Alcohol use and misuse account for 3. The harmful effects of alcohol misuse are far reaching and range from individual health risks, morbidity, and mortality to consequences for family, friends, and the larger society.
This article reviews a few of the cultural and social influences on alcohol use and places individual alcohol use within the contexts and environments where people live and interact. It includes a discussion of macrolevel factors, such as advertising and marketing, immigration and discrimination factors, and how neighborhoods, families, and peers influence alcohol use.
The alcohol research literature is overwhelmingly focused on risk factors, from the societal level down to the individual. Worldwide, 3. Excessive alcohol use is the third leading cause of death in the United States, accounting for 88, deaths per year Centers for Disease Control and Prevention Globally, alcohol-attributable disease and injury are responsible for an estimated 4 percent of mortality and 4 to 5 percent of disability-adjusted life-years DALYs Rehm et al.
The harmful codings da alcool in Engels of alcohol misuse are far reaching and range from accidents and injuries to disease and death, as well as consequences for family, friends, and the larger society. Economic costs attributed to excessive alcohol consumption are considerable. Much of codings da alcool in Engels costs result from a loss in workplace productivity as well as health care expenses, criminal justice involvement, and motor vehicle crashes Rehm et al. This article reviews some of the cultural and social influences on alcohol use and places individual alcohol use within the contexts and environments where people live and interact.
This is not an exhaustive review but aims to show the wide range of contexts that may shape alcohol use. Across the world, men consume more alcohol than women, and women in more developed countries drink more than women in developing countries Rehm et al.
American men are much more likely than women to use alcohol Binge drinking is defined here as the number of instances in the past 12 months that women drank 4 or more drinks and men drank 5 or more drinks within a 2-hour period. Among racial and ethnic groups, Whites report the highest overall alcohol use among persons age 12 and over Alarmingly, according to two nationally representative samples, trends in alcohol misuse increased among both men and women and African-American and Hispanic youth over the decade between — and — Rates of dependence also increased among men, young Black women, and Asian men during the same time period Grant et al.
Given these trends, it is clear that a better understanding of the underlying social and cultural factors contributing to these disparities is needed. For example, socioeconomic status SES indicators i. People with higher SES tend to drink more frequently than others Huckle et al. Among drinkers, low-SES groups tend to drink larger quantities of alcohol Huckle et al. Like other health issues, alcohol use can be linked to a complex array of factors ranging from individual-level i.
On a population level, emerging research has documented the relationship between social determinants and health Berkman and Kawachi ; Berkman et al. Social capital theory suggests that social networks and connections influence health Berkman et al.
Individuals who have higher levels of social support and community cohesion generally are thought to be healthier because they have better links to basic health information, better access to health services, and greater financial support with medical costs. Berkman and Kawachi This article examines these population-level as well as individual influences through a social—ecological framework, which posits that human health and development occur across a spectrum—from the individual to the macro or societal level Bronfenbrenner In the context of alcohol use, individuals are nested within their microsystem their home, work, and school environmentswhich is nested itself within the larger community.
Macrolevel factors, such as exposure to advertising, may influence family and peer network attitudes and norms, which ultimately affect individual attitudes and behaviors see figure. A social—ecological framework for explaining influences on alcohol use. Individual-level factors that influence alcohol use are nested within home, work, and school environments, which are nested within the larger community. Macro-level factors, such as exposure to advertising, may influence family and codings da alcool in Engels network attitudes and norms, which ultimately affect individual attitudes and behaviors.
Media exposure helps influence social norms about alcohol through advertising, product placements, and stories in a wide range of sources, including movies, television, social media, and other forms of entertainment.
Although alcohol sales and marketing are highly regulated, people are exposed to a wide variety of alcohol and liquor advertisements, especially in the United States. Whether these advertisements directly result in an increase in consumption has been the topic of many public policy debates and much alcohol and consumer research.
