Profiles of the Key Populations

1
Part II

• Profiles of the Key Populations

2
German

• In the target areas of Macomb County, People
  reporting German Ancestry are the largest group.
  This is consistent with the U.S. Population in
  general In total, 109,879 people reported German
  ancestry to the Census Bureau, which is 22.9 of
  the total population of the six cities.

3
German

• German-Americans of Macomb County are mostly born
  in the US. Only 2 of that population is foreign
  born. 90.7 of foreign born Germans in the Macomb
  County entered the United States before 1990.
• 4.6 of German households in Macomb County are
  classified as single-mother households (the
  county average is 5.8).

4
Polish

• Polish ancestry was the second most widely
  reported in the selected geographies of Macomb
  County. 90,501 residents claimed Polish ancestry,
  which equals 18.8 of the total population of the
  target areas.

5
Polish

• A relatively small percentage of Polish-Americans
  in Macomb County is foreign born (3.5). However,
  of the foreign born Poles 28.2 entered in the
  1990s and 10.8 entered the US in the year 2000
  or after.
• 7 of the Polish population of Macomb County
  speaks Polish at home (an estimated 6,000 people
  in the target communities).

6
Polish

• Median Family income of Polish families slightly
  exceeds the county average (73,401 compared to
  69,063).
• 4.3 of all Polish households are composed of a
  single mother with children under 18, while the
  county average is 5.8.

7
Italian

• Italian ancestry was well represented in the
  selected locations. 13.2 of the total population
  reported Italian background (63,563 residents of
  the selected target communities).

8
Italian

• 5 of the Italian-American population of Macomb
  County is foreign born. Of the foreign born
  Italians, 94.6 of Italians entered the United
  States before 1990. Only 2.3 came after the year
  2000.

9
Italian

• Italians are slightly wealthier than the average
  Macomb County family, with the Italian median
  family income being 74,539 (compared to the
  general populations 69,063).

10
Irish

• There are 57,533 people claiming Irish ancestry
  in the selected cities of Macomb County, which
  accounts to 12 of the total population.
• About 1 of the Irish-Americans living in Macomb
  County are foreign born.
• 6.4 of Irish households in Macomb County are
  classified as single-mother households (the
  county average is 5.8)

11
Irish

• Because it is an older immigrant group, the
  socioeconomic indicators for that population, as
  in the case with German-Americans, are almost
  identical to the general populations.

12
African-American

• There are 28,628 residents reporting Black or
  African-American as their race in the selected
  geographies of Macomb County, which accounts for
  6 of the total population.

13
African-American

• The African-American population in Macomb County
  is relatively small (only 6 of the county is
  African-American, compared to 12.4 in the
  country, as a whole)
• 21.6 of the African-American households of
  Macomb County are single-mother households with
  children (5.8 is the county average).

14
African-American

• Median family income of African-American families
  in Macomb County is 49,973, which is
  significantly lower than the County average of
  63,063.

15
Asian

• There are 18,755 people self-identifying as Asian
  in the selected target communities which is 3.9
  of the total population of those geographies.

16
Asian

• Out of the entire population of Macomb County,
  28 of all Asians are Indians, while 22 claim
  Filipino ancestry. Those two largest Asian
  populations are followed by much smaller groups
  such as Chinese (10.6 of Asians), Hmong (9.7),
  Vietnamese (8.3), and Koreans (7.4).

17
Asian

• Asian-Americans of Macomb County are mostly
  foreign born (69). 27.3 entered the US in 2000
  or later, and 36.7 speak English language less
  than very well.
• The educational attainment of the Asian
  population in Macomb County is well above the
  county average.

18
Asian

• 35.5 of Asians hold a Bachelors degree and
  17.2 have a graduate or professional degree
  (compared to, respectively, 14 and 7.1 of the
  county population).
• Median Asian family income is comparable to the
  county average.
• 3.2 of Asian households in Macomb County are
  classified as single-mother households with
  children (the county average is 5.8)

19
Arab

• Arab ancestry is reported by 14,386 people in the
  selected cities in Macomb County. That amounts to
  3 of the total population of those cities.

20
Arab

• According to the Detroit Arab-American Study, 58
  of Arab Americans residing in Macomb County are
  Christians. Of the Christians, 73 are Catholics,
  24 are Orthodox, and 3 are Protestants. 42 of
  Arab-Americans are Muslim, with 23 of those
  being Shia and 15 being Sunni.

21
Arab

• About 66 of Arab-Americans consider themselves
  white. The rest usually indicate membership in an
  other race.
• 75 of Arab-Americans are foreign born Of those
  37 have come to the US from Lebanon and Syria,
  35 are from Iraq, 12 from Palestine and
  Jordan, and 9 from Yemen.

22
Arab

• 86 of Arab-Americans speak a language other than
  English at home, however, 80 declare that they
  speak English well.
• 25 report a family income of 100,000 or above,
  which is considerably higher than the average
  for the general population.

23
Arab

• Arab-Americans born in the US are even more
  affluent (36 report a family income of 100,000
  or more, while only 7 report income of less than
  20,000) .
• However, there are also more Arab-Americans who
  report family income of under 20,000 than the
  general population (24 of Arabs compared to 18
  of the general public).

