Poverty and alcohol

 

From: ‘Oh go on – HAVE ONE MORE

(Published by Nest:  http://www.nestsrilanka.org/)

From the complex of connections between alcohol and poverty, this article tries to extract those with potential to generate novel and useful applications. Alcohol has diverse influences on people’s economic status while economic status in turn affects alcohol use in many ways. The impact of alcohol on poverty is more than through just the money spent on it. And the converse influence, of poverty on alcohol, has far more to it than found in the inane explanation that heavy consumption is the result of the harshness of poor lives. Less recognised aspects of the interactions between alcohol and poverty will be examined in some detail here.

We need also to look at some common factors that have impact on both alcohol use and poverty (for example, prevailing political philosophy) and things jointly influenced by alcohol and poverty (for example, health problems, education, wellbeing of families and society). This synergistic effect of alcohol and poverty has implications for agencies interested in promoting ‘development’.

Issues to address therefore include the following:

  1. Influence of poverty on alcohol use and problems.
  2. Influence of alcohol use on poverty and poverty alleviation.
  3. Effect of alcohol use and poverty on health, education and quality of life.
  4. What can be done to reduce harm and increase well-being in relation to each of these.

The literature on both subjects is vast, and much of it speculative. This paper is not a formal review of existing literature but an attempt to select things that have most promise in improving how we may understand the connections and how we can respond sensibly.  Given the intention to provide more of a synthesis than a collation of evidence, I have avoided referencing the document as a whole, and provided instead a list of the most important sources as a kind of reading list at the end. I try as well not to reiterate the known evidence-based strategies already in use for the public good. This is not to underestimate their value but to focus on the particular thrust of this paper.

Clear understanding is essential for progress. We need to see plainly the bases on which our current actions are founded. It becomes possible then to examine our assumptions critically and to put them to empirical test. Quite a few interventions for ‘poverty alleviation’ or reducing alcohol problems are founded on premises that are vague or not explicitly laid out for critical scrutiny. This makes their evidence-base weak.

What is true for alcohol is often true for many other ‘socially used’ chemical substances. But in this paper I avoid repeatedly saying ‘alcohol, tobacco and illegal drugs’, even when a statement applies to the wider set of substances, and choose instead to refer mostly to alcohol – with just occasional reminders of these other substances.

I will first, as background, set out a few significant attributes of poverty, poverty alleviation efforts and alcohol use that deserve attention. I will then take up the four issues listed earlier here.

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(among issues examined is the following)

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2.  INFLUENCE OF ALCOHOL USE ON POVERTY AND POVERTY ALLEVIATION

Meaningful connections as well as statistical associations support the conclusion that alcohol contributes to generating and worsening poverty in many societies. This conclusion may be disputed but it is undisputable that people don’t become wealthier by drinking more.

Of the many aspects of development on which alcohol has an impact, let’s consider the issues of how heavy a cost alcohol constitutes for the poor and the effect of alcohol on poverty alleviation.

Recognised alcohol spending

We generally recognize that the economic impact of alcohol consumption is too narrow a measure of its influence on development. Most people would also see that the economic impact of alcohol is not easily estimated by calculating the reported expenditures on alcohol, given the well known tendency of people to under-report their alcohol expenditures. But the reported cost of alcohol is still worth calculating.

In various studies and censuses the money spent on alcohol and other goods that people buy are surveyed and calculated. There are many formal and informal studies from poorer countries assessing the ‘economic impact’ of alcohol in terms of how much money people say they spend on alcohol – elicited by asking, for instance, the expenditure on alcohol in the past week or on a typical drinking day and so on. Despite the recognised likely underestimation, these costs for the poor are found to be a huge burden when viewed as a proportion of people’s income.

The percentage of income spent on alcohol is found to be vastly larger than what we’d guess. The combined cost of alcohol, tobacco and other such substances is, in abjectly poor communities, appallingly large. The damaging impact on the most deprived families, of desperately needed resources being thus taken away from the little available for food and other basics, should be constantly emphasised – until its seriousness is more widely recognised.

Unrecognised alcohol spending

Several mechanisms contribute to the underestimation of alcohol expenditure. One of these is simply the deliberate or unwitting under-reporting of costs by consumers. We can at least make a correction for such underestimates, for we suspect that this tendency operates. But there are other mechanisms too, which lead to some significant alcohol costs being unnoticed.

One unnoticed channel of alcohol expenditure it the subsidization of others’ alcohol expenses. Where one party wittingly or unwittingly pays for another’s drinks, the cost is not reported as such by the party that consumes or by the party that provides the money.  This is not a reference to the ritual of different members of the drinking group buying rounds of drinks but to a more ‘one-way’ channel, with heavier consumers being regularly subsidized by the others. In some non-western cultures the tendency for some drinkers to ‘persuade’ others to pay for their consumption is quite strong.

Small events are frequent and expenses are regularly pooled among heavy users and others and neither party notices or reports the real cost. Even non-celebratory or non-event-based alcohol use (namely regular or day-to-day use) is subsidized in many ways. Much of people’s ‘irregular income’ such as from lotteries, bribes, fraud and cheating, gets readily channelled into the alcohol pool. ‘Loans’ taken and not repaid, forcible donations gathered from various sources and collections for alleged communal good deeds are other sources of funds get channelled into meeting regular alcohol expenses. All of these occurrences lead to regular heavy drinkers having their expenses subsidized by others. A large contributor to the daily alcohol purchases of heavy drinkers of poorer families are their wives, who contribute part of their meagre earnings for the man’s alcohol, so as to keep the peace within the home.

