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Ethnicity and Alcohol EthnicityChapter heading and alcohol A review of the UK literature Rachel Hurcombe July 2010 Mariana Bayley Anthony Goodman This literature review draws together recorded drinking patterns among minority ethnic groups in the UK over the last 15 years and considers the evidence for service provision and support. A recommendation in implementing the Government’s alcohol strategy, Safe. Sensible. Social. is to assess the need for and develop provision for black and minority ethnic groups. This need is heightened by the growing minority ethnic population and changes in consumption levels that may emerge over generations. The review explores differences in drinking patterns by ethnicity and the cultural and social contexts around which the use of alcohol is established and maintained. This review: • describes drinking levels as reported in national surveys and local research; • considers processes and infl uences that help to explain why drinking rates among ethnic groups in a new country may change over time; • examines help-seeking, support and service provision for minority ethnic groups; • examines the extent to which services are equipped to respond to the needs of minority ethnic groups. www.jrf.org.uk ChapterContents heading List of fi gures and tables 3 Executive summary 4 1 Introduction 7 2 Drinking patterns 15 3 Drinking cultures 37 4 Service provision and access 52 5 Conclusions and further research 65 Notes 69 References 70 Appendix 1: UK literature search results 77 Appendix 2: International literature search results 78 Appendix 3: Research samples and ethnic groups 79 Appendix 4: Categorising ethnicity within the literature 83 Appendix 5: Abstinence by ethnicity 85 Appendix 6: Abstinence by religion 88 Appendix 7: Frequent and current drinking patterns by ethnicity 90 Appendix 8: Frequent and current drinking patterns by religion 94 Appendix 9: Drinking intensity by ethnicity 95 Appendix 10: Drinking intensity by religion 99 Appendix 11: Age of initiation of alcohol use by ethnicity and gender 100 Appendix 12: Drinking consequences by ethnicity 101 Acknowledgements 104 About the authors 104 2 Contents List of fi gures and tables Figures Tables 1 Minority ethnic population in the UK, 2001 9 1 The UK population by ethnic group, April 2001 9 2 Age of fi rst consumption by ethnicity 31 2 The UK population by religious group, April 2001 10 3 Regional drinking rates in the UK 13 4 Differences in alcohol-related problems by ethnic group 29 5 Antisocial behaviour/law-breaking when drunk by ethnic and/or religious group 34 6 Attitudes to drinking by ethnicity 38 7 Drinking preferences by ethnicity 44 List of fi gures and tables 3 ChapterExecutive heading summary This literature review explores the research Mixed ethnicities on abstinence and drinking patterns among People from mixed ethnic backgrounds have minority ethnic groups in the UK over the last high rates of current use and are less likely to 15 years. It considers whether rates of alcohol abstain than people from non-white minority use are changing among ethnic groups and ethnic groups. People from mixed ethnicities the possible impact of changes in drinking also report relatively high rates of heavy and very behaviour on the support and services needed. heavy drinking compared with other non-white The report is based on a review of English- ethnicities. Differences between men and women language publications focusing on alcohol and for abstinence and frequent drinking are also less ethnicity that have been produced in the UK marked than for other minority ethnic groups. since 1995. White ethnicities Background Irish people are less likely to abstain compared with other ethnic groups and with the general Historically people from certain minority ethnic population. Deaths related to alcohol are groups report lower levels of drinking, and fewer higher for Irish men and women compared minority ethnic individuals present to alcohol with the general population in England and services with problems related to alcohol misuse. Wales, and adults in higher income brackets Some research shows that drinking patterns are more likely to exceed recommended in second-generation minority ethnic groups alcohol limits. Abstinence decreased among may start to resemble the drinking habits of the Irish girls between 1999 and 2004. general population. At the same time, drinking Deaths related to alcohol are higher for Scottish patterns among some fi rst-generation minority men and women in England and Wales compared ethnic groups resemble those from their country with the general population. of origin. Changes in the ethnic composition of local populations along with changes in drinking South Asian ethnicities rates present challenges to services in providing Alcohol-related deaths are higher among Indian accessible and culturally sensitive interventions men compared with the general population, that meet service users’ needs. Consequently, and between 1999 and 2004 Indian women an understanding of drinking patterns among showed an increase in drinking frequently minority ethnic groups, and their preferences