24
Hispanic/Latino

• 1.1 of the population of the Macomb County
  target communities self-identifies as
  Hispanic/Latino. Thus there are 5,221 residents
  claiming Hispanic ethnicity in those geographies.
  

25
Hispanic/Latino

• Michigan Hispanics are in large numbers foreign
  born (29). 34.9 entered the United States in
  2000 or later.
• 58.1 of Michigan Hispanics speak a language
  other than English at home, and 28.4 report that
  they speak English less than very well.

26
Hispanic/Latino

• Median family income of a Hispanic family in
  Michigan is significantly lower than the average
  family (40,698 compared to 60,269).
• 13 of Hispanic households in Michigan are
  classified as single-mother with children
  households (the state average is 7.5).

27
Hispanic/Latino

• The Michigan Hispanics report lower education
  levels than the general population. 8.9 of
  Hispanics hold a Bachelors degree, and 5.1 of
  Hispanics holds a graduate or professional degree
  (compared to, respectively, 15.1 and 9.3 of the
  general population).

28
Hispanic/Latino

• Because the drinking patterns of Hispanic
  groups vary, it is worth noting that 75.5 all
  Hispanics are Mexican, 8.1 are Puerto Rican,
  4.1 are Central American, with Guatemalans being
  the largest group and 2.9 are South American
  with Columbians and Argentineans being the two
  largest groups.

29
Hispanic/Latino

• By race, 49.4 are white, 2.4 are Black, 38.7
  designate themselves as some other race and
  7.3 say they are of two or more races. These
  figures represent the state of Michigan as a
  whole. There is no separate breakdown for Macomb
  County available.

30
Religious Affiliations
31
Macomb County Religious Affiliations
Source The Association of Religion Data
Archives, 2000
32
Catholics

• The Archdiocese of Detroits 2008 figures on the
  affiliated Catholic population of Macomb County
  is 240,744 individuals and 84,130 households.
• We estimate that Catholics make up 30 of the
  total population of the selected areas (we
  estimate the number of Catholics in the target
  communities to be between 138,000 and 140,000).

33
Protestants

• There were 90,103 white Protestants in Macomb
  County, according to the 2000 study by the
  Association of the Religious Data Archives. Of
  these, 69 are Evangelical Christians, and 31
  belong to Mainline Protestant denominations.

34
Protestants

• We estimate that there are between 45,000 and
  50,000 African-American Protestants belonging
  primarily to Evangelical and Pentecostal
  Churches. The ARDA estimates 438,874 persons in
  Macomb County who are officially unaffiliated
  with any congregation. Most are probably
  Protestant in orientation. There are, in
  addition, aside from those who identify as
  Jewish, about 4,500 persons affiliated with
  non-Christian faiths.

35
Jewish Americans

• The Census Bureau does not report on populations
  by religion. The most likely ancestry choice for
  people who consider themselves Jewish by religion
  or culture is Russian.

36
Jewish Americans

• The study of the Jewish population conducted by
  the Jewish Federation of Metropolitan Detroit in
  2005 identifies about 300 Jewish households in
  the target areas of Macomb County, with St. Clair
  Shores having about 2/3 of the total. This
  comprises approximately 800-1,000 people.

37
Outline of Ethnic and Religious Drinking Cultures

• There is a vast body of literature that has
  focused on alcohol use and population diversity
  since the 1940s. It is from this rich collection
  of social science data and studies that we will
  draw an understanding of culture to drinking
  patterns that will provide a background for
  community to use in addressing key issues related
  to the prevention of problems associated with
  alcohol use.

38
Premises and Assumptions

• Scholars have long noted a basic difference
  between Protestant and Catholic cultures in the
  European world from which the majority of the
  current population of the United States descends.
  They have also examined the differences between
  ethno-religious groups in the United States. The
  distinction is important because differences stem
  not only from the religion and culture in the
  place of origin but also reflect the experience
  of the group in America. African American
  culture is a prime example of the preponderant
  significance of the second factor.

39

• The new world experience often modified the
  patterns brought from the place of origin, but it
  rarely obliterated them entirely. The American
  or White patterns of alcohol use are themselves
  a modification and acculturation of
  Anglo/Germanic subculture practices and thus
  represent one important variant of northern
  European Protestant patterns.
• There are also significant regional differences
  in that norm, in particular the drinking patterns
  in the southern United States.

40

• Acculturation to general U.S. norms is often not
  the same across different ethnic groups. There
  are also differential acculturation patterns for
  each ethnic group so that while some cultural
  practices change, others remain unchanged or are
  only marginally affected. In some cases, the
  drinking patterns show remarkable persistence
  despite many generations of acculturation in the
  United States. A 1998 study by D.A. Dawson has
  pointed out the stability of drinking subcultures
  of European ethnic groups in America over a long
  period of time.

41
White Drinking Culture?

• The general racial/ethnic categories used in most
  general population studies are of little value in
  the study of alcohol use and abuse patterns.
  There are no real White or Asian drinking
  cultures. The diversity of ethnic groups
  described in this way is so broad that they are
  meaningless. White largely functions as a
  default category or a placeholder for national
  average. It is without cultural significance.
  There are also significant variations among
  groups lumped under the category
  Hispanic/Latino.