Recent studies have used robust methodological designs in order to assess the effects of advertisements on alcohol consumption Grenard et al. It is likely that the effects of advertisement differ across age groups and races. The alcohol industry uses complex targeted marketing codings da alcool in Engels that focus on African Americans, Latinos, and American Indians, among other demographic groups, such as youth and other ethnic minorities Alaniz and Wilkes ; Codings da alcool in Engels et al.
Empirical studies show that targeted alcohol marketing results in individuals developing codings da alcool in Engels beliefs about drinking, and creating and expanding environments where codings da alcool in Engels use is socially acceptable and encouraged Alaniz and Wilkes ; Hastings et al. These factors can result in the onset of drinking and binge drinking, and in increased alcohol consumption Tanski et al. Since the introduction of flavored codings da alcool in Engels beverages in the s, the alcohol industry has engaged in targeted marketing efforts toward youth in general, and especially young codings da alcool in Engels Mosher and Johnsson Products with sweet fruity flavors, colorful appearance and packaging, as well as lower alcohol content are designed to appeal to young women.
Fruity drinks mask the taste of traditional alcoholic codings da alcool in Engels with the sugary flavors of soft drinks Mosher and Johnssonmaking them more palatable for this consumer market. Although the alcohol industry claims that its marketing strategies target adults ages 21—29, products like flavored alcoholic beverages remain attractive to younger drinkers.
Research estimates that Approximately 75 percent of high school seniors and 64 percent of high school 10th graders report having experimented with alcohol Kann et al. Youth under age 21 see and hear marketing for flavored alcoholic beverages disproportionally on a per capita basis compared with adults Jernigan et al.
Furthermore, youth exposed to alcohol advertisements tend to drink more on average than their peers who were exposed to less intensive alcohol-related marketing Snyder et al. Specifically, the authors found that each additional advertisement viewed by youth increased the reported number of drinks consumed by 1 percent. Alcohol marketing also can lead to youth and young adults developing alcohol brand preferences Albers et al.
For example, youth reported on average 11 more drinks per month when responding to an online survey that used brand-specific measures compared with a survey using more general alcohol measures Roberts et al.
The relationship between alcohol brand receptivity and alcohol brand consumption also has been linked to whether codings da alcool in Engels when adolescents codings da alcool in Engels to binge drink Morgenstern et al. Increased use of social media for alcohol marketing has paralleled changes in communication methods among adolescents and college-age youth Hoffman et al.
Marketing techniques for a wide range of products reflect studies that online platforms are likely to influence codings da alcool in Engels behaviors Cook et al. Social-networking sites such as Twitter, Instagram, and Facebook feature alcohol-related marketing.
One study found that bythere were more than 1, alcohol-related sites on Facebook alone Nhean et al. Alcohol use increases with the number of online peer ties and greater peer density, a measure of interconnectedness in the social network Cook et al. Despite self-imposed regulations aimed at preventing underage youth from accessing alcohol advertisements on social media, more than two-thirds of advertisements on YouTube are accessible to youth under the legal drinking age Barry et al.
Racial and ethnic minorities, especially those living in African-American communities, are likewise exposed to targeted alcohol beverage advertisements Wilson and Till African Americans account for 13 percent of the U. Malt liquor generally has higher alcohol content, is less expensive, and is sold in larger volumes than other beers and ales, and African Americans are exposed to more malt liquor advertisements than other groups.
Billboards and other advertisements for malt liquor are disproportionately found in neighborhoods with higher percentages of African Americans, and rap music lyrics frequently mention malt liquor Herd ; McKee et al.
When examining alcohol advertising in newspapers, Cohen and colleagues found that there were more alcohol-related ads in newspapers targeted to African-American readers compared with newspapers with a more general readership. Kwate and Meyer found a correlation between problem drinking among African-American women and exposure to alcohol advertisements, suggesting that as ad exposure increased, so did alcohol consumption.
These findings, however, must be interpreted with caution, as it is difficult to determine whether advertisements directly result in increased alcohol consumption. To begin with, a variety of marketing strategies including distribution, product development, pricing, and codings da alcool in Engels marketing all may affect links between advertising and consumption Alaniz and Wilkes ; Roberts et al.
