Drinking Among Older Canadian-Asians and Other Ethno-Cultural Groups
As many Canadian communities are ethnically diverse, it is important to consider different factors that might influence how and to what degree substance use problems such as alcohol or prescription drugs occur among specific ethnic groups of seniors in those communities.
For example, when a community has a large proportion of seniors who are from (or their ancestors came from) China, India, or South East Asia, how may that affect the proportion of older adult drinkers and older adult problem drinkers in that community? Does ethnicity affect seeking help for an older adult?
It is an important issue to consider in Canada. For example in British Columbia, over one million citizens of the province's 4 million population are immigrants — 60% of whom are from a visible minority. Of the 40,000 immigrants who arrived in BC in 2001, more than 75% were from an Asian country.
There really isn't any Canadian literature directly on point, but American researchers offer some starting points that may be helpful for looking at drinking norms and drinking problems among older Canadian-Asians and other Far Eastern ethnic groups:
We know that in the general Canadian population, drinking at any level tends to be less common among older age groups, and this is more often the case for women than men. This is also likely to be the same for specific ethnic groups. At the same time:
1. Remember, not all ethnic groups are the same: American research points out that although many surveys may treat people as a single ethnic group, this population is in fact ethnically highly diverse. (1) In Canada, Asians may include people of Chinese, Japanese, East Indian (e.g., Pakistani, Indian, and Sri Lankan), Korean, Filipino, and Southeast Asian (e.g., Vietnamese, Laotian, Cambodian, Malaysian, and Thai) origin. Even within each of these groups, various subgroups may exist. For example, Chinese-Canadians and their ancestors may have come to the Canada from Mainland China, Taiwan, or Hong Kong. There can also be differences in drinking depending on whether a person is a new immigrant who brings a cultural drinking pattern from a home country, or who is trying to adjust to the stresses here, or if a person's ancestors have been in Canada for generations.
In the United States, alcohol use has been studied most frequently in Chinese and Japanese people, followed by Koreans and Filipinos. Southeast Asians generally have been studied separately because their drinking problems tend to differ from those of other Asian-Americans. (1)
2. Education and income level can make a difference: We know that in general both educational attainment and economic status strongly influence drinking patterns and, consequently, risk for alcohol-related problems in the general Canadian population. That may be a factor for specific ethnic groups.
3. Understand diversity within the group: There is a lot of economic heterogeneity in and among each of the Chinese, Japanese, East Indian and South Asian groups. This may reflect things such language (do they speak either of the two official languages), work history, level of education, and how long they have been in Canada.
4. Understand attitudes and behaviours in place of origin: Drinking and drinking behavior may largely reflect the attitudes and behavior of the mainstream culture in which the respondents were living before coming to Canada, or in the case of those who were born here, the culture of the group.
5. Don't assume, understand how those attitudes may be changing: In Canada and in some Asian countries, drinking behaviors have changed substantially over the past few decades. That can significantly affect what we can say is "true" about any ethnic group's drinking pattern.
6. Rates of drinking can be lower, but vary from group to group: American research looking at the drinking patterns found that the lifetime alcohol use rate among Chinese-, Japanese-, Korean-, and Filipino-Americans is much lower than the general US population. Japanese-Americans had the highest percentage among the ethnic groups, and Chinese-Americans had the lowest, percentage of both lifetime drinkers and heavy drinkers. For example, in one large survey, 69% of Japanese-Americans, 49% of Korean- Americans, 38% of Filipino-Americans, 36% of Vietnamese-Americans, and 25% of Chinese- Americans reported consuming 10 or more drinks in their lifetime. (1)
The percentage in the American general population is 85%.
7. Drinking is more common among people with higher education. It has been suggested that because educational attainment is related to alcohol use patterns and East Indians in the United States have the highest proportion of people with advanced academic degrees among Asian - Pacific Islander immigrants, their drinking practices may differ (may be higher) from those of other immigrants. (1)
8. Genetics may have some influence as a protective factor: There has been some suggestion that genetic factors can influence the drinking patterns. For example, up to 50% of Asians carry a gene that causes to experience the unpleasant flushing reaction if they drink, these people may consume less or no alcohol and therefore be at reduced risk for alcoholism. (1)
9. Drinking norms are important too: Other research suggests that drinking norms and the availability of alcoholic beverages probably have at least as great an impact on alcohol consumption in Asian populations as do any genetic factors. (1)
10. Consider cultural values: Some researchers believe that low alcohol consumption levels among Asians are related to cultural values, such as the influence of ancient Confucian and Taoist philosophies on Chinese and Japanese drinking styles. The emphasis on conformity and harmony in those philosophies is believed to promote a moderate drinking style. (2) Or responsibility to others in the Chinese culture may help reinforce moderate drinking and sanctions against drunkenness. Also, drinking in most Asian cultures takes place in prescribed social situations, which may limit the likelihood of alcohol abuse.