42
Black Culture

• The racial designation Black is usually treated
  as synonymous with African Americans and as such,
  does designate a people who share a racial/ethnic
  identity and a common culture. There are,
  however, a number of groups who share the same
  racial identification but not the culture. These
  include ethnic groups of the Caribbean origin and
  recent immigrants from Africa itself.

43
Drinking Cultures

• Historians divide Western and Mediterranean
  Europe into two broad cultural zones for purposes
  of defining drinking cultures The former
  provinces of the Roman Empire, that speak a
  Romance language, are largely Catholic, consume
  wine as the chief alcohol drink and have a
  commercial wine industry. This area would also
  include Greece, which is Orthodox and Greek
  speaking. The second region is Protestant,
  Germanic in language and culture, uses beer as
  its alcohol of choice and was not part of the
  Roman Empire (or not for long in the case of
  England). Although there are exceptions on the
  periphery of these zones Ireland, the Rhineland,
  southwestern Germany and the Dalmatian Coast,
  they hold up well and are statistically
  significant.

44
Temperance and Non-Temperance Cultures

• These two areas have been described by H.G.
  Levine as the temperance (Protestant/Germanic
  Europe) and non-temperance (Catholic/Mediterranean
  ) cultural zones

45
Temperance Cultures

• Temperance cultures are strongly concerned with
  alcohol abuse and continuing approaches to
  preventing drinking problems. More drinking is
  done in all male groups in places devoted to
  drinking. Behavioral problems associated with
  drinking are more apparent in these societies and
  more attention is focused on them. It is
  significant that temperance societies consume
  less alcohol and a smaller proportion of it is
  wine than non-temperance societies.

46
Non-Temperance Cultures

• Non-temperance societies, in contrast, consume
  more alcohol, primarily wine, and in more
  integrated social and communal settings such as
  meals and religious ceremonies or in cafes,
  restaurants or other establishments where
  drinking is not the predominant focus and where
  members of both genders and persons of different
  ages are present. More drinking takes place in
  family settings than in Temperance Cultures.

47
The Saloon

• It is worth noting the significance of the
  different drinking venues of temperance and
  non-temperance societies for the development of
  the drinking cultures in the United States. The
  19th century saw the evolution of the 18th
  century inn into the American working class
  saloon so characteristic of Irish immigrant
  neighborhoods with its emphasis on all male
  clientele devoted almost exclusively to drinking

48
The Biergarten

• Catholic German immigrants, primarily from
  Bavaria, brought to the United States the idea of
  the biergarten, or beer garden, which was a
  family oriented establishment that either served
  food or provided picnic-like grounds for families
  to consume food brought from home along with
  beer. Although Bavaria is German speaking and
  the beverage of choice is beer, it is also
  Catholic, located near a wine growing and
  consuming region and was on the edge of the Roman
  world for centuries. It is culturally a part of
  the non-temperance zone.

49
Cultural Differences

• One other aspect of the distinction between
  temperance and non-temperance cultures in Europe
  bears examination. Temperance cultures, which
  see alcohol as a significant problem, generate
  organizations and social mechanisms to attack the
  problem. Thus Iceland, with one of the lowest
  levels of per capita alcohol consumption in
  Europe, has the largest number of AA branches per
  capita while Luxembourg, a non-temperance society
  with the highest per capita alcohol consumption
  in Europe, has no AA branches

50
AA in Temperance Societies

• There is often an overall preponderance of AA
  branches in countries where the Protestant
  majority is relatively slight. It has been
  suggested that these are generated in response to
  the existence of a Non-Temperance (Catholic)
  cultural minority and the desire of the majority
  group to control the perceived problems it
  presents

51
Culture and Prohibition

• This insight has a direct bearing on the American
  prohibition movement and the 18th Amendment,
  which most historians agree, was an attempt by
  the Protestant majority to deal with the
  perceived cultural menace of the large new
  Catholic immigration. This was the 20th
  centurys first major cultural war

52
Moderationism

• In the wake of the Reformation, the new
  Protestant religions that emerged adopted a
  moderationist stance toward alcohol. While not
  as affirmative as the Catholic stance,
  Protestantism accepted moderate use of alcohol as
  acceptable.
• The groups most represented here were Lutherans
  and Episcopalians.

53
The First Great Awakening

• By the 18th century, with increasing emphasis on
  individual rather than communal religious
  experience, personal responsibility for
  salvation, a number of Protestant groups
  especially those born out of the First Great
  Awakening began to see alcohol as evil and its
  use as a sin. These included Methodists,
  Baptists and various Pentecostal groups. Thus by
  the end of 18th Century, in particular in the
  Anglo American world, alcohol was condemned from
  many pulpits and its use prohibited under pain of
  sin.

54
The Second Great Awakening

• The second Great Awakening at the beginning of
  the 19th century reinforced the idea of the
  intrinsic evil of alcohol and the groups which
  emerged out of this revival, such as the Mormons,
  eschewed the use of alcohol with great fervor.
  The 19th century saw the spawning of large
  numbers of temperance and prohibitionist
  movements which often had wide inter-denominationa
  l support.

55
U.S.- A Temperance Society

• It is clear that in its general approach to
  alcohol use United States society clearly falls
  into the temperance camp as a result of its
  Anglo/Germanic heritage and the dominance of
  Protestantism in the shaping of its culture. The
  extent of the dominance is shown by the fact that
  85 of all American Catholics and 90 of all
  American Jews and Orthodox Christians trace their
  ancestry to immigrants who arrived after the
  centennial of the United States in 1876.

