‘Women of my age tend to drink’: Understanding how older Australian and Danish women negotiate the pleasures and risks of their alcohol use
When we think of risky drinking, typically we think of young people ‘binge drinking’, passing out on the footpath and generally looking a bit ‘messy’. The media reinforces the notion that drinking is primarily a problem among young people by regularly circulating stories and images of young people being drunk in public and causing problems either to themselves or bystanders. This emphasis on young people’s drinking is not surprising, particularly since they are more likely to drink in public places, where their drinking is highly visible.
Less visible are the increasing numbers of older people in many first world countries who drink at levels that increase their risk of illness and injury. For example, between 2007 and 2016 the rate of risky drinking (defined as more than 10 standard drinks per week, or four standard drinks on any one occasion) among older Australians in their 60s increased by 17%, with this age group the most likely in Australia to have five or more drinks, at least five days a week (https://nla.gov.au/nla.obj-2442872363/view ). Rates of very high risk drinking (11 or more standard drinks at least yearly) among people aged 55-64 has also increased (https://nla.gov.au/nla.obj-2442872363/view).
In contrast, and despite their reputation as heavier drinkers, the proportion of 18-24 year old Australians drinking at risky levels has reduced significantly, from 31% in 2010 to 18.5% in 2016 (https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-key-findings/contents/alcohol-use), while most other age groups have also experienced a downward trend in risky drinking.
Among older women, risky drinking has increased relative both to older men and younger women. For example, the proportion of Danish women aged 55-64 years exceeding low risk levels is higher than among women aged 25-54 years, while Australian women aged 50-59 years are now more likely to drink at risky levels than any other age group – including 18-24 year old women. Current generations of middle aged and young-old (65-74 years) are also drinking more frequently than previous generations.
In our research, recently published in Sociology of Health and Illness (Dare et al. 2020), we explored the social context to drinking among Danish and Australian women aged 50 to 70 years that might help to explain these trends. Better understandings of where, with who and why older women drink are a necessary step in developing gender-sensitive, age-appropriate public health programs to help minimise alcohol-related harm in this cohort.
Rather than problematising women’s drinking, we wanted to understand the meanings women drinkers ascribed to their alcohol use. To do this, we adopted a qualitative interpretative approach, and used social constructionism as a framework to investigate how women ‘talk’ about their drinking. Through qualitative interviews with 24 Australian women and 25 Danish women aged 50 to 69 years (median age 60 years), we identified three major themes – ‘controlled and acceptable drinking’; ‘constructing alcohol use across the generations’; and ‘negotiating alcohol as a health risk’.
Across both cohorts, alcohol was overwhelmingly described as a normal, acceptable and enjoyable part of life for women their age. However, many of our respondents also qualified ‘acceptable’ and ‘moderate’ drinking among women, as being about their ability to ‘stay in control’ while drinking. That is, women appearing to be visibly intoxicated, falling over, being obnoxious, aggressive and crude was viewed as transgressing acceptable feminine norms of behaviour. In this context, drinking in an acceptable, age-appropriate way was defined by whether the women could control their behaviour, rather than how much or how frequently they drank.
Our respondents also defined their ‘acceptable’ drinking by contrasting it with younger women’s drinking practices. Both the Australian and Danish women constructed younger women’s alcohol use as problematic. They observed that younger women ‘drank to get drunk’, while in contrast they prioritised the aesthetic aspects such as the taste of fine wine. Such comparisons appeared to legitimise participants’ perceptions of their drinking as acceptable, and potentially enabled them to cognitively minimise their personal susceptibility to alcohol-related harm.
Only a few respondents viewed their drinking as a health risk. As with previous research documenting the “denial of injury” technique (Piacentini), several participants appeared to cognitively distance their drinking from health issues they were experiencing, or defended their drinking by suggesting health risks could be offset through exercise and a healthy diet.
By applying a social constructionist framework, our research highlights that some older women may be more likely to assess the appropriateness and acceptability of their drinking based on their ability to stay in control, rather than how much or how often they drink, or potential health risks. This indicates the need for public health campaigns that are more sensitive to older women’s beliefs, values and attitudes about alcohol and associated health risks, in order to minimise alcohol-related harms now and into the future.
Julie is a Senior Lecturer and Public Health researcher in the School of Medical and Health Sciences, Edith Cowan University, in Perth, Western Australia. She has a particular interest in the social context underpinning health behaviours, including alcohol use amongst middle-aged and older women, physical activity amongst older people, and the adoption of whole food plant-based diets. Julie has also led projects investigating social engagement and social isolation amongst older adults and is currently involved in research ranging from an exploration of social capital in a community centre, to promoting social engagement and wellbeing amongst frail older adults through exercise programs in residential aged care facilities.
Associate Professor, Head of Research, Clinical Nursing Research Unit, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Denmark. Mette has a Master in Nursing from Flinders University, Australia and a PhD in Medicine from Aarhus University, Denmark. Since 2002, Mette has worked with teaching, research and development within health and nursing sciences. Mette’s research interests include alcohol and other drug research; Fundamentals of Care, particularly among vulnerable and stigmatized groups, public health; health behaviour; mixed methods research and methodology development. In her current role as Associate Professor, Mette is highly engaged with PhD supervision, international research collaboration and research management.
Celia Wilkinson (PhD) has worked in the alcohol and other drug field for the past thirty years and has been conducting research on AOD and ageing for the past 15 years, commencing with her PhD on alcohol use amongst older Australians which was completed in 2008. She now currently works as a private consultant on AOD and ageing related
Kathrine Hoffmann Kusk
Sociologist, Clinical Nursing Research Unit, Aalborg University Hospital, Denmark. Kathrine has been working in the research unit for the last seven years with a lots of different work assignments. Kathrine’s research interest includes public health especially with focus on alcohol, Fundamentals of Care and methodology development.