Social roles and alcohol consumption: A study of 10 industrialised countries

The empirical evidence as regards the precise associations between alcohol use and social roles, and these associations across genders and cultures is heterogeneous. The literature tends to focus on two central but conflicting theories. The first – classic role theory – assumes that a higher number of social roles is associated with a more structured life and thus fewer opportunities to drink heavily. The second – the multiple burden hypothesis – posits that the increasing complexity of multiple social roles leads to higher stress levels, and thus to increased alcohol use. Survey data on 25–54-year olds in 10 western industrialised countries which participate in the Gender, Alcohol and Culture: An International Study (GenACIS) project were used to test whether holding the three main social roles – partnership, parenthood, and paid labour – had a more protective or a more detrimental association with problematic alcohol use than holding fewer roles. Age and education were included as possible confounders, while the outcome variables were risky single occasion drinking (RSOD) and heavy-volume drinking. For both men and women and in almost all countries, the study found that those who had all three roles were least likely to drink heavily or engage in RSOD, thus supporting the assumptions of classic role theory. It also found that the protective effect of multiple roles was more consistent for RSOD. There were a few countries where a two-role model gave a better fit. Results for Germany (RSOD), Switzerland, and the Unites States (heavy-volume drinking) indicate that the role of paid labour appears to be particularly relevant for risky alcohol use among women. Despite some variability in the association between paid labour and heavy drinking or RSOD among women, in almost all countries the greater the number of roles a person held, the lower their risk of this type of alcohol use was.     

The regional geography of alcohol consumption in England: Comparing drinking frequency and binge drinking

Alcohol consumption frequency and volume are known to be related to health problems among drinkers. Most of the existing literature that analyses regional variation in drinking behaviour uses measures of consumption that relate only to volume, such as ’binge drinking’. This study compares the regional association of alcohol consumption using measures of drinking frequency (daily drinking) and volume (binge drinking) using a nationally representative sample of residents using the Health Survey for England, 2011–2013. Results suggest the presence of two differentiated drinking patterns with relevant policy implications. We find that people in northern regions are more likely to binge drink, whereas people in southern regions are more likely to drink on most days. Regression analysis shows that regional variation in binge drinking remains strong when taking into account individual and neighbourhood level controls. The findings provide support for regional targeting of interventions that aim to reduce the frequency as well as volume of drinking.     

The Association between Scholastic Measures,Alcohol Outcome Expectancies and Alcohol Use: A Cross-sectional Study in Northern Ireland

Alcohol use among adolescents is associated with both short-term (truancy, illness, trouble with police) and long-term (dependence, unemployment) negative consequences. Moreover, because of its developmental nature, adolescent drinking behaviour is difficult to accurately assess. Individual-level scholastic variables and alcohol outcome expectancies have been found to be associated with drinking behaviours. This study used a cross-sectional design to investigate: the relationship between alcohol use and individual-level scholastic variables, namely academic motivation and academic self-efficacy; and the relationship between alcohol use and alcohol outcome expectancies, while controlling for a wide range of other variables. Participants were post-primary (high) school pupils in the greater Belfast area of Northern Ireland. They completed a range of questionnaires including measures assessing academic self-efficacy, academic motivation, alcohol outcome expectancies, and a composite measure of alcohol use. Results showed that, controlling for the hierarchical nature of the data, socio-demographic variables and other possible confounders, lower reported scores on the individual-level scholastic measures, higher reported scores on positive alcohol outcome expectancies, and lower reported scores on negative alcohol outcome expectancies remained significantly associated with more problematic drinking. Results are discussed in the context of contemporaneous school-related research.     

Eating disorders in adolescent boys: a review of the adolescent and young adult literature

Although a number of studies have investigated eating disorders in adolescence and the topic has been thoroughly reviewed, these studies have typically focused on females, only to state that the approach and treatment should be similar in males. Recently, there have been a number of studies that have explored gender differences in eating disorders. In this article, we review the literature pertaining to two DSM-IV-defined disorders (anorexia nervosa and bulimia nervosa), a DSM-IV-defined research disorder (binge eating disorder), and two DSM-PC-defined disorders (dieting/body image and purging/binge-eating behaviors), highlighting those findings that pertain to disordered eating in adolescent boys.     