56
East Central Europe and Ireland

• The breakdown of Europe into temperance and
  non-temperance societies leaves large areas of
  the continent mainly East Central Europe and
  Ireland unaccounted for. These have sent a
  significant number of immigrants to the United
  States including the Detroit area.. These are
  Catholic regions that are in terms of drinking
  cultures, an intermediate area

57
East Central Europe and Ireland

• These regions had no viniculture and were never a
  part of the Roman world. The area is heavily
  Catholic, the alcohol consumption is high and the
  perception that the society has serious alcohol
  problems is widely held. Yet temperance movements
  have not been a significant feature of the
  culture of East Central Europe. In many ways,
  the drinking patterns resemble those of Germanic
  Protestant areas. There has been some historical
  temperance activity in Ireland, but never to the
  extent it had existed in temperance areas.

58
South Asian Muslim and Middle Eastern Heritage

• The Middle East and South Asia are largely Muslim
  and the use of alcohol is strictly forbidden by
  the Quran. Such alcohol use as exists is
  surreptitious and usually practiced by
  westernized elites. The World Health Organization
  reports that societies with majority Muslim
  populations have very high rates of abstention.
  Egypt shows 99.5 abstention. Lebanon, even with
  its large Christian minority, is cited as having
  77.4 abstention.

59
Christians in the Middle East

• The Christian Societies in the Middle East in
  their attitudes and use of alcohol resemble
  closely non-temperance Mediterranean societies
  and they consume a low amount of alcohol per
  capita. There is pressure on Middle Eastern
  Christians, as a minority whose status is often
  precarious, to use alcohol in ways, and at rates,
  that would not offend the surrounding Muslim
  society. The sale of alcohol where permitted in
  Muslim societies is invariable in the hands of
  Christian merchants.

60
South Asia and the Far East Hindu Attitudes
Toward the Use of Alcohol

• In the long and complex history of Hinduism,
  there have been strictures prohibiting or
  restricting the use of alcohol. In recent memory
  Mahatma Gandhi, who led the struggle for the
  independence of India from British Rule, called
  on Indians to eschew the use of alcohol in
  keeping with his deeply ascetic approach to
  Hinduism. Some Indian States ban alcohol and
  others have partial prohibition.

61
Hindu Attitudes

• An important factor for understanding alcohol use
  is that it has no role or place in social and
  religious life. The modern Hindu position is to
  urge the moderate use of alcohol but to prefer
  abstention. According to the World Health
  Organization over 79 of the population of India
  is abstainers (2000-2001). Hindu immigrants to
  the United States follow the trend of the upper
  and middle-class in India toward moderate use or
  abstinence. There is no documentation of serious
  alcohol problems among Hindu immigrants in the
  United States.

62
East Asian Patterns of Alcohol Use

• In East Asian populations (Chinese, Japanese,
  Vietnamese, Filipino and Korean) drinking is
  generally moderate and problems associated with
  drinking are not severe. The amount of alcohol
  consumed however varies. The WHO statistics from
  a variety of studies for populations from these
  areas are as follows

63
Flushing

• Flushing" is a physiological reaction to the
  ingestion of alcohol found among East Asians
  characterized by a flushing of the skin,
  especially the face, ears and upper body, an
  increase in body temperature and in some cases
  nausea, headaches, dizziness, rapid heartbeat and
  feelings of anxiety. Scholars have argued that
  these physiological symptoms provide a
  significant protective factor against alcohol
  use. Others have argued that this is true mainly
  for those in whom the flushing takes place
  rapidly after alcohol is consumed and is not
  significantly protective for alcohol in those in
  which the reaction develops gradually.

64
Flushing

• Studies of drinking by Asian women suggest that
  for women the embarrassment cause by facial
  flushing is as much, or more, protective than the
  physical symptoms. Finally, it should be noted
  that the factor may be more protective in some
  cultures and not others. The flushing reaction
  is found among certain American Indian groups,
  but does not appear to provide a protective
  factor in the face of strong cultural forces in
  societies that sanction or encourage heavy
  alcohol use

65
Alcohol and East Asian Cultures

• One of the key cultural explanations for low
  alcohol use by certain East Asian groups
  particularly among Chinese, Japanese and Korean
  is the influence of Confucian and Taoist
  philosophies on their drinking patterns. These
  philosophies stress strong family unity,
  hierarchical social control and social harmony
  and conformity that serve to moderate drinking
  patterns. Several studies note the emphasis on
  ones obligation and responsibility to others and
  notions of familial honor reinforce the idea of
  moderation and create sanctions against heavy
  drinking

66
Japanese Culture

• Japanese culture, which shares both a Buddhist
  and Confucian heritage with China, focuses on
  collective achievement, the interdependence of
  individuals in the workplace and society and
  restraint and responsible public behavior. It is
  also characterized by moderate drinking patterns
  despite the widespread use of alcohol. Given the
  ethos of these societies, much of the drinking
  takes place in specific social situations.
  Drinking patterns are learned in a family or
  other traditional settings.

