Abstract
To build on current understandings of alcohol use, this study explored socially based trajectories
of everyday alcohol use across the lives of indigenous Māori in Aotearoa, as described by older Māori. A Māori centred research approach was employed using face to face interviews with 13 older Māori people to explore their personal experiences of alcohol use over their lifetime. Thematic analysis was used to identify key life events and social factors which influenced
participants’ alcohol use within three chronologically ordered life stages: childhood, adulthood, and, older age. Participants’ perceptions of alcohol use by others during childhood, their first
alcohol use experience, meeting their partner and having children, and, the impact of ageing were all related to changes in alcohol use. These results build on public health conceptualisations
of alcohol use among Māori by offering insight into the social influences of alcohol use. These
findings can be used to inform future research to show the role of everyday alcohol use in regard to health and wellbeing.
Keywords:Māori; alcohol; social; policy; public health.
Introduction
The norms around alcohol use are socially learned, determined by changing values and attitudes, within cultures and across social environments (Jayne et al., 2010). Social factors including gender, social networks, religious ideologies, and ethnicity influence alcohol use (Cagney, 2006; Gordon et al., 2012; Oetting et al., 1998; Preston & Goodfellow, 2006; Rehm et
al., 1996). Accordingly, people’s alcohol use may change in response to changing social environments and factors at different life stages including childhood, adulthood and older age. Research shows for example that alcohol use increases among individuals during adolescence through to early adulthood (Casswell, Stewart, Connolly & Silva, 1991; Gates, Corbin &
Fromme, 2016), and this may be influenced by factors such as parental attitudes towards alcohol use (Casswell et al., 1991; Yu, 2003) and early exposure to substance use (Loxley et al., 2004, as cited in Toumbourou & Catalano, 2005). Life events such as separating from a partner, having children (Emslie, Hunt & Lyons, 2012; Jochman & Fromme, 2010), and marriage (Jochman & Fromme, 2010; Kretsch & Harden, 2014), have been found to influence alcohol use during adulthood. Dealing with illness or loss, retirement, and the influence of family and friends have
been identified as having an effect on older people’s alcohol use (Hodges & Maskill, 2014a;
Khan et al., 2006; Kuerbis & Sacco, 2012; Perreira & Sloan, 2001; Resnick et al., 2003; Wang, Steier & Gallo, 2014).
From a public health perspective, alcohol use is primarily framed in terms of problematic use and alcohol related harm (Inter-Agency Committee on Drugs, 2015; Jayne et al., 2010; Keane, 2009; Rehm et al., 1996; SIRC, 1998). Harms include those associated with intoxication such as accidents, injuries, violence, and crime, and those associated with long term alcohol use such as alcohol related health conditions (Inter-Agency Committee on Drugs, 2015; Ministry of Health, 2015). Accordingly, alcohol policy and interventions employ prevention and/or harm minimisation strategies (Inter-Agency Committee on Drugs, 2015; Keane, 2009; Stockwell, Gruenewald, Toumbourou & Loxley, 2005), including regulating alcohol access and enforcing alcohol use laws (Gray & Saggers, 2005; Inter-Agency Committee on Drugs, 2015; Stockwell et al., 2005), to reduce overall consumption, binge drinking, and the level of intoxication among individuals (ALAC & Ministry of Health, 2001; Inter-Agency Committee on Drugs, 2015; Keane, 2009; Wood, France, Hunt, Eades & Slack-Smith, 2008). Such interventions have acknowledged the social context of alcohol use, but only in regard to hazardous drinking and alcohol related harm.
Further, these initiatives may have limited applicability and relevance when applied to indigenous populations (Brady, 2000; Gray & Saggers, 2005; Wood et al., 2008). National data in Aotearoa show harmful alcohol use statistics among Māori have not reduced in the last two
decades (ALAC & Ministry of Health, 2001; Ministry of Health, 2009, 2015, 2016). This reflects other indigenous patterns of alcohol use over time (Wilson et al., 2010) and highlights the need
for more understanding of alcohol use. While harm minimisation strategies such as the Māori Warden organisation (Fleras, 1981) and alcohol-free marae (Durie, 2004) in Aotearoa include cultural perspectives, broader understandings of the social context of everyday alcohol use
among Māori and other indigenous populations are not part of public health theorising.