Education,alcohol use and abuse among young adults in Britain

In this article we explore the relationship between education and alcohol consumption. We examine whether the probability of abusing alcohol differs across educational groups. We use data from the British Cohort Study, a longitudinal study of one week’s birth in Britain in 1970. We analysed data collected at age 34 (in 2004) and complement it with information gathered at previous sweeps. Measures of alcohol abuse include alcohol consumption above NHS guidelines, daily alcohol consumption and problem drinking. We found that higher educational attainment is associated with increased odds of daily alcohol consumption and problem drinking. The relationship is stronger for females than males. Individuals who achieved high educational test scores in childhood are at a significantly higher risk of abusing alcohol across all dimensions. Our results also suggest that educational qualifications and academic performance are associated with the probability of belonging to different typologies of alcohol consumers among women while this association is not present in the case of educational qualifications and is very weak in the case of academic performance among males.     

Westernization and tobacco use among young people in Delhi,India

Few studies have explored the relationship between acculturation and health in non-immigrant populations. The purpose of this study was to investigate the relationship between “westernization” and tobacco use among adolescents living in Delhi, India. A bi-dimensional model of acculturation was adapted for use in this study to examine (a) whether young people’s identification with Western culture in this setting is related to tobacco use, and (b) whether their maintenance of more traditional Indian ways of living is related to tobacco use. Multiple types of tobacco commonly used in India (e.g., cigarettes, bidis, chewing tobacco) were considered. Socioeconomic status (SES), gender, and grade level were examined as potential effect modifiers of the relationship between “westernization” and tobacco use. The study was cross-sectional by design and included 3512 students in eighth and tenth grades who were enrolled in 14 Private (higher SES) and Government (lower SES) schools in Delhi, India. A self-report survey was used to collect information on tobacco use and “westernization.” The results suggest that young people’s identification with Western influences may increase their risk for tobacco use, while their maintenance of traditional Indian ways of living confers some protection. Importantly, these effects were independent of one another. Boys benefitted more from protective effects than girls, and tenth graders gained more consistent benefits than eighth graders in this regard, too. Negative effects associated with identification with Western ways of living were, in contrast, consistent across gender and grade level. The positive and negative effects of acculturation on adolescent tobacco use held for all tobacco products considered here. Future interventions designed to curb youth tobacco use in India may benefit by paying closer attention to cultural preferences of these young consumers.     

Alcohol, marijuana, and American youth: the unintended consequences of government regulation

This paper analyzes the impact of increases in the minimum drinking age on the prevalence of alcohol and marijuana use among high school seniors. The empirical analysis is based on a large sample of students from 43 states over the years 1980-1989. We find that increases in the legal minimum drinking age did slightly reduce the prevalence of alcohol consumption. We also find, however, that increased legal minimum drinking ages had the unintended consequence of slightly increasing the prevalence of marijuana consumption. Estimates from a structural model suggest that this unintended consequence is attributable to standard substitution effects.     

Recent trends in risky alcohol consumption and related harm among young people in Victoria, Australia

OBJECTIVE: To examine recent trends in the proportion of young people who drink at risky levels and the rate of alcohol-related harms experienced by young people in Victoria, Australia. METHODS: The study uses published data from a series of surveys that ask questions relating to alcohol consumption to ascertain whether the proportion of young people drinking at risky levels has increased over the time period in which data are available. Alcohol-caused hospital admissions and emergency department presentations for young people are also examined over recent years to assess trends in alcohol-related harms. RESULTS: The survey data shows mixed results, with no clear trend in the rate of risky drinking among young people. The harms data suggests that rates of alcohol-related harm, particularly acute intoxication, have increased dramatically over recent years. CONCLUSIONS: The relationship between survey-derived estimates of alcohol consumption and rates of alcohol-related harms is not as clear-cut as expected, and raise concerns about the sensitivity of population surveys in detecting changes in harmful drinking patterns. IMPLICATIONS: The current increasing trends in alcohol-related harms for young people in Victoria suggest the need for immediate public health interventions.     

Cycling and the city: a case study of how gendered, ethnic and class identities can shape healthy transport choices

As a form of 'active transport', cycling has been encouraged as a route to improving population health. However, in many high-income countries, despite being widely seen as a 'healthy' choice, few people do cycle for transport. Further, where cycling is rare, it is not a choice made equally across the population. In London, for instance, cycling is disproportionately an activity of affluent, White, men. This paper takes London as a case study to explore why the meanings of cycling might resonate differently across urban, gendered, ethnic and class identities. Drawing on qualitative interview data with 78 individuals, we suggest first that the relative visibility of cycling when few do it means that it is publicly gendered in a way that more normalised modes of transport are not; conversely, the very invisibility of Black and Asian cyclists reduces their opportunities to see cycling as a candidate mode of transport. Second, following Bourdieu, we argue that the affinities different population groups have for cycling may reflect the locally constituted 'accomplishments' contained in cycling. In London, cycling represents the archetypal efficient mode for autonomous individuals to travel in ways that maximise their future-health gain, and minimise wasted time and dependence on others. However, it relies on the cultivation of a particular 'assertive' style to defend against the risks of road danger and aggression. While the identities of some professional (largely White) men and women could be bolstered by cycling, the aesthetic and symbolic goals of cycling were less appealing to those with other class, gendered and ethnic identities.     

吸烟、饮酒与肝癌关系的条件logistic回归分析

目的 探讨吸烟、饮酒与肝癌发生的关系.方法 采用配对病例对照研究,收集福州地区388例肝癌新发病例和388例对照,对可能的危险因素进行了调整混杂因素(喝茶、乙肝和人均收入)的多因素条件logistic回归分析.结果 在控制了混杂因素后,吸烟和大量饮酒的OR值分别是2.42和2.98.吸烟与饮酒对肝癌的发生具有联合作用....     

Conflicts in the workplace,negative acts and health consequences: evidence from a clinical evaluation

Interpersonal conflicts at workplace are increasing in relation to high competitiveness and pressures at work, mainly connected with labor market globalization. Their manifestation is multifaceted in relation to different working conditions and they not only hinder health, performance, and job satisfaction, but can also harm people''s rights and dignity. The study analyses issues related to work conflicts and adverse health consequences in 1,493 workers who approached a hospital service for work-related stress and harassment over a 3-year period. The subjects were examined according to a broad protocol covering working conditions, sources of conflict and negative actions suffered, and resulting impact on health status. Many critical conditions were reported in all occupational sectors with some differentiation in relation to gender (women more at risk) and employment status. Higher qualified levels were more exposed to experiencing severe personal adversities aimed at their progressive expulsion or resignation, with consequent higher risk of chronic adjustment disorders, while lower levels reported more stressful conditions in terms of interpersonal disputes and greater interference in the home-work interface. The study can provide useful indications for a better understanding of workplace conflicts in order to set up the most appropriate actions to manage and prevent them.     

'People make assumptions about our communities': sexual health amongst teenagers from black and minority ethnic backgrounds in East london

Objectives . (1) To explore sexual behaviour and relationships amongst Black and minority ethnic (BME) teenagers in East London. (2) To examine how these relationships are shaped by culture, gender, peer norms and religion. (3) To describe the implications for sexual health policy and practice in urban, multicultural areas.

Design . This report draws primarily on the qualitative arm of a mixed methods study which collected data from 126 young people, aged 15–18, largely through focus groups in the London boroughs of Hackney, Newham and Tower Hamlets.

Results . Previous research has reported culture influencing the patterning of risk/protection amongst BME groups. Our data suggest that this is mediated by gender, religion and youth. Religion reportedly influenced young women's sexual behaviour in multiple ways. Young people described gendered norms in meeting and flirting with partners, and the role of mobile phones and peer pressure.

Conclusion . Our paper suggests culture, gender, religion and youth influence BME teenagers in aspects of sexual relationships, and that these social markers may have different contextual meanings for individuals. The multiplicity of factors affecting attitudes/behaviour requires a range of contraceptive, counselling, screening and sex education services available for all teenagers, although delivery patterns may differ in response to differing needs.     

Comparative prevalence,correlates of impairment,and service utilization for eating disorders across US ethnic groups: Implications for reducing ethnic disparities in health care access for eating disorders

Objective:

The study compared the prevalence, correlates of functional impairment, and service utilization for eating disorders across Latinos, Asians, and African Americans living in the United States to non‐Latino Whites.

Method:

Pooled data from the NIMH Collaborative Psychiatric Epidemiological Studies (CPES;NIMH, 2007) were used.

Results:

The prevalence of anorexia nervosa (AN) and binge‐eating disorder (BED) were similar across all groups examined, but bulimia nervosa (BN) was more prevalent among Latinos and African Americans than non‐Latino Whites. Despite similar prevalence of BED among ethnic groups examined, lifetime prevalence of any binge eating (ABE) was greater among each of the ethnic minority groups in comparison to non‐Latino Whites. Lifetime prevalence of mental health service utilization was lower among ethnic minority groups studied than for non‐Latino Whites for respondents with a lifetime history of any eating disorder.

Discussion:

These findings suggest the need for clinician training and health policy interventions to achieve optimal and equitable care for eating disorders across all ethnic groups in the United States. © 2010 by Wiley Periodicals, Inc. (Int J Eat Disord 2011)

     

Covariations of emotional states and alcohol consumption: evidence from 2 years of daily data collection

We examined inter- and intra-individual covariations of mood and alcohol consumption in a sample of 171 light, medium, and heavy alcohol consumers aged 21 and over who reported daily about drinking and mood for a period of up to 2 years. The sample was recruited by advertisements in local newspapers and referral from former respondents in Northern Vermont, USA, between July 1997 and September 2000. Participants reported daily alcohol consumption and mood via interactive voice response (IVR) technology. Within-subject correlations were calculated for each individual separately and analyzed via cluster analysis. The cluster solution was subsequently used as a categorical Level-2 predictor in hierarchical linear modeling of daily alcohol consumption. Cluster analyses of the within-subject correlations revealed four clusters: (1) emotion-inhibited drinking (drinking combined with reduced emotional arousal, n=12); (2) "positive emotion drinking" (drinking in combination with positive mood, n=69); (3) "stress drinking" (drinking combined with negative mood, n=12); and (4) "non-emotional drinking" (no relationship between alcohol consumption and mood, n=78). Hierarchical linear modeling (HLM) analyses revealed that a significant amount of random variance of the Level-1 mood slopes (38% and 40%) was accounted for by the clusters, demonstrating the predictive power of cluster membership on individual drinking patterns. Although Cluster 3 members (stress drinking) did not report significantly higher levels of alcohol consumption, they were more likely to report current and lifetime dependence symptoms. The results point to the existence of stable, but diverse drinking patterns among non-clinical alcohol consumers with potentially different implications for development into alcohol abuse and dependence.     

Addressing alcohol and other drug use among young people from migrant and ethnic minority backgrounds: Perspectives of service providers in Melbourne,Australia

Young people from migrant and ethnic minority backgrounds are recognised as emerging priority populations for reducing alcohol and other drug (AOD)-related harms in Australia. Limited research has investigated how service providers address AOD challenges in migrant communities. In this qualitative study, we interviewed 15 service providers from AOD, migrant support, community and other health services in a diverse region of Melbourne. Interviews explored the challenges that service providers faced and the strategies they implemented to engage with young migrants in relation to AOD use. Thematic analysis was used to generate four themes: stigma as a barrier to service delivery, intergenerational differences between young people and parents, the need for outreach and establishing trust and understanding over time. Service providers believed that stigma prevented many young people from migrant backgrounds having open conversations about their AOD use with family members and professionals. Participants perceived that some parents had less AOD-related knowledge and lower English language proficiency than their children creating challenges for effective communication. Service providers recognised the importance of engaging with young people in settings where they felt comfortable rather than expecting them to approach their service. Participants also acknowledged the need to invest time in establishing trust and understanding with young migrants so they could facilitate conversations about AOD use as relationships evolved. Although service providers had a strong understanding of young people's needs, they found it challenging to build relationships in the context of funding and time constraints. Our results indicate the need for long-term funding and timelines that enable service providers to build strong relationships with young migrants, their families and their broader cultural communities to facilitate access to AOD support.     

Adolescent drinking,social identity,and parenting for safety: Perspectives from Australian adolescents and parents

We explored young people and parents' views on adolescent drinking and safety in the locations where drinking may occur. Focus groups with adolescents and parents showed that many believed adolescent drinking and drunkenness is normative. Younger adolescents had more negative views of adolescent drinkers than their older peers. Adolescent drinking occurred in private settings and parents made decisions about allowing their adolescent children to attend social events based on the level of safety attributed to the location. If adolescent drinking was likely then home was the preferred location as it provided scope for risk minimisation. Positive portrayals of non-drinking adolescents and information to assist parents' decision-making are needed.     