67
Japanese Culture

• For the Japanese, sharing drinking and getting
  drunk without overstepping societal norms is an
  important aspect of appropriate drinking
  behavior. On the other hand, a person who
  becomes violent or obnoxious due to drunkenness
  is reviled by the Japanese and is labeled a
  shoran (pathological drinker).
• It is suggested in the literature that acceptable
  drinking and drunkenness patterns are part of
  societal norms in Japan

68
Christian Influences

• It is worth noting in passing that those Asian
  cultures (Korean, Vietnamese, Filipino) which
  show higher rates of alcohol use with the
  exception of Japan have populations with
  significant numbers of Christians, with those in
  the Philippines and Vietnam being largely
  Catholic. This may mitigate to some degree older
  cultural influences.

69
Buddhism and Alcohol use

• Buddhism developed in the Indian subcontinent as
  an offshoot of early Hinduism in the 6th century
  BCE. It spread widely into Southeast Asia
  (Thailand, Myanmar, Laos, Cambodia, and Vietnam),
  China, Tibet, Korea and Japan. It has influence
  in all of these areas, but the strongest
  influence is in Southeast Asia where it
  predominates and has little competition from
  Confucianism, Taoism and Shinto. Alcohol
  consumption is considered inconsistent with the
  Buddhist quest for understanding through
  meditation, the development of the mind and the
  need to let go of attachments and appetites. One
  of the five precepts of Buddhism is to refrain
  from intoxicants.

70
Buddhism and Alcohol

• Even in overwhelmingly Buddhist countries, the
  strict adherence to the stricture to refrain from
  the use of intoxicants is practiced only by a
  minority, mostly monks. In practice, many
  Buddhists believe that the use of alcohol is
  acceptable if used in moderation. This is
  justified by evoking Buddhas preaching of the
  middle way philosophy. Nevertheless, the
  adherence to Buddhism must be regarded as a
  protective factor.

71
Judaism and Alcohol

• As a religion Judaism has no proscription against
  alcohol use, in fact, Jewish religious ritual
  incorporates the drinking of wine and blesses it.
  Like all major religions, Judaism disapproves
  strongly of drunkenness and the abuse of alcohol.
  
• Most of the Jews in the Macomb area are from
  Central and East Central Europe (Ashkenazi) with
  a small number being of Middle Eastern and
  Mediterranean origin (Sephardic). The drinking
  culture of Jews is, however, more like the
  non-temperance drinking cultures of Southern
  Europe than that of Northern and Eastern Europe.

72
Judaism and Alcohol

• Jewish society contains very few abstainers and
  Jews as a group consume amounts of alcohol per
  capita that is comparable to the high consumption
  levels found among Italians. Yet, like Italians,
  they show low percentages of alcohol problems.
  Jews who move away from their religion and
  culture, however, take on the general norms
  associated with alcohol use in the society which
  they are living.

73
Judaism-Protective Factors

• Glassner and Berg summarized the protective
  factors in Jewish culture
• The protective social processes are as follows
  (1) association of alcohol abuse with non-Jews
  (2) integration of moderate drinking norms,
  practices and symbolism for oneself and
  significant others during childhood by means of
  religious and secular ritual (3) continual
  reiteration of moderate drinking through
  restriction of most primary relationships to
  other moderate drinkers and (4) a repertoire of
  techniques to avoid drinking more than one wants
  to drink amid social pressure.

74
Summary-Moderate Drinking Cultures

• Alcohol consumption is accepted and is governed
  by social custom, so that people learn
  constructive norms for drinking behavior.
• The existence of good and bad styles of drinking,
  and the differences between them, are explicitly
  taught.
• Alcohol is not seen as obviating personal
  control skills for consuming alcohol responsibly
  are taught, and drunken misbehavior is
  disapproved and sanctioned

75
Summary-Immoderate Drinking Cultures

• Drinking is not governed by agreed upon social
  standards, so that drinkers are on their own or
  must rely on the peer group for norms.
• Drinking is disapproved and abstinence is
  encouraged, leaving those who do drink without a
  model of social drinking to imitate they thus
  have a proclivity to drink excessively.
• Alcohol is seen as overpowering the individuals
  capacity for self-management, so that drinking is
  in itself an excuse for excess.

76
Protective Factor-Non-Temperance Societies

• Another researcher has noted as a protective
  factor in moderate or non-temperance drinking
  cultures the idea that drinking is divorced from
  an individuals effort to escape personal anxiety
  or difficult or intolerable social situations.
  He adds that in these cultures the concept of
  restraint indicates that drinking is only one of
  many activities and it carries a relatively low
  level of emotionalism . . . .

77
Alcohol Use and Abuse in Key European Immigrant
Sending Areas

• The World Health Organization (WHO) reports that
  Ireland and Poland have low rates of abstention
  showing 22 and 19 abstainers respectively among
  the adult population. WHO also reports a 12.2
  rate of alcohol dependence among Poles (23.3
  male and 4.1 female) in a 1999 study. This is
  the highest reported percentage for any nation in
  this study.

