Consideration of our data in light of theories of lay epidemiology
and identities has informed an under-recognised area of
public health concern. Strengthening the evidence for specific risks
to health from alcohol and clarifying how these interact with
behaviour might increase the impact of preventive strategies to
reduce heavy drinking in later life. However, the processes by
which identities can be constructed are ‘tremendously powerful’ in
governing social interaction ([38], p5), and the concept of identities
can also improve understanding of public health issues around
older people’s alcohol-related behaviour. Although older people
construct positive identities for themselves by discounting stigma
[65], emphasising propriety to avoid stigma around alcohol could
lead them to treat unhealthy behaviour as normal, such as the
drinking of eight pints of beer endorsed in Excerpt 6 on the
grounds of apparent self-control. Long-term comparative data
indicate that consuming alcohol at high risk in later life tends to
reinforce some social resources at the expense of others [66]; older
men’s heavy drinking is positively associated with friends’ approval
for drinking, but is likely to be reduced over time if they have a
partner who drinks less heavily [67]. Access to a strong identity as
a moderate drinker might enable older adults to resist normative
influences within relationships that support heavy drinking. This
identity should retain strengths such as sociability without implying
susceptibility to alcoholism. Community-level interventions to
reinforce heavy drinking as unhealthy but not necessarily
synonymous with dependency would facilitate older people’s
discussion of alcohol use with services, particularly if they clarified
specifically how and why health can be at risk from heavy drinking
in the absence of immediate symptoms. Future research could
extend our findings by exploring identities around such interventions,
and among older adults not using services.
Author Contributions
Conceived and designed the experiments: CAH AC GBW JL EFSK.
Performed the experiments: GBW. Analyzed the data: GBW KM. Wrote
the paper: GBW EFSK AC JL KM CAH