Abstract
This multi-national study hypothesized that higher levels of country-level gender equality would predict smaller differences in the frequency of women’s compared to men’s drinking in public (like bars and restaurants) settings and possibly private (home or party) settings. GENACIS project survey data with drinking contexts included 22 countries in Europe (8); the Americas (7); Asia (3); Australasia (2), and Africa (2), analyzed using hierarchical linear models (individuals nested within country). Age, gender and marital status were individual predictors; country-level gender equality as well as equality in economic participation, education, and political participation, and reproductive autonomy and context of violence against women measures were country-level variables. In separate models, more reproductive autonomy, economic participation, and educational attainment and less violence against women predicted smaller differences in drinking in public settings. Once controlling for country-level economic status, only equality in economic participation predicted the size of the gender difference. Most country-level variables did not explain the gender difference in frequency of drinking in private settings. Where gender equality predicted this difference, the direction of the findings was opposite from the direction in public settings, with more equality predicting a larger gender difference, although this relationship was no longer significant after controlling for country-level economic status. Findings suggest that country-level gender equality may influence gender differences in drinking. However, the effects of gender equality on drinking may depend on the specific alcohol measure, in this case drinking context, as well as on the aspect of gender equality considered. Similar studies that use only global measures of gender equality may miss key relationships. We consider potential implications for alcohol related consequences, policy and public health.
Highlights
There is increasing recognition that gender equality, along with other social factors, influence health [1,2] and thereby, public health
Unlike results for public settings, married people reported significantly higher frequency of drinking in private settings than unmarried people and age was not associated with frequency of drinking
Unlike the public setting results in Model 2, only gender equality in educational attainment was significantly associated with the gender slope coefficient
Summary
There is increasing recognition that gender equality, along with other social factors, influence health [1,2] and thereby, public health. It is possible that increases in gender equality may lead to women adopting riskier and traditionally more male health behaviors, including smoking and alcohol consumption. These health behaviors, in turn, may negatively impact health outcomes. The relationships between macro-level gender equality and different health outcomes, including morbidity, mortality, reproductive health, mental health, tobacco, and violence (all of public health significance), have been explored [5,6,7,8,9,10]. This study generally found that increased gender equality predicted a convergence in alcohol consumption and consequences
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