78
Poland and Ireland

• There are no comparable data for Ireland on this
  issue. On the matter of binge drinking among
  youth, Poland and Ireland show the highest
  percentages of the 27 nations who report data on
  this question. The 1999 studies credit Ireland
  with 31 of youth 15-16 engaged in binge drinking
  with males and females both reporting 31.
  Polish figures are 31 overall and 41 for males
  and 14 for females for 15-16 year olds.
• These are two of the largest Catholic ethnic
  groups in the Macomb County service area and
  studies show strong persistence of these patterns
  in immigration

79
English Protestants

• The English Protestant group is more like the
  Irish Catholic group than it is like any of the
  other ethnic groups. A notable change in drinking
  behavior occurred among English Protestants
  between the grandparental and parental
  generations. Perhaps this is the result of the
  movement from rural into urban areas. A similar
  change occurred in the adolescent generation, so
  that English Protestants, once a relatively
  moderate drinking group seem to drink almost as
  much as the Irish in the parental generation and
  in the adolescent generation they drink even
  more.

80
English Protestants

• Growth in consumption by the English group
  extends very clearly to the women. English women
  consumed more alcohol than the women in any other
  European American ethnic group. Interestingly
  enough, although English men show high rates of
  problems with alcohol, English women showed among
  the lowest. In other ways, however, including the
  high rate of abstainers, the English group
  follows the Protestant.

81
Drinking Patterns Among Hispanics

• Abstention and Heavy Drinking
• Women 46 of Cuban, 44 Puerto Rican and 43 of
  Mexican women report abstention from alcohol.
  Frequent heavy drinking was reported among 3 of
  Mexican American women and less than 1 of Cuban
  and Puerto Rican women according to a 1994 study.
  Another study in 1997 that targeted all Hispanic
  women reported that abstinence from alcohol had
  risen from 47 in 1984 to 57 in 1995.

82
Drinking Patterns Among Hispanics

• Men 28 of Mexican men and 22 Cuban men report
  abstaining from alcohol. No figures were
  available for Puerto Ricans. Frequent heavy
  drinking is reported by 17 of Mexican males and
  5 among Cubans.
• One study reports that in addition to drinking
  less than men drink in their respective ethnic
  groups, Mexican, Puerto Rican and Cuban women
  hold less permissive attitudes toward womens
  drinking than they do to mens drinking

83
Drinking Patterns Among Hispanics

• Hispanic Americans of Central America, South
  America or Caribbean ancestry consume less
  alcohol than Mexican Americans in particular.
  Studies of Dominican immigrants show low
  consumption of alcohol dependence.
• Among Mexicans, those of Indian ancestry reported
  higher rates of lifetime alcohol abuse and/or
  dependence than do non-Indian Mexicans.
• Among Hispanic men, the unemployed showed higher
  incidence of alcohol related problems than those
  who were employed. Lower income also correlated
  positively with alcohol problems

84
African Americans

• Much of the earlier literature on
  African-American drinking patterns has focused on
  the problems associated with heavy drinking. Few
  of these studies have examined patterns of
  abstinence or light to moderate drinking. Heavy
  drinking was seen as a response to racism and
  social disorganization, or conversely, cultural
  attitudes that were more permissive and liberal
  than Whites. In addition, researchers have
  pointed to the negative consequences of
  advertising which have targeted African-American
  consumers with encouragement to consume alcohol,
  especially high potency alcoholic drinks.
• Research in the last two decades has developed a
  richer and complex picture based on historical
  research and empirical data

85
African-Americans

• Other research has shown that in many respects
  African-American drinking patterns vary
  considerably from those of the general population
  and have displayed marked changes in recent years
  in comparison to Whites.

86
African-Americans

• One of the factors that have been identified as
  of major significance in changing
  African-American drinking patterns has been the
  mass migration from the rural south to the north.
  It resulted in increased alcohol consumption
  over several generations. In this the
  African-American migration seems to have had an
  effect similar to the one that increased alcohol
  use and dependency among Americans of
  Anglo/German ancestry and Eastern and Southern
  European immigrants who moved from rural United
  States or rural Europe to American cities at the
  end of the 19th and beginning of the 20th
  centuries

87
African-Americans

• In 1984 study rates of heavy drinking among
  African-American males were highest in their 40s
  and 50s while rates for Whites were highest
  among men in their twenties. In their 50s the
  rates diverge so that Whites show rates of heavy
  drinking that are significantly higher than
  African-Americans. The White rate is 16 while
  the African-American rate is 3.

88
African Americans

• Abstention African-American men show abstention
  rates of 36 compared to a White rate of 26.
  African-American women have abstention rates of
  55 versus 39 for White women. Other studies
  have put abstention from alcohol in the range of
  45-60 for African-American women with 34-36
  listing themselves as infrequent drinkers.
  Only 2-8 are heavy drinkers

89
African Americans

• Abstention African-American men show abstention
  rates of 36 compared to a White rate of 26.
  African-American women have abstention rates of
  55 versus 39 for White women. Other studies
  have put abstention from alcohol in the range of
  45-60 for African-American women with 34-36
  listing themselves as infrequent drinkers.
  Only 2-8 are heavy drinkers

90
African Americans

• Most African-Americans are members of Protestant
  Evangelical and Pentecostal churches, in
  particular Southern Baptist, which are strongly
  opposed to the use of alcohol. Church
  affiliation is thus considered a protective
  factor for African-Americans especially for
  African-American women who are more frequent
  churchgoers than African-American men are. It is
  also a protective for African-American men who
  participate regularly in church activities.

91
African Americans

• In general, it can be said that African-Americans
  consume less alcohol and are less likely to
  develop alcohol dependency than Whites or
  Hispanics. African-Americans (and Hispanics)
  are more likely, however, to continue dependence
  once it is initiated than Whites are.

92
African Americans

• African-American youth had the lowest rate of
  drinking and the lowest rate of heavy drinking
  and alcohol dependence problems.
• African-Americans whose origin is in English
  speaking areas of the Caribbean have even lower
  rates of alcohol use, heavy drinking and
  dependency than do African-Americans.

93
African Americans

• One interesting finding is that being widowed
  among African-American men was strongly
  associated with a lower risk for alcohol related
  problems in comparison to married men. In
  contrast, being separated, widowed, divorced or
  never married was a higher risk factor for both
  men and women among Whites than those who were
  never married. We have found no specific data on
  the impact of separation or divorce on
  African-Americans

94
African Americans

• Among African-American youth, according to
  several recent studies, a strong and positive
  identification with African American life and
  culture has been shown to be a protective factor

95
African Americans

• African Americans currently have higher rates of
  alcohol related medical problems and mortality
  rates than White despite their higher abstinence
  rates. The rates are three times as high in some
  cases.

96
American Indians

• There is a remarkable heterogeneity of the
  American Indian group which comprises more than
  500 different tribes using more than 200 distinct
  languages. The use of alcohol varies widely
  among these groups. Some Indian tribes show very
  high rates of abstention, while others show
  patterns of heavy consumption and alcohol
  dependency. There are even considerable
  differences among those in the heavy
  consumption/dependency category. For example,
  the Navaho have low rates of cirrhosis and fetal
  alcohol syndrome (1.3 per 100,000) as a result of
  a pattern of recreational binge drinking, whereas
  Plains tribes such as the Lakota/Dakota people
  show high rates of cirrhosis and fetal alcohol
  syndrome (10.6 per 100,000) as a result of heavy
  daily drinking

97
American Indians

• Another example of differences can be observed
  among three peoples who live near each other
  Navaho, Hopi and Apache. The Apache allow sale
  of alcohol on their reservation and show patterns
  of consumption that is more moderate and have
  much lower dependency problems than their
  neighbors. The Navaho on the other hand do not
  permit the sale of alcohol on the reservation,
  but do use it, primarily in binge drinking
  episodes. This heavy binge drinking appears to
  be accepted and the families are supportive. The
  Hopi, on the other hand, strongly disapprove of
  all alcohol use and drinkers are forced out and
  ostracized into drinkers ghettos on the
  reservation.

98
American Indians

• A Major longitudinal studies drinking patterns
  of adult American Indians done concludes,
  American Indians and Alaskan natives report less
  current drinking and about the same level of
  binge drinking as white non-Hispanics by age and
  sex. American Indians and Alaskan native men
  report lower levels of chronic drinking than
  White men at older age levels. Other recent
  studies show that levels of drinking by American
  Indian males are sharply reduced in middle-age as
  men mature and take on family responsibilities.

99
American Indians

• To explain heavy use and dependency by a
  significant portion of the Indian group that
  engages in problem drinking, scholars have
  pointed to several causes.
• Societal factors including poverty, unemployment,
  discrimination and lack of integration into
  traditional or western culture.
• Coping with negative emotions i.e. anxiety,
  frustration, despair, powerlessness.
• Special Indian cultural responses (desire to
  reach a desired state of altered consciousness

100
American Indians

• Clearly, the explanation is complex and not
  mono-causal. There is no single factor that can
  explain this still poorly studied phenomenon.
  Research has, however, shown that high
  integration into either traditional tribal
  society or full acculturation into western
  culture appear to be protective factors. Being
  deracinated and caught between cultures is
  clearly a risk factor.

101
American Indians

• The hypothesis that in the part sought to explain
  heavy drinking patterns of American Indians as a
  biological predisposition has been recently
  discarded as unproven. No studies have been able
  to demonstrate the validity of this thesis and
  current studies have shown that Indians do not
  appear to have overall greater physiological or
  psychological predisposition to alcohol use than
  other ethnic groups.

102
Drinking and Religion Correlations

• The studies show that, in general, college
  students who believed religion was important to
  them had much lower levels of alcohol use (66.3)
  than those who claimed religion was not important
  (89.5) Similar findings were reported for high
  school seniors. In both cases, the respondents
  lack of religious orientation was one of the most
  powerful predictors for at risk behaviors,
  including binge drinking.

103
Drinking and Religion Correlations

• A key study has Catholics with 90.1 drinkers,
  followed by Protestants from groups that did not
  prohibit drinking at 86.2, in third place were
  Jews (85.2) and finally Protestants who were
  prohibited from drinking by their faith at 60.3.
  Catholic males had the highest rates in all
  studies of binge drinking.

104
Drinking and Religion Correlations

• In a look at those whose commitment to their
  faith was intrinsic (internalized and deeply
  held) versus those whose commitment was extrinsic
  (superficial and lightly held) all studies showed
  a much lower use of alcohol and less problems
  with alcohol by those who had an intrinsic faith.
  The one exception was Catholic males who showed
  little difference between those whose religion
  was extrinsic as opposed to those who held their
  faith intrinsically.

