Kim Bloomfield

Alcoholics Anonymous as a Mutual-Help Movement : a Study in Eight Societies

This collaborative study offers a look at Alcoholics Anonymous as a social movement, a belief system, a model for small group interactions and an international phenomenon. It covers what happens at an AA meeting, how members interact and how it fits into varying cultural traditions.

Do neighborhoods affect individual mortality? A systematic review and meta-analysis of multilevel studies

There has been increasing interest in investigating whether inhabitants in socially or physically deprived neighborhoods have higher mortality when individual socioeconomic status is adjusted for. Results so far appear ambiguous and the objective of this study was to conduct a systematic literature review of previous studies and to quantify the association between area-level socioeconomic status (ALSES) and all-cause mortality in a meta-analysis. Current guidelines for systematic reviews and meta-analyses were followed. Articles were retrieved from Medline, Embase, Social Sciences Citation Index and PsycInfo and individually evaluated by two researchers. Only peer-reviewed multilevel studies from high-income countries, which analyzed the influence of at least one area-level indicator and which controlled for individual SES, were included. The ALSES estimates in each study were first combined into a single estimate using weighted linear regression. In the meta-analysis we calculated combined estimates with random effects to account for heterogeneity between studies. Out of the 40 studies found eligible for the systematic review 18 studies were included in the meta-analysis. The systematic review suggests that there is an association between social cohesion and mortality but found no evidence for a clear association for area-level income inequality or for social capital. Studies including more than one area level suggest that characteristics on different area levels contribute to individual mortality. In the meta-analysis we found significantly higher mortality among inhabitants living in areas with low ALSES. Associations were stronger for men and younger age groups and in studies analyzing geographical units with fewer inhabitants.

Investigating gender convergence in alcohol consumption in Finland, Germany, the Netherlands, and Switzerland: A repeated survey analysis

Since the 1970s there has been concern that women may have started to adopt the drinking behaviors of men, a process seen as the result of emancipation in which women increasingly move into professions and/or lifestyles similar to those of men. This is called the convergence hypothesis. The present analysis investigated a possible closing of the gender gap and includes four countries that had national survey data for at least two time points: Finland (1984, 1992), Germany (1984, 1990), The Netherlands (1981, 1989), and Switzerland (1987, 1992). Significant convergence could be found only in Finland, which consisted of a greater increase of Finnish women becoming current drinkers and of a greater relative increase in the womens mean consumption. The fact that gender convergence was found only for Finland could be due not only to the longer observation period, but also to the egalitarian position of women and the changing drinking culture of the country.

Alcohol Consumption Estimates in Surveys in Europe: Comparability and Sensitivity for Gender Differences

The comparability of general population studies on alcohol from nine European countries is evaluated from three points of view: (1) methodologic aspects influencing alcohol estimates, (2) variation between countries in coverage of sales estimates of alcohol consumption, and (3) associations between type of question used to measure alcohol consumption and gender differences in alcohol consumption. With respect to methodologic aspects, it was found that the studies differed on most of the 10 points included in this comparison. The coverage of sales estimates by surveys varies between 39% (Germany) and 56% (France). With respect to type of question and gender differences, it was found that more elaborate sets of questions on alcohol consumption are associated with smaller gender differences in the prevalence of heavy drinking (>600 g 100% alc/mo). It is concluded that the methodologic differences between studies and the differences in sales coverage do not allow cross‐national comparison of survey estimates of alcohol consumption of different European countries. Compared with more elaborate sets of questions on alcohol consumption, simple questions on alcohol consumption are likely to underestimate gender differences in the prevalence of heavier drinking.

Gender differences in drinking patterns in nine European countries: descriptive findings

Gender differences in drinking patterns in nine European countries (the Czech Republic, Finland, France, Germany, Italy, The Netherlands, Scotland, Sweden, and Switzerland) were examined using data from surveys conducted in the late 1980s and early 1990s. Drinking patterns were analyzed with regard to sociodemographic variables such as age, education, employment, marital status, and parenthood. Age was closely related to drinking in every society, but the patterns were different in different societies. Women with higher education tended to consume more alcohol than women with lower education in many societies, whereas a similar pattern was not found among men. Unemployment seemed to be more strongly related to womens drinking than to that of men. Divorced men consistently consumed the most alcohol in every country. Parenthood was profoundly and consistently associated across societies with womens monthly consumption and prevalence of heavy drinking.

Drinking Cultures and the Position of Women in Nine European Countries.

