Abstract
BackgroundLittle is known about alcohol consumption among Africans living in rural and urban Africa compared to African migrants in Europe. We compared the patterns of alcohol consumption in a group of Ghanaians living in different locations in Ghana and in Europe and examined the factors associated with drinking alcohol.MethodsData were from a cross-sectional study (RODAM) of Ghanaians aged 25–70 years living in rural and urban Ghana and in Amsterdam, Berlin and London. Information on how often participants consumed at least one standard alcoholic drink in the preceding 12 months, the type of alcoholic beverage and the average serving size was obtained using a food propensity questionnaire. The associations between drinking alcohol and socio-demographic variables, and frequency of attending religious services were investigated using logistic regression models stratified by site and sex. For Ghanaians living in Europe, the number of years since migration and acculturation were also included in the model as covariates.Results4280 participants (62.2% women) were included in the analyses. In both men and women, the prevalence of drinking and amount of alcohol consumed per day was highest in Berlin (prevalence of drinking 71.0% and 61.7%) and lowest in urban Ghana (41.4% and 26.8%). After adjustment for age and education in both men and women in Europe, those attending religious services less frequently reported higher levels of drinking alcohol than non-attendants (never attend/no religion compared to attending service at least once a week men OR 4.60 95% CI 2.85, 7.44; women OR 1.80 95% CI 1.12, 2.90) p-trend with frequency <0.001 in men; 0.002 in women); this association was seen also in men in rural Ghana (p-trend = 0.001) and women in urban Ghana (p-trend = 0.02). The prevalence of drinking was positively associated with years since migration in both men and women in Europe ((OR per years increase in time lived in Europe 1.25 (95% CI 1.02,1.53) test for trend p = 0.03 in women; OR 1.29 (95% CI 1.03, 1.62 p = 0.03 in men) but no association was found with self-reported measures of acculturation (ethnic identity, cultural orientation or social networks).ConclusionThere are marked differences in alcohol consumption between Ghanaians living in Europe and in Ghana suggesting migration has an important influence of drinking patterns and also suggesting the possibility of requiring different strategies in alcohol reduction campaigns among Ghanaians in different locations.
Highlights
Alcohol consumption is a major public health issue worldwide, accounting for a significant burden of morbidity and mortality annually.[1,2,3] The harmful effect of alcohol is determined by the volume of alcohol consumed, and by the pattern of drinking and the quality of alcohol consumed.[4,5,6,7] The disease burden per litre of alcohol consumed has been shown to be greater in poorer populations and lower-income countries compared to higher income populations and countries.[8]Several factors have been identified at the individual and societal level to affect the magnitude and patterns of alcohol consumption
This study aims to compare the alcohol consumption and drinking patterns in a relatively homogenous population of Ghanaians living in different geographic locations in Europe and in urban and rural Ghana and to examine socio-demographic factors associated with the alcohol consumption in the different locations
Within Ghana, alcohol consumption was more common in rural than urban areas. In both urban and rural Ghana, the prevalence of drinking alcohol was lower compared to Ghanaians in Europe, in women. This supports the findings of a previous study comparing NCD risk factors in urban, rural and migrant populations showed a significantly lower alcohol consumption in urban compared to rural groups in China and Ghana whereas urban participants in South Africa were significantly more likely to consume alcohol regularly compared to rural participants.[12]
Summary
Several factors have been identified at the individual and societal level to affect the magnitude and patterns of alcohol consumption. These include environmental factors such as economic development, cultural and social factors including religious belief, availability of alcohol and the effectiveness of alcohol policies.[9, 10] A wide variation in alcohol consumption has been reported across world regions and between countries.[3, 11] Globally, the highest levels of alcohol consumption are reported in the European and American regions with intermediate levels reported in the African region.[3] Patterns and types of alcohol consumed may differ between countries but within different regions of a country such as urban and rural areas and in migrant groups.[12] Drinking behaviour could be influenced by drinkingrelated cultural norms which might differ between migrant and host populations.[13]. We compared the patterns of alcohol consumption in a group of Ghanaians living in different locations in Ghana and in Europe and examined the factors associated with drinking alcohol
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