105
Drinking and Religion Correlations

• This may suggest a failure to make a connection
  by college aged Catholic males between alcohol
  use and religious faith. Conversely, it may
  represent the overriding of religious belief and
  culture by ethnic cultures which are intimately
  bound up with Catholicism. College aged Catholic
  males of Irish or Polish ethnicity are likely to
  be among those in this position.

106
Drinking and Religion Correlations

• These studies clearly indicate that, in general,
  religious orientation and in particular a strong
  intrinsic commitment is a key protective factor
  vis-à-vis alcohol for college students of all
  religious faith and both genders with the
  possible exception of Catholic males.
• It is also worth noting that African American
  college students, most of whom have affiliation
  with Protestant faiths which oppose the use of
  alcohol, have far lower rates of alcohol use and
  problem drinking than White students have.

107
Ethnicity and Drunk Driving

• Several studies have looked at the prevalence of
  drunk driving for different ethnic and racial
  groups. These studies use the standard census
  racial and ethnic categories. A 1995 national
  probability study demonstrated that Hispanics and
  Whites engaged in high risk driving after
  drinking enough to be in trouble if stopped by
  the police in the twelve months prior to the
  survey in the following percentages White 22,
  Hispanic 21. In contrast only 14 of
  African-Americans exhibited similar behavior.

108
Ethnicity and Drunk Driving

• Second generation Hispanic men (i.e. born in the
  United States of immigrant parents) were three
  times more likely to drink and drive than those
  who were immigrants born outside of the U.S.
  Hispanic men also had higher rates of ever having
  been arrested for driving while under the
  influence of alcohol (19) compared to White
  (13) and African-American (11) males.

109
Ethnicity and Drunk Driving

• The rates of alcohol-related fatal crashes also
  vary among ethnic and racial groups. Between
  1990 and 1994, Whites (44) and African-Americans
  (45.2) had similar rates of alcohol involvement
  in motor vehicle fatalities. Among Hispanics,
  the proportion of those involved in alcohol
  related motor vehicle fatalities was 54.6 for
  Mexican Americans and 36.6 for Cuban Americans.

110
Ethnicity and Drunk Driving

• Asian Americans as a group were the lowest with
  28.2 while American Indians have the highest
  rate at 68.1. It is necessary to note that a
  major contributing factor to the high American
  Indian fatality rate was the distance to medical
  facilities and the quality of emergency care
  available at those facilities.

111
Ethnicity and Drunk Driving

• A more recent survey of the literature suggests
  that collision rates and injuries in cases in
  which alcohol is a factor are higher for
  Latinos/as, African Americans and Native
  Americans than among Whites or Asians. The
  authors cite higher rates of impaired driving and
  lack of safety belt compliances as key factors
  for collision injury. They also note higher
  rates of pedestrian injury among communities of
  color as a result of impaired driving.

112
Ethnicity and Drunk Driving

• The disparities between rates for these groups
  are in part correlated with lower socio-economic
  status and education and for those who are
  foreign born the effect of language and cultural
  barriers, insufficient knowledge of relevant laws
  and a lower familiarity with driving behavior and
  customs in the United States.

113
Ethnicity and Drunk Driving

• The effect of these factors is thus diminished
  significantly by rise in socio-economic status
  and education and longer term residency in the
  U.S. for foreign born. It is worth underlining
  that the same factors which enhance risk for
  impaired driving among immigrants from groups in
  protected classes also operate as risk factors
  for immigrants in White groups, including lack
  of safety belt compliance.

114
Ethnicity and Drunk Driving

• The National Highway Traffic Safety
  Administration has documented, in a series of
  longitudinal studies, that overall for the
  general population the number of fatalities due
  to impaired driving has declined by 38 between
  the years 1987 2007. Among teenage drivers the
  percentage has declined by 67 since tracking
  began in 1982 (1982 4,212 deaths vs. 2007
  1,393). The decline since 2000 has been almost
  20.

115
Ethnicity and Drunk Driving

• Among African Americans, however, the decline in
  fatalities has been less steep falling by 16
  between 1987 and 2001 with 1,710 deaths in 1987
  and 1,438 deaths in 2007. The number of
  fatalities in African American teen driving
  crashes in which alcohol use was a factor has
  declined 25 since 1987 from 141 fatalities to
  106 fatalities in 2007.

116
Ethnicity and Drunk Driving

• The number of Hispanics killed in auto accidents
  in which alcohol was a factor, on the other hand,
  has risen from 3,913 in 1993 to 5,405 in 2006.
  Among Hispanic teens (ages 16 20) the number of
  fatalities in which alcohol was a factor has
  risen from 897 in 1990 to 998 in 2006.

117
Ethnicity and Drunk Driving

• It should be noted that the National Highway
  Traffic Safety Administration statistics do not
  control for size of the population. Thus, the
  national decline as well as that for African
  Americans is considerable larger per capita than
  the figures by themselves would indicate and the
  Hispanic figures for teens probable do not
  indicate a significant rise and may, in fact, be
  a per capita decline. The figures for the
  general Hispanic population probably indicate a
  rise albeit not as large per capita as an initial
  impression that the figures convey. Because of
  widely varying estimates of the number of
  undocumented Hispanic residents, it is difficult
  to speak with further certainty on this issue.