Nine European countries involved in the Biomed Project “Alcohol Consumption and Alcohol Problems Among Women in European Countries”; are described in relation to sociodemographic characteristics and drinking patterns. The populations of the nine countries, especially women, have become much older during the period 1950–1995. Also, women tend to have fewer children, and at an older age, so that the percentage of the younger age groups is decreasing. If we connect this to the fact that women now are more a part of the labor force than before, we might infer that the observed decrease in gender difference in alcohol use is to be explained in relation to economic factors. In terms of drinking patterns, a broad division can be made between two wide regions: (a) the northern dry area, where beer is the leading beverage, consumed on weekends and outside mealtimes; and (b) the southern, or Mediterranean, wet area, where wine is the main beverage, usually drunk at meals. However, the dispersion in alcohol consumption found among the study countries in 1961 declined considerably by 1997. In this respect, European countries are getting more similar, so that we may consider this phenomenon a “convergence”; of alcohol drinking in Europe. More generally, changes from a more traditional drinking pattern to a novel one from another country may be due to several factors, one of which is the increasing relevance of women in the drinking context. On the treatment side, such a relevance is nowadays visible through the better availability of both health services and nonstatutory organizations to take care of women affected with alcohol‐related problems.

Socio-demographic correlates of alcohol consumption in the Danish general population

Aims: Little is known about specific Danish drinking patterns. This paper investigates how various socio-demographic factors are related to Danish alcohol consumption with special focus on age and sex. Methods: Data come from a national telephone survey of the Danish general population conducted in 2003 with a final sample size of 2,030 cases. Measures of beverage specific current drinking, overall drinking, daily drinking, heavy episodic drinking, mean consumption, volume per drinking occasion and frequency of drinking were analysed. Results: A little over 5% of the population are abstainers. Fourteen per cent of men and 9% of women are heavy drinkers; 38% of men and 18% of women are heavy episodic drinkers. Youth of both sexes drink heavily, and especially in a binge drinking style. Regular, more temperate drinking is associated with increasing age. Multivariate analyses suggest that other than age and sex, classical socioeconomic factors do not play a great a role in determining drinking patterns. Social integrative factors in particular influence womens drinking. Conclusions: With respect to the rest of Europe and North America, Danes consume high levels of alcohol with a large percentage of youth drinking in a binge pattern. Classical socioeconomic factors play a lesser role in determining drinking patterns compared to other Western countries. Longitudinal studies and studies of alcohol-related consequences in the Danish general population should be conducted to better formulate alcohol and public health policy.

Alcohol Consumption and Alcohol Problems Among Women in European Countries.

Traditionally, less research has been conducted on womens drinking as compared to mens. But womens drinking has been shown to differ from mens in terms of consumption patterns and in factors determining heavy and problematic drinking. Thus, special efforts are needed to increase knowledge in this field. This article introduces a set of papers from the recently completed concerted action project “Alcohol Consumption and Alcohol Problems among Women in European Countries, “ supported by the European Commission. The aim of the study was to examine and compare the drinking patterns and problems of women in 9 European countries. This was done by comparing alcohol consumption and alcohol problem rates within and between countries and between men and women and among women. The project also developed recommendations for much needed standardized measures of alcohol consumption and alcohol problems for use in European alcohol epidemiological research.Traditionally, less research has been conducted on womens drinking as compared to mens. But womens drinking has been shown to differ from mens in terms of consumption patterns and in factors determining heavy and problematic drinking. Thus, special efforts are needed to increase knowledge in this field. This article introduces a set of papers from the recently completed concerted action project “Alcohol Consumption and Alcohol Problems among Women in European Countries, “ supported by the European Commission. The aim of the study was to examine and compare the drinking patterns and problems of women in 9 European countries. This was done by comparing alcohol consumption and alcohol problem rates within and between countries and between men and women and among women. The project also developed recommendations for much needed standardized measures of alcohol consumption and alcohol problems for use in European alcohol epidemiological research.

Women's Roles and Women's Drinking: A Comparative Study in Four European Countries.

The present study analyzes the influence of role combinations on heavy drinking in four European countries: Finland, France, Germany, and Switzerland. Data sets come from nationally representative surveys. A growing number of studies have investigated the influence of social roles on alcohol consumption. Different theories such as role accumulation, role overload, and role deprivation aim to explain the association between roles and poor mental health, including heavy alcohol consumption. The results show that roles and role combinations influence heavy drinking differently in each country. The findings also indicate that the social position of women in a country is strongly connected to the differing associations between specific role combinations and heavy drinking across countries. No single role theory can be applied cross‐culturally. Large‐scale surveys are needed to test statistically the association between role combinations and heavy drinking.

Life stage, alcohol consumption patterns, alcohol-related consequences and gender

This paper presents findings from a European collaborative study. A common framework for reanalysis of existing data was devised. Alcohol‐related problems encountered were classified as “internal”; and “external.”; Logistic regression analyses were then conducted to predict lifetime presence of any internal problem, any external problem, and any problem at all. The predictor variables were gender, life stage (corresponding roughly to young, middle and older age), past years drinking level in four categories of grams of alcohol per month, and past years “binge”; drinking. All four predictor variables were associated with the presence of alcohol‐related problems, with women and retired people having fewer problems and heavy drinkers and binge drinkers having more. At all levels of alcohol consumption, men were more likely than women to experience at least one adverse consequence. Internal problems were more common than external problems. Country differences are discussed and recommendations are made for further studies.