Hall, Wayne; Hunter, Ernest; Spargo, Randolph --- "Alcohol Consumption and its Correlates in a Remote Aboriginal Population" [1991] AboriginalLawB 38; (1991) 1(51) Aboriginal Law Bulletin 8

• Alcohol Consumption And Its Correlates In A Remote Aboriginal Population
• References:

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Alcohol Consumption and its Correlates in a Remote Aboriginal Population

by Ernest Hunter, Wayne Hall and Randolph Spargo

During the bicetennial year of European colonisation of Australia, the Royal Commission into Aboriginal Deaths in Custody briefly focussed national attention on Aboriginal affairs. Alcohol consumption and its consequences was a central issue throughout those investigations . Access to alcohol, along with an enduring prurient preoccupation with "the dreaded half-caste menace" (Bates, 1938), has long been a cause of obsessional ruminations by the framers of law and conventional morality. During a much earlier anniversary of colonisation, the fiftieth, the Licensed Publicans Act (1838) forbade the supply of alcohol to "any aboriginal native of New South Wales or New Holland". Subsequently, all mainland states and territories followed suit (McCorquodale, 1985). In some parts of remote Australia it was only two decades ago that legislation prohibiting the sale of alcohol to Aborigines was repealed.

The subject of Aborigines and alcohol is thus embedded in the history of inter-cultural relations that has only in the last decades received systematic attention. In this context alcohol is not only a substance, but a symbol; its prohibition has had complex meanings. In remote Australia access to alcohol was the most immediate and tangible expression of 'full rights', and for many Aborigines was seen as synonymous (Sansom, 1980). Alcohol - affected Aboriginal behaviour, which challenges and confronts the standards and norms of the wider society, clearly retains this meaning for certain groups (Sackett, 1988). While the illegality of Aboriginal drinking ensured that alcohol would be a central issue in Aboriginal / police relations, this has not ceased with the repeal of restrictive legislation. Aborigines remain the most frequently arrested and incarcerated group in Australia. In August 1988 Aborigines were placed in custody nationally at a rate twenty times that of non-Aborigines (Western Australia had a rate forty three times greater), with 30% of such detentions being due to drunkenness, some three times higher than the rate for non-Aborigines (McDonald, 1990).

In an era of supposed greater insight and understanding, the Aboriginal 'problem' has metamorphosed into a spectrum of Aboriginal 'problems' amongst which Aboriginal drinking looms large. The construction of this problem has changed with time, from a manifestation of aracially based deficiency in selfcontrol, requiring 'protection' through legislation; to the objectification of deviance necessitating incarceration; to the objectification of Aboriginal disadvantage, to be remedied with social interventions (such as the decriminalisation of public intoxication and the setting up of 'drying out' centres).

It is thus only recently that the inter-cultural context has been foregrounded in discussions of Aboriginal drinking, while the responses remain directed at Aborigines. The centrality of the social and historical context was presented from an Aboriginal perspective by the National Aboriginal Health Strategy WorkingParty which stated that:

"there is consensus in the Aboriginal community that understands the 'alcohol problem' from a community perspective, as a symptom (ultimately a symptom of dispossession) of alienation, and discrimination which leads to loss of self esteem" (1989:194).

Nevertheless, public opinion about Aboriginal alcohol use remains guided largely by prejudice and ignorance, compounded by a paucity of systematic research. Indeed, influencing the common wisdom regarding measures to 'deal with Aboriginal drinking problems' are three particularly tenacious stereotypes: that there is some genetic (read racial) factor, as a result of which Aborigines cannot "handle their grog"; that all Aborigines are drinkers; and that all Aboriginal drinkers are drunks.

The point of this paper is not to suggest that alcohol does not constitute a problem in Aboriginal communities. Indeed, the significant social and psychological consequences aside, with respect to the contribution of alcohol to premature morbidity alone, the available material indicates that the "proportion of Aboriginal deaths which are considered to be alcohol - related fluctuates around 10% (generally higher for men and lower for women: a figure which is three to four times higher than the general Australian population)" (Alexander, 1990:16). Rather, it is to illustrate the insubstantial basis on which prevailing stereotypes are grounded, and to examine those presumptions in the light of recent research.

While there are genetically based racial differences in alcohol metabolism, a genetic basis for Aboriginal vulnerability to the direct effects of alcohol is not supported by research evidence. There is only one study available, comparing a small mixed descent group of Aboriginal males with Europeans in Western Australia, which demonstrated no difference in rates of elimination (Marinovich, Larsson & Barber, 1976). However, genetic theories have resurfaced following research in the United States, leading to proposals for further genetic research with Aborigines. It is unlikely, regardless of research, that genetic theories will be abandoned.