In line with much public health literature, there is widespread recognition of problematic and harmful use of alcohol among Indigenous peoples (Bjerregaard et al., 2004; Byron, 1996; Gray & Saggers, 2005; Hunter, 1993; Saggers & Gray, 1998; Seale et al., 2002), including Māori
in Aotearoa (Bramley et al., 2003; Durie, 2004; Fryer et al., 2011; Ministry of Health, 2009; Moewaka Barnes et al., 2003). However, researchers suggest the reporting of indigenous
people’s patterns of alcohol use are biased; focusing predominantly on harmful alcohol use, rather than on everyday and unproblematic use of alcohol (e.g. Sargent, 1983; Seale et al., 2002; Spicer et al., 2003). Such bias works to create and consolidate negative stereotypes (Spicer et al., 2003), as well as ignoring the diversity of alcohol use among indigenous people (Sargent, 1983). While it is important to acknowledge the issue of problematic alcohol use and its destructive impact within indigenous societies, constructions of indigenous people’s alcohol use may be
biased by a focus on problematic drinking alone and at the expense of ignoring the broader social location of alcohol use. This focus ignores questions about the role of everyday and non-
problematic alcohol use in relation to health.
Alcohol use in general has been recognised as a ‘normal’ part of everyday social life among Māori (Cagney, 2006; Durie, 2004), and research shows it is often socially motivated
(Awatere et al., 1984; Clarke & Ebbett, 2010; Herbert, Forster, McCreanor, & Stephens, 2017; TPK & ALAC, 1995). There has long been commentary on the scarcity of research exploring these social components (Awatere et al., 1984; Clarke & Ebbett, 2010; Saggers & Gray, 1998),
and such scarcity remains (McKenzie et al., 2014) suggesting that research on the everyday
social context of alcohol use among Māori is needed.
Among Māori, exploration of a social perspective would build on current public health
understandings, and provide a more nuanced picture of the diverse social realities of alcohol use. Moreover, consideration of the social factors and life events influencing such change across the lifetime is necessary for the development of more culturally appropriate and relevant national
alcohol policy and initiatives targeted at Māori (Keane, 2009; Wood et al., 2008). In this study, we aimed to highlight the broader social location of alcohol use within the everyday lives of
Māori by describing the perspectives of older Māori. Older Māori participants were recruited in
acknowledgment of their wealth of knowledge and understanding based on their lifetime
experiences. Such wisdom provides a depth of understanding of the socially based trajectories of
alcohol use among Māori.
Method
A Māori centred approach was employed in this study to understand alcohol use from
within a Māori worldview and in a mana enhancing manner (Cunningham, 2000; Durie, 1997a). This approach seeks to incorporate the research norms and expectations of Māori to ensure
ethical, appropriate and relevant research practice. For example, Māori centred research involves
the use of tikanga to guide research design and practice, and is founded on three key principles:
whakapiki tangata, whakatuia, and mana Māori (Durie, 1997a). Māori people, particularly older Māori, prefer research encounters that are face to face (Cram, 2001; Smith, 2012). Accordingly,
face to face interviews were used to provide a space for older Māori to share their experiences of
alcohol use.
Participants
Sixty participants from the Health, Work and Retirement Longitudinal study (see www.massey.ac.nz/hart/) cohort were invited to participate in the current study. Criteria for
participation were: those who identified as Māori, were aged 60 years or over, had consented to
being invited for interviews. Thirteen older Māori (7 men and 6 women) agreed to participate.
Participants were provided a pseudonym to protect their identity.
Procedure
Potential participants were sent an information sheet and an invitation to meet with the interviewer at a whakawhanaunga hui to discuss the research. All thirteen people who engaged in these hui chose to contribute to the project and were given the option of being interviewed directly after whakawhanaunga had concluded, or at a later date. Eleven opted to be interviewed directly after whakawhanaunga had concluded and two opted to be interviewed later. For these two participants a subsequent hui was arranged to conduct the interview.