and heavily. Indian women in higher income for support and service provision, is required. brackets are more likely to exceed recommended guidelines for alcohol consumption. Summary of fi ndings for Sikh men show high rates of heavy different ethnic groups drinking, and are over-represented for liver cirrhosis. However, second-generation male Most minority ethnic groups have higher rates Sikhs are less likely to drink or drink heavily of abstinence and lower levels of frequent and than fi rst-generation male Sikhs. Conversely, heavy drinking when compared with the reports of Sikh girls having ever drunk and British population as a whole and to people drinking frequently increased in the 1990s. from white backgrounds. Drinking patterns Although abstinence levels dropped for Hindu vary both between and within minority boys in the 1990s, and second-generation men ethnic groups. drink slightly more regularly than fi rst-generation men, heavy drinking among this group has not 4 Executive summary shown an increase. Hindus are less likely to drink of moving to a new country can be affected by if they report that religion is important to them. factors such as people’s access to education People from Bangladesh are less likely to and employment opportunities, socioeconomic consume alcohol than other ethnic groups, and status, and peer infl uences and lifestyle choices. drinking rates are low amongst the group. For example, changes in socioeconomic status Drinking is polarised for people from Pakistan. among some minority ethnic groups may help Drinking rates remain low among Pakistani men to account for changes in consumption levels. and women, but Pakistani men who do drink Indian, Pakistani, Chinese and Irish men, and consume more units of alcohol compared with Indian, Chinese and Irish women are less likely those from other minority ethnic groups. A similar to abstain and more likely to drink occasionally pattern emerges for Muslims; Muslim men and if they are in the highest income brackets. Irish women are both likely to abstain, but, among men and women, and Indian women, are also drinkers, rates tend to be high compared with other more likely to exceed recommended limits and religious groups. drink heavily if they earn higher incomes. In general, studies suggest that abstinence Chinese ethnicity and low levels of drinking among non- Despite low levels of drinking among Chinese white ethnic groups are associated with a men and women, frequent and heavy drinking strong ethnic identity, strong family and local rose signifi cantly for Chinese men between community ties, continuing links with the host 1999 and 2004. country, and maintaining religious values. Qualitative research has identifi ed sources of Black ethnicities tension between generations in some minority Black Caribbean people have higher levels of ethnic groups. Young people from minority ethnic drinking than people from South Asian and Chinese groups with strong religious ties that forbid drinking, ethnicities, but lower levels compared to people or that are less tolerant of drinking among women, from white backgrounds and with the general may hide their drinking for fear of repercussions population. They also have lower rates of alcohol- and bringing shame on their families. This is related mortality compared with people from evident among some young people belonging white and South Asian backgrounds in the UK. to the Muslim, Sikh and Hindu religions. Black African people have higher levels of drinking compared with most South Asian Support and service provision ethnicities,but lower rates of alcohol use than the general population and people from Minority ethnic groups are under-represented white backgrounds. They also tend to report proportionately among those seeking treatment rates lower than Black Caribbean people. and advice for drinking problems; they may not be aware of how they can be supported, Why drinking rates may be or of specialist or mainstream services. In changing particular, Muslim men and those on lower incomes from minority ethnic groups have Over time, minority ethnic groups who have settled reported being unsure about where to go in a new country may start to adopt new attitudes for advice. Reluctance to approach outside and behaviours, and their drinking rates may start agencies can lead to underestimating the to refl ect the rates found in the general population need among different ethnic groups. of that country. Researchers suggest that these Women and young people from South Asian processes of acculturation help to explain changes ethnic groups, who are expected to be abstinent, in drinking rates observed in some ethnic groups. may hide their drinking. For people who are Stress associated with migration has also been socially excluded because of their drinking and linked with increases in levels of drinking among are drinking at harmful levels, some research certain minority ethnic groups. The experience suggests that new approaches should be explored Executive summary 5 to raise awareness and discussion of alcohol ethnicity, for example, gender, religion and sexuality.
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