The second two stereotypes can be examined in light of quantitative information gathered through research in the Kimberley region (Hunter, Hall & Spargo, 1991). The Kimberley region covers nearly half a million square kilometres of the far north of Western Australia, with an Aboriginal population for 1986 estimated at just over 13000. European occupation of the region has been substantially shorter than in the Eastern States, with the first permanent settlement being just over a century ago, and the last Aborigines 'coming in' from the desert only in the 1960's.

For this research a computer generated random sample of the Aboriginal population was generated. Over two years (1988 and 1989) 519 out of 532 individuals from the sample who were identified as alive and residing in the region were contacted, with 516 consenting to participate. The research involved anthropometric and cardiovascular examination, a dietary inventory, an assessment of alcohol intake, with sections of the questionnaire directed to exploring a number of social and psychological factors related to alcohol use. Alcohol use was quantified on the basis of the identified pattern of drinking (constant, intermittent or episodic) by diarising two forty-eight hour drinking periods to generate a quantity consumed per-drinking-day (in grams of alcohol).

The volume of information obtained precludes a comprehensive summary. Instead, information will be presented relating to: economic circumstances of Kimberley Aborigines; distribution of alcohol consumption and some social correlates of alcohol use, specifically incarceration. The methodology will not be discussed here; the reader is referred to the primary document for that information, and for a more comprehensive treatment of these and related issues.[1]

The Aboriginal population of the Kimberley, as defined by this survey, is clearly socially and economically disadvantaged by comparison with the wider Australian population. Only 14% of the sample were in paid employment, with the highest proportions being for males between twenty and thirty. The median monthly income (cash in hand) was larger for women than men ($522 and $462 respectively), and for those of mixed-descent compared to full-descent ($543-$469). While the difference by descent reflects opportunity (mixed-descent Aborigines more likely to live in towns where employment is possible, to have been educated, and to have had more opportunities for developing skills useful in dealing with bureaucracies), the differences by sex resulted from the structure of the welfare system that prioritises the needs of women with children. The Aboriginal employment profile is thus of late entry into the work force, high rates of unemployment, which is often chronic and interspersed by menial work, and early permanent exit from the work-force. Although our sample did pick a number of quite wealthy individuals, Aborigines of the Kimberley, by and large, are poor.

Current drinking status (drinker, ex-drinker or lifetime abstainer) was also powerfully related to age and sex, as demonstrated in figures 1 and 2. It is immediately evident that a significant proportion of Kimberley Aborigines do not drink, indeed more than among the wider population. It is also clear that there is a significant group who have given up alcohol, which for men constituted over a third of those aged forty one to seventy. Of the ex-drinkers, nearly three-quarters (64% of males and 85% of females) had stopped for more than two years. The major reasons identified for ceasing were personal and family relationships (45%), and health (31 %).

From the results of the sample and knowledge of the Aboriginal population structure of the region, it was possible to make estimates of the prevalence of drinking and patterns of consumption for the Kimberley Aboriginal population as a whole. This procedure predicted that 76% of adult Aboriginal males are current drinkers, equally divided between constant, intermittent and episodic drinkers. Only 46% of Kimberley Aboriginal women are drinkers, they are twice as likely to be episodic rather than constant drinkers, with intermittent drinkers intermediate. Thus Kimberley Aboriginal women are both less likely to drink, and less likely to drink frequently, than Aboriginal men. The proportion of current drinkers in this Aboriginal population is thus less than in the wider Australian population, where three-quarters of women and 87% of men identify as being alcohol consumers (National Heart Foundation, 1989).

Age and sex differences persist in the examination of quantity consumed. The amounts consumed are substantial, the median consumption per drinking day for young males being 169 grams, approximately eleven full cans of full strength beer (for young women median consumption was eighty-eight grams). For males, consumption falls progressively with age in a linear fashion, for females the quantity consumed per drinking day increases to the fourth decade, declining in a linear fashion thereafter, being between half to two-thirds of the levels for males at all ages. Using the National Health and Medical Research Council (1987) guidelines, 74% of episodic drinkers in the sample, 84% of intermittent drinkers, and 94% of constant drinkers were shown to be consuming alcohol at "harmful" levels (over sixty grams of alcohol per day for males and forty grams per day for females). These findings are consistent with other studies which similarly found a lower overall prevalence of drinking than in the wider society, but with a higher proportion of consumption at harmful levels, particularly amongst younger males (Watson, Fleming & Alexander, 1988). While the amounts consumed are generally large, there are Kimberley Aboriginal residents who drink moderately. This is a small, largely town resident group who consume alcohol episodically. The infrequency of consumption and the quantity consumed by these drinkers thus appears to be primarily a matter of choice, rather than reflecting the exigencies of access dictated by remoteness.