11. But understand the risk factors too, especially for immigrants: Racism, physical, emotional and psychological stresses involved in migration, resettlement and adaptation to a new community and a new life, are all related to high rates of depression, anxiety and post-traumatic stress among immigrant groups. The high rate of current stress — the degree of stress created by adjustment- related tasks like learning a new language, finding a job, rebuilding social supports and redefining roles- is an important factor. (3)
12. Don't stereotype, cultural norms and groups change: Other American research (2) suggests a lot of caution in drawing conclusions. Despite the generally low drinking rates among Asian-Americans, there are substantial variations in drinking among different Asian groups. For example, in a study among four Asian ethnic groups in Los Angeles, there were more drinkers than abstainers among Japanese-Americans and Chinese- Americans and more abstainers than drinkers among Filipino-Americans and Korean-Americans.
13. There can be important in-group differences: The rates of heavy drinking also differed greatly among Asian groups: with the highest proportions of heavy drinkers found among Japanese-Americans, followed by Filipino-Americans, Korean- Americans, and Chinese-Americans. They also noted big gender differences: women being much more likely to abstain or consume lesser amounts of alcohol than men.
14. Be cautious about using treatment statistics as your measure of whether problems exist in the community: Not much is known about the utilization and effectiveness of alcoholism treatment among Chinese, Japanese, Korean, and Filipino groups. It is very clear that these ethnic groups generally are underrepresented in alcohol treatment centers (i.e., their proportion in the treatment population is lower than in the general population). Hospital admission rates for alcohol-related problems are low among these groups. (1)
15. Understand the stigmatization than can occur within the ethno-cultural group: Ethnic minorities may experience mental health stigmas more harshly than those from the majority group. The stigma for addictions is similar. "A greater sense of group identity in Asian cultures seems to extend stigma to the extended family more than in the Western world. As a result of this family-shared shame, coupled with different cultural perceptions of causes and treatments for psychological problems, research confirms that some minority groups in Canada delay longer in seeking any kind of treatment than Euro-Canadians." (3)
16. Status as elder: Another consideration is the expected role of older people within the families. It may be shaming and disrespectful to one’s elders and one's family for younger members to raise the issue of concern about an older person's drinking or other substance use problem.
17. Culture can make an important difference in how mental health and addiction problems are defined and described. The paper " Cross Cultural Mental Health and Addictions Issues" notes that "Racism within the mental health and addiction system can leave many who do seek out services struggling to integrate a medical diagnosis of mental illness or addiction with their different cultural, spiritual worldview and conceptions of health, illness and healing… In fact, it has been acknowledged in studies that mental health practitioners are generally more inaccurate in diagnosing persons whose race does not correspond with their own." (3)
18. Cultural differences can affect recognition of the issue by service providers: "Cultural differences often make it difficult for doctors and patients to communicate with one another. For example, … a Chinese person may report bodily symptoms in a doctor’s office and only offer emotional information about sadness and hopelessness if directly asked. If a person does communicate about emotions, it may be expressed in terms of metaphors. For example, in Chinese society, talking about “fatigue” or “tiredness” is often an indication of despair." (3)
19. Existing services often have barriers: This does not necessarily mean, however, that Asian-Americans have fewer alcohol-related problems than do other ethnic groups. Rather, the figures may reflect a reluctance of this population to use existing services. It has been pointed out that families rarely seek treatment for alcohol problems, because they want to avoid the shame and disgrace traditionally associated with admitting these problems outside the family.
20. Services can also reduce those barriers: At the same time, some studies have demonstrated that treatment utilization by Asian-Americans increases substantially if bilingual and bicultural personnel provide by the treatment services. (1)
(1) Makimoto, K. Drinking Patterns and Drinking Problems Among Asian-Americans and Pacific Islanders. Alcohol Health and Research World, Vol. 22 (4) 270-5. Online at: www.niaaa.nih.gov/publications/arh22-4/270.pdf
(2) Caetano, R., Clark, C. & Tam, T. (1998).Alcohol Consumption Among Racial/Ethnic Minorities, Alcohol Health and Research World, Vol. 22 (4) 236-238. Online at : www.niaaa.nih.gov/publications/arh22-4/233.pdf
(3) BC Partners for Mental Health and Addiction (2003) Cross Cultural Mental Health and Addictions Issues. Online: www.mentalhealthaddictions.bc.ca/content/disorders/crosscultural.pdf
Page last updated Sunday October 31, 2004
Questions? Comments? Contact Webmaster: