1. 1st Pan American Conference on Alcohol Policies Alcohol, Gender and Culture in Peru: Preliminary epidemiological estimates Marina Piazza, MPH, ScD; Inés Bustamante, MPH, MSc Cayetano Heredia University

2. Outline Background Background Objectives Objectives Methods Methods Sample characteristics Sample characteristics Selected results Selected results Discussion and Comments Discussion and Comments

3. BACKGROUND I From Global Status Report: Per capita GDP is the lowest of all South and Central America countries except for Bolivia (4470 per person in 2001) Compare: Brazil = 7070 Per capita consumption also low at 5.43 L pure alcohol per person/year Has been fairly stable since the early 1960’s Unrecorded consumption about +1 Litre Pattern = 3 out of 4 (considered hazardous)

4. BACKGROUND II What is GENACIS in Peru? Gender, Alcohol, and Culture in Peru measured demographic data, alcohol consumption, and health and social outcomes Adults residents of Lima 8.8 million residents (30 % of the population) All data collected and analyzed by faculty of Cayetano Heredia University

5. Objectives: This preliminary analysis has two aims: 1.Present drinking in Peru in terms of the drinking status of the population and the amount of consumption 2.reasons for not drinking

6. METHODS I - Sample Data presented = Lima only N = 1110 Age = 18 to 64 Sample taken from a multistage probability sample Taken from 1996 Census of Peru, uses Census tracks Composed of face to face interviews Within households of Lima Data presented is (unfortunately) unweighted

7. Sample Characteristics I %GenderMale33.9 Female66.1 Civil Status Married34.1 Living with a partner 25.0 Widowed2.0 Divorced0.4 Married but separated 5.9 Never Married 32.6 Age18-2935.1 30-3924.3 40-4920.5 50-5915.3 60-656.8

8. Sample Characteristics I %Education No schooling 1.1 Less than elementary 6.4 Completed elementary 6.8 No high school 14.5 Completed high school 34.8 College or more 36.5 Income Less then 500 soles 25.0 $1 = 3.3 soles 500 to 999 soles 49.6 1000 to 2499 21.1 2500 to 3999 2.3 4000 to 4499 1.0 5000 or more 0.9

9. Results – Drinking Status MalesFemalesTotal Lifetime Abstainer 2.77.45.8 Current Abstainer 15.732.626.8 Current Drinker 81.660.167.4 The percentage of current drinkers for Lima (67%) is higher than the one observed for Mexico (58%) and USA (65%) Lima has a similar percentage of drinkers than the reported by Uruguay As compared to Uruguay, we observed a higher percentage of former drinkers (26% vs. 19.3%) and a smaller proportion of lifetime abstainers (5.8 vs. 12.6)

10. Annual number of standard drinks BeverageMeanMalesFemales Wine9042 Beer21562 Distilled Spirits (whiskey/tequila)10074 Other spirits (rum, vodka, etc) 23095 Prepared beverages (punto g, shumir, sangria) 20736 Liquors (curazao, licor de cacao, licor de café)7744 Other fermented beverages (malta, chica, sidra) 17133

11. Reasons for not drinking GenderMalesFemales No occasion where I wanted to drink 18.728.4 Responsibilities37.336.4 Does not interest me 58.766.1 Religion22.715.9 Brought up not to drink 8.016.2 Too expensive 28.029.7 Bad for your health 57.359.3 I am on medication 13.38.6 I am pregnant/trying to get pregnant N/A6.1 Do not like the taste 24.052.3 Bad effect on my activities 29.332.4 Would be afraid of alcoholism/ Becoming alcoholic 5.34.0

12. Discussion I How does this data compare with previous estimates? How does this data compare with previous estimates? From Global Status Report (2004)From Global Status Report (2004) Abstention (2002):Abstention (2002): 16.6% (Males) 16.6% (Males) 23.6% (Females) 23.6% (Females) A small increase in abstention but data has limitations A small increase in abstention but data has limitations Consumption of spirits has been decreasing, with beer on the rise Consumption of spirits has been decreasing, with beer on the rise

13. DISCUSSION II The occurrence of alcohol use in Lima's community population reaches levels above seen in US and other countries of the region, and presents similar gender epidemiological patterns in the male-female ratio. Conservative first estimates: given the higher proportion of females in this sample. Limitations include possible under-reporting due to social desirability, as well as other widely-appreciated sources of error in this type of survey research. In terms of cultural differences, we look forward to see the results for the city of Ayacucho. Previous results show that abstention rates tend to be higher in remote regions, closer to 50%

14. Conclusion Relatively poor pattern of drinking may combine with moderate per capita consumption to create alcohol-related problems and outcomes, both social and health-related More analysis needed in coming months, which will be enriched by the new Ayacucho data coming in and a weighting system to better represent the Peruvian population Nonetheless, the results of this preliminary analysis guide the republic's strategy for addressing its goals for a healthy population with respect to use of alcohol.