Gender Equality, Drinking Cultures and Second-Hand Harms from Alcohol in the 50 US States

Can alcohol policy prevent harms to women and children from men's alcohol consumption? An overview of existing literature and suggested ways forward

The World Health Organization's list of cost-effective alcohol control policies is a widely-used resource that highlights strategies to address alcohol-related harms. However, there is more evidence on how recommended policies impact harms to people who drink alcohol-such as physical health problems caused by heavy alcohol use-than on secondhand harms inflicted on someone other than the person drinking alcohol, i.e., alcohol's harms to others. In this essay, we describe evidence of impacts of alcohol policy on harms to women and children resulting from men's alcohol consumption, as well as options for making policies more relevant for reducing intimate partner violence and child abuse. We begin with an overview of harms to women and children resulting from men's alcohol consumption and review cost-effective alcohol policies with potential to reduce these harms based on likely mechanisms of action. Next, we present a rapid review of reviews to describe existing evidence of impacts of these policies on the outcomes of physical violence, sexual violence, and child abuse and neglect. We found little evidence of systematic evaluation of impacts of these important alcohol policies on harms to women and children. Thus, we advocate for increased attention in evaluation research to the impacts of alcohol policies on harms experienced by women and children who are exposed to men who drink alcohol. We also argue for more consideration of a broader range of policies and interventions to reduce these specific types of harm. Finally, we present a conceptual model illustrating how alcohol policies may be supplemented with other interventions specifically tailored to reduce alcohol-related harms commonly experienced by women and children as a result of men's alcohol use.

A longitudinal analysis on determinants of problem drinking among Korean women: focusing on a gender perspective

Background

In recent years, female drinking has been on the rise worldwide, and this trend can be observed in Korea as well. Accordingly, this study aimed to examine the heterogeneous longitudinal changes in drinking patterns among Korean women, while also exploring the determinants of these changes. In particular, the study identified the gender perspective-related determinants of the classified patterns of problem drinking.

Methods

Data on 4615 adult women who participated in the Korea Welfare Panel Study (KOWEPS) for 3 years (2018–2020) were analyzed longitudinally using SPSS Statistics 22.0 and M-plus 7.0. The changes in female drinking patterns were analyzed using latent class growth analysis. Subsequently, multinomial logistic regression analysis was performed to identify the predictive factors affecting the changes in drinking patterns.

Results

Latent class analysis yielded three classes: “low problem drinking/decreased,” “moderate problem drinking/maintained,” and “high problem drinking/increased.” Of the participants, 80.4% were in the first class, 14.5% in the second, and 5.1% in the third. After controlling for sociodemographic and psychosocial factors, we found: i) domestic violence, work–family balance stress, and gender role perception were not statistically significant for the “moderate problem drinking/maintained” class; lower levels of depression (odds ratio; OR = .750, p < .05) and higher levels of satisfaction with social relationships (OR = 1.257, p < .05) increased the probability of belonging to the “moderate problem drinking/maintained” group compared to the low problem drinking/decreased class; ii) in the “high problem drinking/increased” class, relative to the low problem drinking/decreased class, experience of domestic violence (OR = 1.857, p < .05), work–family balance stress (OR = 1.309, p < .05), and gender role perception (OR = .705, p < .05) were significant predictors of drinking behavior.

Conclusions

Problem drinking in Korean women demonstrated heterogeneous patterns of change, with gender-specific factors being the main predictors of this change. Therefore, this study developed a strategy for reducing the harmful effects of female drinking, which considers the characteristics of the changes in women’s drinking patterns as well as factors from the gender perspective.

Gender specific cut-off points of age for disability among rural elderly in Anhui Province, China

Objective

The purpose of this study was to determine the optimal cut-off values of age for disability in order to predict the risk of disability for older adults in rural areas.

Methods

WHO Disability Assessment Schedule 2.0 was used to assess disability. The cut-off values of age for disability were obtained by ROC curve analysis.

Results

The cut-off points of age for cognition restriction, mobility restriction, self-care restriction, getting along with people restriction, life activities restriction, and social participation restriction for men were 70.5, 68.5, 72.5, 70.5, 71.5, and 68.5 years old, respectively. The cut-off points of age for cognition disability, mobility restriction, self-care disability, getting along with people disability, life activities disability, and social participation disability for women were 72.5, 71.5, 70.5, 70.5, 71.5, and 71.5 years old, respectively. Over the cut-off values of age was an independent risk factor for disability (P < 0.05).

Conclusion

Presenting first disability symptoms were different between men and women. Preventive efforts to prevent future disability should be different for men and women.

Structural sexism and Women's alcohol use in the United States, 1988-2016

BACKGROUND

Women's alcohol consumption and binge drinking have increased concurrent with socio-economic gains and may be related to structural sexism.

METHODS

We examined associations between structural sexism (state-level sex inequality in political/economic status), and alcohol outcomes among women in Monitoring the Future (N = 20,859) from 1988 to 2016 (ages 27-45 in 2016). We controlled for state and individual confounders and tested three mediators: depressive symptoms, restrictive alcohol norms, and college completion.

