Academic journal article Health Sociology Review

Healthy Adults and Maternal Bodies: Reformulations of Gender in Australian Alcohol Guidelines

Academic journal article Health Sociology Review

Healthy Adults and Maternal Bodies: Reformulations of Gender in Australian Alcohol Guidelines

Article excerpt

ender is a taken-for-granted and naturalised feature of public health discourse on drink- ing. Female drinkers are routinely addressed in terms of their vulnerability to the harmful effects of alcohol, a vulnerability which is understood as both biological and social. Not only are female bodies and bodily organs identified as more rap- idly affected by alcohol due to their size and composition, women who become intoxicated are warned of their increased risk of unsafe sex and sexual violence. Drinking guidelines are tra- ditionally structured according to sexual differ- ence, with levels of safe consumption set at a lower level for women than for men. In a pattern similar to those adopted by other countries, the 2001 Australian Alcohol Guidelines contained sep- arate recommendations for men (no more than four standard drinks a day for low risk drinking) and women (no more than two standard drinks a day for low risk drinking) (National Health and Medical Research Council, 2001a). However in 2009 a new version of the guidelines was released which contained substantial revisions related to gender. These recommend a single low risk level for 'healthy men and women' (no more than two standard drinks a day) while advocating abstinence for pregnant and breast- feeding women (NHMRC, 2009a).

This article examines the formulations of gen- der and sexual difference in Australian public health texts on drinking, focussing on the 2009 guidelines. The article builds on and contributes to critical scholarship on public health, health promotion and the proliferation of governmental directives for healthy living. Drawing on the work of philosopher and historian Michel Foucault, social science scholars have highlighted the regu- latory effects of health discourses and practices on individuals who are exhorted to make informed choices, take responsibility for their wellbeing and reduce their risks of future ill-health (Crawford, 2006; Peterson, Davis, Fraser, & Lindsay, 2010; Peterson & Lupton, 1996). As Peterson et al. state, 'In the new public health, everyone is called upon to play their part in advancing 'the pub- lic's' health' through attention to lifestyle, healthy eating, exercise and preventive testing (Peterson et al., 2010, p. 394). As a result, health and its pursuit have become increasingly central to ideals of autonomy and citizenship.

In this environment, where the protection and pursuit of health has become such a publicly sig- nificant and socially meaningful activity, changes in public health texts such as the Australian alco- hol guidelines can reveal noteworthy shifts in the meanings of social categories such as gender. Moreover, such texts not only reflect but repro- duce changing norms and ideals of selfhood and social relationships. Thus the aim of this article is to analyse the discourses of health, risk and gender which are employed in the 2009 alcohol guidelines. The article is not concerned with the effectiveness of the guidelines in terms of policy goals such as the reduction of alcohol-related harm. Following the tradition of Foucauldian analysis, it reads the guidelines critically rather than accepting their stated intentions at face value. A key focus of the article is the guidelines' replacement of a binary male/female categorisa- tion of risk and vulnerability with a single class of adult men and women. While moving away from the notion of female vulnerability to alco- hol, the guidelines demonstrate an intensification of concern about foetuses, infants and children as at high risk of alcohol-related harm, as reflected in their recommendation of abstinence for preg- nant and breastfeeding women. I argue that this reorganisation of gendered vulnerability to alcohol reflects several important shifts that have taken place both in public health discourse and in the social practices and cultural norms of gender.

In Australia, New Zealand and the United Kingdom the health discourse on alcohol consump- tion has both promoted and reflected a growing public concern about excessive drinking, especially 'binge-drinking' as a routine aspect of youth leisure (Keane, 2009; McCreanor, Greenaway, Barnes, Botell, & Gregory, 2005; Measham & Brain, 2005). …

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