Research on women's drinking occurs in largely disparate disciplines-including public health, health promotion, psychology, sociology, and cultural studies-and draws on differing philosophical understandings and theoretical frameworks. Tensions between the aims and paradigmatic underpinnings of this research (across and within disciplines) have meant that knowledge and insight can be frequently disciplinary-specific and somewhat siloed. However, in line with the social and economic determinants of the health model, alcohol research needs approaches that can explore how multiple gender-related factors-biological, psycho-social, material, and socio-cultural-combine to produce certain drinking behaviours, pleasures and potential harms. We argue that critical realism as a philosophical underpinning to research can accommodate this broader conceptualization, enabling researchers to draw on multiple perspectives to better understand women's drinking. We illustrate the benefit of this approach by presenting a critical realist theoretical framework for understanding women's drinking that outlines interrelationships between the psychoactive properties of alcohol, the role of embodied individual characteristics and the material, institutional and socio-cultural contexts in which women live. This approach can underpin and foster inter-disciplinary research collaboration to inform more nuanced health promotion practices and policies to reduce alcohol-related harm in a wide range of women across societies.
Keywords: alcohol; critical realism; evidence-based health promotion; gender; methodology.
Research has shown that over the last few decades women’s alcohol consumption has increased alongside rising rates of alcohol-related harm. A range of different research approaches explores women’s drinking. However, many researchers have worked within their own disciplines with little input from other alternative, and sometimes inconsistent, approaches. In this paper, we argue that critical realism is an approach that can enable researchers to draw on a variety of research perspectives to provide greater insight and understanding of women’s drinking. We illustrate how this can benefit knowledge of women’s drinking by exploring the interrelationships between the properties of alcohol as a psychoactive substance, the role of individual characteristics and experiences, and the realities of women’s lives. Critical realism is also able to incorporate the social and economic determinants of health model that critically considers the role of individual aspects, living and working conditions, and social and cultural factors on health behaviours. By contributing to an understanding of diverse drinking practices, this approach can assist health promotion policy and practice seeking to prevent and reduce alcohol-related harm in a wide range of women across societies.
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