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Countries that value autonomy and egalitarianism tend to have higher alcohol consumption

Dr. Joseph Delano Fule Robles
11 Dec 2017

Societies that value autonomy and harmony tend to have higher alcohol consumption as compared with more conservative societies that value hierarchy and embeddedness, a recent study has shown.

Data estimates of total alcohol consumption per capita (litres of pure alcohol per year) from 74 countries were obtained from the WHO Global Health Observatory data repository.

Analysis showed that cultural value orientations, namely autonomy and harmony, were significantly associated with alcohol consumption.  Hierarchy and embeddedness, which are characteristics of more traditional societies, were negatively associated with alcohol consumption. [Front Psychol 2017;8:1963]

Changes in cultural harmony, mastery, autonomy and egalitarianism were associated with increases in alcohol consumption in males, but not females. Changes in cultural embeddedness and hierarchy were associated with decreases in alcohol consumption in females, but not in males.

Among the variables, education and gender were found to be significantly and positively associated with alcohol consumption. Income, however, was not significantly associated with alcohol consumption.

Pearson correlation analysis between 35 European nations and 39 non-European nations revealed that for intellectual autonomy (r=0.16 vs r=0.08) and egalitarianism (r=0.30 vs r=0.02), European countries showed stronger positive correlations with alcohol consumption vs non-European countries. 

For hierarchy, European countries showed a weaker negative correlation (r=-0.07) with alcohol consumption vs non-European countries (r=-0.23).

Data were obtained from nine countries from Africa, 12 from the Americas, four from the Eastern Mediterranean region, 35 from Europe, five from Southeast Asia and nine from the Western Pacific region.

A 3-year average value for total alcohol consumption was obtained for males and females separately for 2008–2010.  Estimates for gross national income per capita were based on the 2011 International Comparison Program (ICP) of the World Bank Group.

“The results tell us that countries which highly valued intellectual and affective autonomy, such as Germany and the UK, generally had higher levels of [alcohol] consumption, and countries which highly valued embeddedness, such as Yemen and Senegal, generally had lower levels of consumption,” the authors said.

These data suggest that certain cultural characteristics in certain demographic areas would increase the risk for disorders such as hypertension, liver cirrhosis and chronic pancreatitis. [Prev Med 2004:38;613-619]

“This can be considered as a modifiable behavioural risk factor for non-communicable diseases such as cardiovascular diseases, cancer, chronic respiratory disease and diabetes at the societal level,” the authors added.

The strengths of the study include independent measurement of variables, specifically education, gender, income and alcohol consumption, from official statistics and self-reporting, which rules out any form of methodological bias.

However, other important variables that influence alcohol consumption, such as average age of a population, the price of alcohol, national alcohol laws/policies and degree of urbanization, were not controlled for.

“Our results suggest that bodies such as WHO should prioritize tackling alcohol consumption in countries that are more autonomous and less traditional, and future research should be directed at further understanding the relationship between cultural values and alcohol,” investigator Dr Richard Inman from the University of Lusiada, Porto, Portugal concluded.

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