There were many social and psychological findings that emerged from the study. It is important to bear in mind that these correlates, in order to be meaningfully interpreted, must be located in the social and historical context of an Aboriginal population which has experienced three decades of rapid and profound social change. The study demonstrated significant correlations between reports of a variety of severe psychological symptoms (for example hallucinations, paranoid ideation and extreme fear states) and of impulses and acts of self-harm (self-mutilation and suicide attempts), with frequenter heavy drinking.

However, perhaps the most startling correlations were those found between alcohol consumption and incarceration. Reports of incarceration in a police lockup, regional or state prison, by age and sex, are demonstrated in figure 3.

The message is immediate and alarming. For Aborigines of the Kimberley, especially males, incarceration is to be anticipated at some point in life. Approximately a half of those adult males under fifty years of age have been in prison. Of those in the sample reporting previous incarceration, it was often a frequent event, with 92% of those answering affirmatively indicating that they had been in a police lock-up within the last year, and nearly 20% within the last month. The risk of incarceration was found to increase steadily with frequency of drinking, with the odds ratio for being incarcerated in a police lock-up being 183 times greater for a constant drinker than for a lifetime abstainer. Constant drinkers were also found to be significantly more likely to be imprisoned. For Kimberley Aborigines, being a male, and (for both males and females) drinking both more frequently and more per-drinking-day, all predicted a higher risk of detention and imprisonment. The findings of this research confirms that Aborigines of the Kimberley are socially and economically disadvantaged. As with previous surveys, this work demonstrates that the proportion of current drinkers among Kimberley Aborigines is less than among the wider Australian population. In addition there is a substantial group of middle aged and older Aborigines who have given up drinking, generally without formal intervention. There is in addition a group, though small, who consume alcohol in moderate amounts. However, the findings also clearly indicate that the majority of Aboriginal drinkers (in particular young males), are consuming alcohol in amounts that are likely to ultimately be harmful to health. In addition alcohol consumption is associated with numerous and often severe personal and social consequences.

It is the opinion of these researchers that while access to facilities and programs for the treatment of alcohol problems should be improved to the standard expected by the wider society, in itself this is clearly insufficient. There must, in addition, be the provision of culturally informed alternatives adapted to local circumstances. However, central to any initiatives that go beyond treatment to preventative strategies, is a commitment to improving economic and social conditions experienced by Aborigines in the Kimberley, and elsewhere.

References:

1. Alexander, K. (Ed.). (1990). Aboriginal alcohol use and related problems: Report and recommendations prepared by an Expert Working Group for the Royal Commission into Aboriginal Deaths in Custody. Alcohol and Drug Foundation, Australia, Canberra.

2. Bates, D. (1972 [19381) The passing of the Aborigines. London: Panther Books.

3. Hunter, E., Hall, W. & Spargo, R. (1991). The distribution and correlates of alcohol consumption in a remote Aboriginal population. Monograph No.12. National Drug and Alcohol Research Centre, Sydney.

4. McCorquodale, J.C (1985). Aborigines: A History of Law and Injustice, 1829-1985. Unpublished PhD thesis, University of New England.

5. McDonald, D. (1990). Research Paper No.13, National Police Custody Survey, August 1988, National Report. Royal Commission into Aboriginal Deaths in Custody, Canberra.

6. National Aboriginal Health Strategy Working Party. (1989). A national Aboriginal health strategy. Canberra: Department of Aboriginal Affairs.

7. National Health and Medical research Council. (1987). Is there a safe level of daily consumption of alcohol for men and women? Recommendations regarding responsible drinking behaviour. Canberra: Australian Government Publishing Service.

8. National Heart Foundation. (1989)National Heart Foundation risk factor prevalence study. Report No.3. Canberra.

9. Sackett, L (1988) Resisting Arrests: Drinking, development and discipline in a desert context. Social Analysis, 24, 66-84.

10. Sansom, B. (1980) The camp at Wallaby Cross: Aboriginal fringe dwellers in Darwin. Canberra: Australian Institute of Aboriginal Studies.

11. Smith, R. M, Hunter, E.M., Spargo, R.M & Hall, W. (1990). Feedback: A summary of research and findings on health and lifestyle presented to Kimberley Aboriginal communities - May 1990. CSIRO Division of Human Nutrition, Adelaide.

12. Watson, C., Fleming, J. & Alexander, K. (1988). A survey of drug use patterns in Northern Territory Aboriginal Communities: 1986-1987. Northern Territory Department of Health and Community Services, Drug and Alcohol Bureau, Darwin.

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[1] A simplified summary of the results of this research, based on materials presented during a region-wide tour to disseminate the findings to participants, communities and agencies, was produced through CSIRO division of Human Nutrition, Adelaide (Smith, Hunter, Spargo and Hall, 1990).