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Kersey K, Lyons AC, Hutton F. Alcohol and drinking within the lives of midlife women: A meta-study systematic review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 99:103453. [PMID: 34653766 DOI: 10.1016/j.drugpo.2021.103453] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND A range of societal changes have created positive and encouraging environments for women's alcohol use. Within this context, in Western countries there is evidence of rising rates of alcohol consumption and related harms among midlife and older women. It is timely and important to explore the role of alcohol in the lives of midlife women to better understand observed data trends and to develop cohort specific policy responses. Focussing on Western countries and those with similar mixed market systems for alcohol regulation, this review aimed to identify 1) how women at midlife make sense of and account for their consumption of alcohol; 2) factors that play a role; and 3) the trends in theoretical underpinnings of qualitative research that explores women's drinking at midlife. METHODS A meta-study approach was undertaken. The review process involved extracting and analysing the data findings of eligible research, as well as reviewing the contextual factors and theoretical framing that actively shape research and findings. RESULTS Social meanings of alcohol were interwoven with alcohol's psycho-active qualities to create strong localised embodied experiences of pleasure, sociability, and respite from complicated lives and stressful circumstances in midlife women. Drinking was shaped by multiple and diverse aspects of social identity, such as sexuality, family status, membership of social and cultural groups, and associated responsibilities, underpinned by the social and material realities of their lives, societal and policy discourses around drinking, and how they physically experienced alcohol in the short and longer term. CONCLUSION For harm reduction strategies to be successful, further research effort should be undertaken to understand alcohol's diverse meanings and functions in women's lives and the individual, material, and socio-cultural factors that feed into these understandings. As well as broad policies that reduce overall consumption and "de-normalise" drinking in society, policy-makers could usefully work with cohorts of women to develop interventions that address the functional role of alcohol in their lives, as well as policies that address permissive regulatory environments and the overall social and economic position of women.
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Affiliation(s)
- Kate Kersey
- School of Health, Victoria University of Wellington, Kelburn Campus, Wellington, New Zealand.
| | - Antonia C Lyons
- School of Health, Victoria University of Wellington, Kelburn Campus, Wellington, New Zealand
| | - Fiona Hutton
- Institute of Criminology, Victoria University of Wellington, Kelburn Campus, Wellington, New Zealand
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Agardh EE, Allebeck P, Flodin P, Wennberg P, Ramstedt M, Knudsen AK, Øverland S, Kinge JM, Tollånes MC, Eikemo TA, Skogen JC, Mäkelä P, Gissler M, Juel K, Moesgaard Iburg K, McGrath JJ, Naghavi M, Vollset SE, Gakidou E, Danielsson AK. Alcohol-attributed disease burden in four Nordic countries between 2000 and 2017: Are the gender gaps narrowing? A comparison using the Global Burden of Disease, Injury and Risk Factor 2017 study. Drug Alcohol Rev 2020; 40:431-442. [PMID: 33210443 PMCID: PMC7983874 DOI: 10.1111/dar.13217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 10/09/2020] [Accepted: 10/23/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION AND AIMS The gender difference in alcohol use seems to have narrowed in the Nordic countries, but it is not clear to what extent this may have affected differences in levels of harm. We compared gender differences in all-cause and cause-specific alcohol-attributed disease burden, as measured by disability-adjusted life-years (DALY), in four Nordic countries in 2000-2017, to find out if gender gaps in DALYs had narrowed. DESIGN AND METHODS Alcohol-attributed disease burden by DALYs per 100 000 population with 95% uncertainty intervals were extracted from the Global Burden of Disease database. RESULTS In 2017, all-cause DALYs in males varied between 2531 in Finland and 976 in Norway, and in females between 620 in Denmark and 270 in Norway. Finland had the largest gender differences and Norway the smallest, closely followed by Sweden. During 2000-2017, absolute gender differences in all-cause DALYs declined by 31% in Denmark, 26% in Finland, 19% in Sweden and 18% in Norway. In Finland, this was driven by a larger relative decline in males than females; in Norway, it was due to increased burden in females. In Denmark, the burden in females declined slightly more than in males, in relative terms, while in Sweden the relative decline was similar in males and females. DISCUSSION AND CONCLUSIONS The gender gaps in harm narrowed to a different extent in the Nordic countries, with the differences driven by different conditions. Findings are informative about how inequality, policy and sociocultural differences affect levels of harm by gender.
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Affiliation(s)
- Emilie E Agardh
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Peter Wennberg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Mats Ramstedt
- Swedish Council for Information on Alcohol and Drugs, Stockholm, Sweden.,Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Ann Kristin Knudsen
- Centre for Disease Burden, The Norwegian Institute of Public Health, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Simon Øverland
- Centre for Disease Burden, The Norwegian Institute of Public Health, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Jonas Minet Kinge
- Centre for Disease Burden, The Norwegian Institute of Public Health, Bergen, Norway.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Mette C Tollånes
- Norwegian Organization for Quality Improvement of Laboratory Examinations, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Terje A Eikemo
- Centre for Global Health Inequalities Research, Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
| | - Pia Mäkelä
- Alcohol and Drugs Unit, Finnish Institute for Health and Welfare, Helsinkim, Finland
| | - Mika Gissler
- Information Services Department, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Knud Juel
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - John J McGrath
- National Center for Register-based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark.,Queensland Brain Institute, The University of Queensland, Brisbane, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Brisbane, Australia
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Stein Emil Vollset
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
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Törrönen J, Samuelsson E, Roumeliotis F, Room R, Kraus L. 'Social health', 'physical health', and well-being: Analysing with bourdieusian concepts the interplay between the practices of heavy drinking and exercise among young people. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 91:102825. [PMID: 32593513 DOI: 10.1016/j.drugpo.2020.102825] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The article examines the interplay between the practices of heavy drinking and exercise among young people. The comparison helps to clarify why young people are currently drinking less than earlier and how the health-related discourses and activities are modifying young people's heavy drinking practices. METHODS The data is based on interviews (n = 56) in Sweden among 15-17-year-olds and 18-19-year-olds. By drawing on Pierre Bourdieu's concepts of habitus, field, and capital, we examine what kinds of resources young people accumulate in the fields of heavy drinking and exercise, how these resources carry symbolic value for distinction, and what kind of health-related habitus they imply. RESULTS The analysis shows that young people's practices in the social spaces of intoxication and exercise are patterned around the 'social health' and 'physical health' approaches and shaped by gendered binaries of masculine dominance. The 'physical health' approach values capable, high-performative, and attractive bodies, whereas the 'social health' approach is oriented towards accumulating social capital. The analysis demonstrates that these approaches affect the interviewees' everyday life practices so that the 'physical health' approach has more power over the 'social health' approach in transforming them. CONCLUSION As the 'physical health' approach appears to modify young people's practices of drinking to be less oriented to intoxication or away from drinking, this may partly explain why young people are drinking less today than earlier. Compared to drinking, the physical health-related social spaces also seem to provide more powerful arenas within which to bolster one's masculine and feminine habitus. This further suggests that intoxication may have lost its symbolic power among young people as a cool activity signalling autonomy, maturity, and transgression of norms.
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Affiliation(s)
- Jukka Törrönen
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden.
| | - Eva Samuelsson
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden; Department of Social Work, Stockholm University, SE-10691 Stockholm, Sweden
| | - Filip Roumeliotis
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden; Department of Criminology, Stockholm University, SE-10691 Stockholm, Sweden
| | - Robin Room
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden; Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC 3086 Australia
| | - Ludwig Kraus
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden; IFT Institut für Therapieforschung, Leopoldstraße 175, 80804 München, Germany; Institute of Psychology, ELTE Eötvös Loránd University, 1075 Budapest, Kazinczy utca 23-27, Hungary
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