Another kind of unseen payment is through contributions for special occasions or major celebrations. Events can range from annual family occasions to once in a lifetime celebrations. Money is taken on loan to keep up to expected standards, and failure to recoup may lead to a lifetime of crippling interest payments to local ‘loan sharks’. Property, jewellery and other possessions can be lost to the family as a result. These kinds of expenses are never reported in alcohol consumption surveys for they are not daily happenings. But their eventual impact is on day to day life.

Hindering poverty alleviation

Alcohol’s role in allowing people to intrude into others’ lives was described previously (under the heading ‘alcohol’). The lack of boundaries for poor people or porosity of the living space and the tendency for this to generate more obvious envy or jealousy was described as well – under the heading ‘poverty’.

Many poverty alleviation efforts try to get poor people to improve their economic status by increasing their incomes. The effect of these is usually unevenly spread among members of the poor community. This leads to improvement being visible.  When there is visible improvement of a family or a few families, while the rest remain as they were, the response of the others is not always wholehearted joy. A desire to stop a few families moving ahead of the common lot may result as well.

In communities dominated by elements hostile to the progress of one’s fellows, alcohol affords a ready means to intrude. A family or small group of families will find it quite hard to improve unless the most influential members of the community are included. The more powerful or influential members find it easiest to insist that their neighbours conform using the license given to intoxication. The heavier alcohol consumers are often the most difficult members of the community to help develop. But if they are likely to be ‘left behind’ they have ways to make sure that others don’t progress either. Alcohol itself constitutes a good means of siphoning money off those who are becoming better off.

Expenditure is enforced through several means. Heavier consumers can ensure, for example, the rule that every happy occasion must be an alcohol occasion. The feeling that much alcohol must be served for a ‘proper’ party is often strongly established. And the visibly improving families can be pushed to have celebrations for fear of becoming the target of negative reactions, especially from those who are loud when drunk. These are only examples of the numerous ways that exist, to keep everybody at the same level as those who are slowest to progress.

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(Eventual conclusions are as follows)

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CONCLUSION

 Poverty is not just low income. Nor are poor people a uniform and homogeneous mass, whose development needs are all the same. But some common characteristics that apply to poor living conditions can be recognised, such as the lack of boundaries leading to others intruding into personal life, aspirations being limited and all extra income being diverted uncontrollably into readymade unproductive channels – especially alcohol use. There are forces to address within and outside poor communities that contribute to ensuring that people do not escape from poverty.

The impact of alcohol on human development is not only on economic matters but also on general wellbeing – including healthy social relating. Alcohol affects both aspects. It is a significant contributor to maintaining and worsening economic difficulties and it likely plays a role in generating poverty too. It keeps poor people collectively poor. Alcohol consumption is driven strongly by ritual and symbolic pressures and not only by the desire for its chemical effect. Huge alcohol expenses impact not only on the families of heavy consumers but also on the community as a whole. Customs associated with alcohol use ensure that those who consume little or no alcohol have to subsidize those who consume more.

There is a major synergy between alcohol use and poverty in damaging people’s wellbeing, including their physical health. The combined influence of these two factors often has disastrous impact. A particular example is the permission that intoxicated individuals are given to interfere in the affairs of others. This social practice causes heightened harm in poorer settings – where the associated overcrowding allows intrusion into each other’s personal lives. The combined effect on the powerless is particularly nasty.

Actions to reduce poverty pay relatively little attention to modifying people’s spending habits and the factors that govern such habits. These include both local and remote influences – the impact of which can be modified by successful collective action. Lack of personal control over expenditure is particularly evident in relation to special events and celebrations. Alcohol provides a good ‘entry point’ to engage communities in a process of positive change or development, which includes taking control over their established patterns of expenditure. People find it quite feasible to reduce their collective alcohol expenditure, when guided to address collectively the determinants of use.

Responses to poverty, alcohol problems and their combined effects on human development would do well to consider the following recommendations:

  • Poverty reduction strategic plans should spell out clearly their underlying assumptions and premises and be comprehensive in their approach. There should be greater attention to the great variety and diversity of people and communities classified as ‘poor’.
  • Comprehensive strategies should include attention to common factors that impede progress of poor families and communities, and ways of overcoming these. Alcohol is an example of such factors, while the tendency for people in a crowded community to obstruct progress of others is another.
  • Poverty reduction interventions must include ways of improving management of limited resources. Unaffordable expenditure on substances such as alcohol, or on special events and celebrations, are examples of things that can readily be changed.
  • Strategic plans should provide space for local initiatives and actively seek lessons that can apply across settings.
  • Proposed poverty reduction interventions should spell out clearly the processes that they propose to generate, within families, communities and society at large, through which their expected results are to be reached.
  • There are many local or community level initiatives that deserve to be a part of broad poverty reduction initiatives. Examples are available of successes using interventions based on specific theoretical premises – which allow dissemination across a wide variety of settings.

Acknowledgement

 Some of the ideas that are set out here developed in the course of a collaboration in 2002/2003 with Bergljot Baklien (at the time with the Norwegian Institute for Rural and Urban Research) and Oystein Bakke of Forut, Norway, on a study of ‘Alcohol and Poverty in Sri Lanka’, sponsored by Forut.

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