For all participants, the interview and consent process was explained with opportunities for questions, before they signed a consent form and the recorded interview began. All hui were held at a venue chosen by each participant. Food and drink were shared at each hui, and koha were given to all participants.
Interviews
Individual interviews of 25-120 minutes duration were conducted in 2014. The variation in the duration of interviews was generally due to the diversity of alcohol use experiences among participants, the number of experiences, and the level of detail that participants chose to share.
The semi structured interview schedule comprised three open-ended questions to
facilitate open conversation. Questions were about general experiences of alcohol use, its role in
participants’ lives, and how their alcohol use had changed as they aged. Any general comments
on participants’ alcohol use were also invited. Participants were informed about the research
questions and then led the discussion by choosing what they wished to share and how. Participants generally responded by describing their lifetime alcohol experiences, including
stories of how alcohol was used in their family environment during childhood, their alcohol experiences during adulthood, and their current alcohol use.
Analysis
The audio-recorded interviews were transcribed for analysis. Eight participants requested to review their transcripts prior to analysis. Two made a number of changes to their transcript.
One participant removed parts describing other people’s alcohol use, that they felt uncomfortable
about including. Major edits were done on the other transcript because the participant felt they had missed important information and their changes were aimed at providing a more accurate account. All agreed to share the final versions of their transcripts. Thematic analysis, as outlined by Braun et al. (2015), was used to identify collective meanings and experiences in the data.
Using the qualitative analysis program Atlas.ti, version 6.2, data were coded based on recurring, repeated, and compelling ideas across the interview transcripts. This analysis revealed three key life stages that alcohol use stories were generally told within: childhood, adulthood and older age. We decided to focus on these life stages and the associated life events and social factors that had an influence on alcohol use. We specifically looked for the commonalities and differences within stories to reveal factors which influenced and shaped alcohol use according to
participants’ accounts.
Results
The participants’ stories of each life stage highlighted particular events and social factors which influenced their ideas about alcohol and its use, in different ways. Excerpts from the interviews are used to illustrate these within the following sections.
Childhood observations of alcohol use
When sharing stories of alcohol use by others in their family environments as children, participants generally described a continuum from abstinence to regular use, and explained why they thought this was the case. Those who described minimal family alcohol use described
barriers such as limited finances, living rurally with limited access to alcohol, religious homes
where alcohol was not permitted, or living in an era in which it was difficult for Māori to access
alcohol. For example Matua A described the limits of finances and access:
In my family its non-existent… Well very seldom use, because number one, we had
no money. Number two, there wasn’t access because there was only one hotel and
that was out in the bush and there were distances that were required to travel, but
basically there just wasn’t any money.
Some described occasional family alcohol use, usually during a particular social event. Participants generally described these occasions as positive, with sociable atmospheres involving
whānau, food, music, singing, and laughter. Outside of these occasions, alcohol use was
minimal. For example, Whaea C said:
Every two or three months there would be a party, there’d be some event; usually
a birthday, after someone’s wedding, or a baby born or something like that…and
there was lots of singing and lots of laughing… but it wasn’t like a regular, and my
parents never drank in between parties.
A third group described a family environment in which alcohol was used regularly. For example, Whaea A said: ‘I was bought up in it; my parents, my grandparents, they were all drinkers… and it’s not only in my family... but it happened in all our families, alcohol was just rife through the whole family’. These participants often described parties that lasted for several
days, where alcohol was shared among whānau and friends along with food and music. Some
participants who observed regular alcohol use highlighted negative aspects, such as violence, that occurred during these occasions. Matua MK said:
It was like…'Once were warriors’ when I was a kid. There where parties all the
time, they used to start Wednesday right through to Sunday when they go to
work… My grandparents were drinkers; they weren’t big drinkers but when they did drink it was violent.
