative income hypothesis is especially relevant
for understanding differences WITHIN nations as well as between them.  While I
tend towards a materialist argument by which greater incidence of poverty would
be related to greater drug use,  the Kawachi, Kennedy, Wilkinson argument is
that people who really aren't poor -- by vitue of comparisons with others --
suffer feelings of shame, envy and stress.  The social comparison process --
also accompanied by weakening social cohesion -- leads to maladpative behaviours
such as drug use.  This may especially be the case in places like the USA (and
the UK?) The weight of evidence suggests that if the relative income hypothesis
has validity it more likely does so in its attempts to explain issues WITHIN
nations rather than BETWEEN nations.

dr



The idea 'that drug problems may be much more of a function of inequalities
within societies rather than any absolute measures of poverty' is based on a
misunderstanding of the relative income hypothesis, which seeks to explain
why health outcomes vary between (relatively wealthy) countries, not why
some people within a country have worse health than others. There is an
extremely steep social 'gradient' in drug misuse within countries which
suggests that poverty and deprivation are closely associated with the more
harmful forms of drug misuse. A study in Greater Glasgow, for example, found
that although there were few differences between affluent and deprived areas
in the proportions of young people who had tried drugs, the most deprived
areas of the city had a rate of emergency hospital admission 30 times higher
than the most affluent. An aggregate-level association between income
inequality and drug misuse does not explain why deprived areas or
individuals are more likely to suffer drug-related harm than affluent ones,
and may reflect higher rates of poverty in more unequal places rather than
the corrosive effects on inequality on the social fabric.

Peter