For example, Molloy found that after controlling for targeting, only moderate advertising effects are seen, despite the strong correlations between alcohol advertising and drinking among youth.
It also is unclear which aspects of online social media advertisements are related to the observed correlations. Research shows that drinkers like advertising about alcohol more than nondrinkers do, respond neurologically to the advertising more intensively than nondrinkers do, and may recall the advertising more clearly Snyder et al.
As a result, making causal statements about alcohol use and marketing is problematic because the temporal order between using alcohol and seeing advertisements is not frequently established Snyder et al. Despite these challenges, it is important to develop new strategies to systematically examine the impact of advertising and marketing on alcohol use among different populations. Further research and evaluation studies also are needed that can help establish whether and how advertising and marketing can lead to alcohol use in vulnerable and disadvantaged populations.
A codings da alcool in Engels of social and cultural factors predict increased alcohol use, including discrimination and its related stigma. The role of discrimination and stress codings da alcool in Engels health-related risk behaviors, including alcohol use, is well established Dawson et al. The stress and coping framework frequently is applied to explain the influence of discrimination and stigma on health Krieger ; Pascoe and Smart Richman ; Walters et al.
This long-held theory posits that people consume alcohol to cope with the stress of their daily lives, including work-related stressors and racial and ethnic discrimination Conger Discrimination is seen as a key social stressor that elicits a physiological response, including elevated blood pressure and release of stress hormones Williams and Mohammedwhich may have lifelong deleterious effects, including increased alcohol use Pascoe and Smart Richman Self-reported unfair treatment and racial discrimination has been linked to higher alcohol use among Asian Americans Chae et al.
The picture is less clear among African Americans. Although similar positive associations have been found between level of discrimination and alcohol use in this population Boynton et codings da alcool in Engels. However, Borrell and colleagues did report an association between discrimination and past-year alcohol use. Past studies suggest that African Americans with higher levels of education were more likely to report experiencing discrimination, whereas the opposite was true among Codings da alcool in Engels Borrell et al.
This may be codings da alcool in Engels better educated African Americans find themselves in situations in which they may be exposed to discrimination, or they may be more acutely aware of how subtly it can be expressed.
Whites of lower SES may be in the minority and therefore may be more likely to report experiencing discrimination. This may explain the mixed results found in this particular population segment, as socioeconomic position actually may mute the effects of discrimination on alcohol use. Further research is needed to examine these potential mechanisms and other underlying factors that interact with racial discrimination to influence and alcohol use and misuse among minorities.
Another group that may be at particular risk for alcohol problems stemming from their experiences with discrimination are those in the lesbian, gay, bisexual, and transgender LGBT community, who experience high levels of discrimination related to sexual orientation and gender identification Krieger and Sidney One study found that more than two-thirds of LGBT adults experienced discrimination, and individuals who reported discrimination based on race, gender, and sexual orientation were almost four times more likely to use alcohol and other substances McCabe et al.
This suggests that future studies and public health interventions should focus not only on racial and gender discrimination, but also sexual orientation and gender identification. Societal influences can shape drinking behavior among immigrants to the United States.
Innearly 40 million people, or 13 percent of the Codings da alcool in Engels. With wide diversity among immigrants in terms codings da alcool in Engels national origin, language, religion, and social class, and with even more reasons for and processes of migration than ever before Dubowitz et al.
Immigration may influence alcohol consumption and its consequences in at least two ways. The first theory suggests that immigrants encounter difficulties and hardships as they transition into a new society and culture Berry Hardships include the stress of experiencing new environments and cultures; living in poor neighborhoods; finding good, secure jobs in safe work codings da alcool in Engels encountering few opportunities to enhance income or wealth; and engaging with fewer and smaller social networks that codings da alcool in Engels otherwise offer instrumental and emotional support.
It also is codings da alcool in Engels that immigrants may not become fully integrated into American society because of experiences with discrimination and obstacles in social mobility Unger et al. Because these factors are associated with alcohol consumption and problems, immigrants may consume more alcohol Unger et al.