Participants often described how their childhood experiences of family alcohol use contributed to their own attitudes and use of alcohol in adulthood. For some, their adulthood alcohol use reflected what they had observed as children while for others it was the opposite. For example, Matua MK, who was raised in a family environment with regular alcohol use, explains how this led to the development of his own minimal use in adulthood. ‘We [the children] just
thought it was normal I suppose… and it just put me right off [alcohol]’. Similarly, Whaea P
shared how her older sister’s regular alcohol use influenced her subsequent minimal alcohol use
during adulthood. ‘As my sisters got older, they left home, man could they hit the booze, and I
didn’t like it…seeing how alcohol affected them, and I didn’t want to be like that’.
Conversely, Whaea A described how her childhood family environment, involving regular alcohol use, predisposed her and her siblings to heavy and regular drinking in their early adult years. ‘As we grew up, we started drinking, my brothers and sisters, we all started… When I got pregnant with my children, I drank, because that’s all we did, that’s all we knew, was to drink’. Other participants contrasted their alcohol use in adulthood with their childhood family environment. For example, some who were raised in abstemious environments described regular alcohol use during adulthood.
In summary, descriptions of childhood observations of alcohol use in family
environments highlighted the diversity of alcohol use experiences among Māori whānau. These early experiences also impacted the development of participants’ own ideas and use of, alcohol
in adult life in different ways.
Alcohol use during adulthood
The second life stage focused on events that restricted or promoted alcohol use during early adulthood. Influential experiences included first alcohol use, meeting partners and their families, having children, and the social context of work.
All participants shared their first alcohol use experience. Some participants described their first experience as hidden from their parents, while others described being supervised by
their parents when they first tried alcohol. Most explained how their first experience influenced their subsequent alcohol use. For example, Whaea C said:
I was introduced to alcohol when I was fourteen years old and the next door
neighbour Mr. I… He said “you can have a little sip” and I was going round getting a sip from everyone’s glasses… and I was ill, oh god I was sick, I never
touched alcohol again until I was seventeen.
For some, like Whaea C, their first alcohol experience led to abstinence for some time. Other participants explained how their alcohol use followed their first experience, as described by Whaea A: ‘it [alcohol use] sort of just started from there’.
Participants reflected on how their alcohol use either decreased or increased as a result of meeting partners and having children, and this was often related to changes in their social milieu.
For example, Matua M describes how meeting his first wife and her whānau increased his
alcohol use:
There wasn’t much [alcohol] growing up until I met my first wife and her family,
that’s when the alcohol sort of affected me because that was part of their side of
living you know… My first wife’s father…used to get all the family, to help shear his sheep… and he would get someone to go up to the pub and buy some beer [afterwards] and that’s how it sort of started….I’d have one, have two, by the end of the night I was that drunk.
For others, alcohol use decreased after meeting their partner. They described ‘settling down’ into
a different kind of lifestyle. Matua W said ‘yeah, once I got married I had to pull back you know’.
For the women, the stories of alcohol use after having children were often descriptions of
family gatherings; coming together to share a meal. While alcohol was present, it wasn’t the
often linked reduced alcohol use to their roles and responsibilities as parents. For example Whaea D said:
I think my alcohol use did change [when she had children]. My husband drunk, so
he would go off to parties… and I stayed home and I only ended up going out with him when the children got a bit older, and our oldest was able to babysit.
Participants also spoke of their work context as a social location for regular alcohol use during adulthood. For example, Matua L said, ‘once I started working, I got into the shearing
sheds, that’s pretty synonymous with alcohol’. Similarly, Whaea PC said:‘basically I never drank at all until I started nursing’. Thus, the social environments of work promoted regular alcohol use among some participants during their adult lives.
In summary, changes to people’s social environments in adulthood triggered either
decreased or increased alcohol use. These reports highlighted the diverse, gendered, and
changing nature of alcohol use among this group of Māori during their adult years.
Alcohol use in older age
The participants generally described their current alcohol use as minimal, often limited to special occasions, and changing in relation to their lifestyle and ageing experiences. For
example, Whaea P said “I always have a drink on Christmas day, like a nice glass of wine…but
that’s it”. For those who had described minimal alcohol use during adulthood, there was little change in their current alcohol use. Others described a decrease in their use.