Alcohol consumption by parents of Pacific families residing in New Zealand: Findings from the Pacific Islands Families Study

Harmful alcohol consumption amongst Pacific people (those of Polynesian descent) is recognized as a public health priority in New Zealand, yet little epidemiological information exists on this pattern of drinking. Using a large birth cohort study, which includes the mother, father and child triad, this study aims to determine the prevalence and change in any harmful drinking levels prenatally, antenatally and in the postpartum period for mothers and fathers, and to measure the concordance of both partners' reports of that drinking in an ethnically representative sample of Pacific families within New Zealand. Participants were selected from births where at least one parent was identified as being of Pacific ethnicity and a New Zealand permanent resident (1376 mothers and 825 fathers at baseline); many of whom are young to middle aged adults. These participants have been prospectively followed-up multiple times since. The Alcohol Use Disorders Identification Test consumption questions (AUDIT-C) were used over successive measurement waves to define any and harmful drinking levels. Recommended screening thresholds were employed. Longitudinal analyses on complete cases and imputed data, accounting for differential attrition, were undertaken and reported. Clear temporal patterns of alcohol consumption emerged for both mothers and fathers, together with significant and important ethnic differences. Moreover, there was considerable movement in alcohol consumption categories between consecutive measurement waves for both mothers and fathers. Among couples, there was significant asymmetry in drinking patterns and poor statistical agreement. However, 9.1% (14.1% in imputed analyses) of Pacific children aged 2 years had both parents indicated for harmful drinking. The significant important heterogeneity and ethnic differences suggest that both ethnic-specific and pan-Pacific interventions and prevention strategies are likely needed for successful interventions. More emphasis should be placed on targeting and addressing parents' alcohol misuse, particularly in the antenatal or postnatal period.     

Alcohol, intestinal bacterial growth, intestinal permeability to endotoxin, and medical consequences: summary of a symposium.

This report is a summary of the symposium on Alcohol, Intestinal Bacterial Growth, Intestinal Permeability to Endotoxin, and Medical Consequences, organized by National Institute on Alcohol Abuse and Alcoholism, Office of Dietary Supplements, and National Institute of Diabetes and Digestive and Kidney Diseases of National Institutes of Health in Rockville, Maryland, October 11, 2006. Alcohol exposure can promote the growth of Gram-negative bacteria in the intestine, which may result in accumulation of endotoxin. In addition, alcohol metabolism by Gram-negative bacteria and intestinal epithelial cells can result in accumulation of acetaldehyde, which in turn can increase intestinal permeability to endotoxin by increasing tyrosine phosphorylation of tight junction and adherens junction proteins. Alcohol-induced generation of nitric oxide may also contribute to increased permeability to endotoxin by reacting with tubulin, which may cause damage to microtubule cytoskeleton and subsequent disruption of intestinal barrier function. Increased intestinal permeability can lead to increased transfer of endotoxin from the intestine to the liver and general circulation where endotoxin may trigger inflammatory changes in the liver and other organs. Alcohol may also increase intestinal permeability to peptidoglycan, which can initiate inflammatory response in liver and other organs. In addition, acute alcohol exposure may potentiate the effect of burn injury on intestinal bacterial growth and permeability. Decreasing the number of Gram-negative bacteria in the intestine can result in decreased production of endotoxin as well as acetaldehyde which is expected to decrease intestinal permeability to endotoxin. In addition, intestinal permeability may be preserved by administering epidermal growth factor, l-glutamine, oats supplementation, or zinc, thereby preventing the transfer of endotoxin to the general circulation. Thus reducing the number of intestinal Gram-negative bacteria and preserving intestinal permeability to endotoxin may attenuate alcoholic liver and other organ injuries.     

Elderly people from ethnic minorities in Liverpool: mental illness, unmet need and barriers to service use

The objective of the Health and Ethnicity Project was to identify unmet need and barriers to the use of psychogeriatric and welfare services by ethnic minority older people living in Liverpool's inner-city. The results presented here are the findings of Phase II of the project in which 71 ethnic minority older people aged 65 years and over were interviewed. These respondents had been diagnosed as suffering from dementia or depression earlier in Phase I. They include Black British, Afro Caribbean and Chinese older people. Findings show a low level of service use in spite of considerable unmet need. Only 8% were in institutions and 46% lived alone. For the 17% living alone in sheltered housing, there was evidence of violence towards wardens, wandering, neglect of rooms and occasional fires. Of the 27% living with a family nearly a half of cases also experienced physical disability. Those in institutions were finding language difficulties and problems in obtaining a suitable diet. Using Yeatts et al.'s typology (1992) ‘lack of knowledge’ barriers and ‘lack of intent’ barriers concerned the group as a whole most, i.e. they either did not know of services or perceived them as being culturally inappropriate. Implications for service providers are considerable: to ensure improved access it is necessary not only to invest more in general medical services but to work in partnership with ethnic minority groups to overcome barriers of mistrust and ensure cultural sensitivity in the services offered.