RESULTS

Increased structural sexism was associated with decreased alcohol consumption frequency (RR: 0.974, 95% CI: 0.971, 0.976) and binge drinking probability (OR: 0.917, 95% CI: 0.909, 0.926). Norms and education but not depressive symptoms partially mediated these relationships.

CONCLUSION

Among women in the midlife in recent years, lower levels of state structural sexism were associated with greater alcohol consumption and binge drinking. These findings suggest that as states become more gender-equal-which confer numerous benefits for women's rights and health-additional resources and messaging may be required to prevent harmful alcohol use among women.

Abortion and the Mission of MCH: Perspectives of MCH and Family Planning Professionals in Health Departments

INTRODUCTION

Prior research shows that maternal and child health (MCH) and family planning (FP) divisions in health departments (HDs) engage in some abortion-related activities, largely when legally mandated; some agencies also initiate abortion-related activities. Yet little is known about health department MCH/FP professionals' views on how abortion-related work aligns with their professional mission.

METHODS

Between November 2017 and June 2018, we conducted in-depth interviews with 29 MCH/FP professionals working in 22 state and local HDs across the U.S. We conducted inductive thematic analysis to identify themes regarding participants' professional mission and values in relation to abortion-related work.

RESULTS

Participants described a strong sense of professional mission. Two contrasting perspectives on abortion and the MCH/FP mission emerged: some participants saw abortion as clearly outside the scope of their mission, even a threat to it, while others saw abortion as solidly within their mission. In states with supportive or restrictive abortion policy environments, professionals' views on abortion and professional mission generally aligned with their overall state policy environment; in states with middle-ground abortion policy environments, a range of perspectives on abortion and professional mission were expressed. Participants who saw abortion as within their mission anchored their work in core public health values such as evidence-based practice, social justice, and ensuring access to health care.

DISCUSSION

There appears to be a lack of consensus about whether and how abortion fits into the mission of MCH/FP. More work is needed to articulate whether and how abortion aligns with the MCH/FP mission.

Impact of Alcohol on Occupational Health and Safety in the Construction Industry at Workplaces with Scaffoldings

The value, care, and customs of workers are essential in terms of occupational health and safety. The abuse of alcohol is widely regarded as a serious threat to the lives, health, and safety of employees. The aim of the research was to identify the main problems that are associated with alcohol abuse and consumption at work among employees in the construction industry, with particular emphasis on workstations where work is carried out on construction scaffoldings. Data for the analysis were obtained from two different sources. The first one was post-accident documentation on occupational accidents. The second one was surveys collected during the research project. This study confirmed that excessive and disproportionate alcohol consumption can be the cause of an accident, and consequently death at workplaces with scaffolding. Of 219 accident reports, 17.4% indicated alcohol as a contributing factor. Analysis of accident documentations shows that in cases where alcohol was indicated as a contributing factor in an accident, the alcohol was consumed during the workday. The results obtained on the basis of the conducted research were able to constitute a justification for the directions of preventive actions carried out in order to reduce the number of occupational accidents in the construction industry caused by alcohol.

Do gender differences in the relationship between living with children and alcohol consumption vary by societal gender inequality?

INTRODUCTION AND AIMS

To better understand the relationship between alcohol consumption and living with children, we assessed whether the association varied for men and women across diverse countries and whether this relationship was moderated by country-level gender inequality.

DESIGN AND METHODS

We used Hierarchical Linear Modelling to analyse data from 32 surveys conducted in 27 countries. Measures included whether the participant was a drinker versus abstainer in past 12 months, annual number of drinks consumed, whether the respondent lived with children, gender (male/female) and age of respondent, and country-level gender inequality measured using the Gender Inequality Index.

RESULTS

Annual drinks consumed was significantly lower for women living with children. Men living with children were generally more likely to be drinkers, and the relationship between annual consumption and living with children was moderated by cultural gender equality: specifically, men in countries with higher gender equality drank less if they lived with children while the association for men in lower equality countries was nonsignificant.

DISCUSSION AND CONCLUSIONS

Although lower alcohol consumption was found generally for women living with children, this relationship was found only for men in countries where there was more gender equality. Given the high risk of harm to children from heavy consumption by adults with whom they live, prevention efforts need to strengthen prevention of heavy consumption by parents and other who live with children, especially for men who live with children in low gender equality countries.

Missing in Action: Sex and Gender in Substance Use Research

Substance use and misuse is a significant global health issue that requires a sex- and gender-based analysis. Substance use patterns and trends are gendered: that is, women and men, girls and boys, and gender-diverse people often exhibit different rates of use of substances, reasons for use, modes of administration, and effects of use. Sex-specific effects and responses to substances are also important, with various substances affecting females and males differentially. Nevertheless, much research and practice in responding to substance use and misuse remains gender blind, ignoring the impacts of sex and gender on this important health issue. This special issue identifies how various aspects of sex and gender matter in substance use, illustrates the application of sex- and gender-based analyses to a range of substances, populations and settings, and assists in progressing sex and gender science in relation to substance use.