Most working mothers do. According to Wharton School of Business economists Betsey Stevenson and Justin Wolfers, women are less happy today than their predecessors in the 1970s, both in absolute terms and relative to men. No wonder. Between 1979 and 2006, the workweek of the typical middle-income American family increased by roughly eleven hours. According to a 2011 study by the Center for Work and Family at Boston College, 65 percent of fathers believed that both parents should contribute equally as caregivers for their children—but only 30 percent of the fathers actually did so.
For me, all the juggling took its toll. Certain disappointments at work were bruising. Menopause hit: anxiety and depression reared their ugly heads. Somewhere along the line, my occasional evenings of drinking too much morphed into drinking on an almost nightly basis. When Nicholas left for university, when the marathon was over and the house was empty, I was lonely: it was then that my evening glass of wine turned into two or three, which eventually became three or four in Montreal.
On this, I am not alone.
Preeminent American alcohol researcher Sharon Wilsnack, of the University of North Dakota, believes we are now witnessing a “global epidemic” in women’s drinking. In 2011, Katherine Keyes, now an assistant professor at Columbia University, reviewed thirty-one international studies of birth-cohort and gender differences in alcohol consumption and mortality. Her conclusion? Those born after the Second World War are more likely to binge drink and develop alcohol-use disorders than their older counterparts.
Sitting in her office, her two-year-old son’s face beaming by her computer, Keyes gets specific: “Those born between 1978 and 1983 are the weekend warriors, drinking to black out. In that age group, there is a reduction in male drinking, and a sharp increase for women.” Meanwhile, women who are in their forties and fifties have a very high risk in terms of heavy drinking and weekly drinking. “We’re not saying, ‘Put down the sherry and go back to the kitchen,’” says Keyes. “But when we see these steep increases, you wonder if we are going to see a larger burden of disease for women.”
In many countries, the answer is yes. Take Britain, for instance, the Lindsay Lohan of the international set.
Most important, Keyes’s study points to the critical role of societal elements in creating a drinking culture. “Traditionally, individual biological factors have been the major focus when it comes to understanding alcohol risk,” says Keyes. “However, this ignores the impact of policy and environment.”
The environment is challenging: witness the rise in alcohol marketing, the feminization of the drinking culture. Women need a break. They feel they deserve a break. And if drinking is about escape, it is also about entitlement and empowerment. Says Keyes: “Those in high-status occupations, working in male-dominated environments, have an increased risk of alcohol use disorders.” In fact, the one protective factor for women is what Keyes calls “low-status occupations.” She puts on her coat, getting ready to head home for the evening. “As gender role traditionality decreased, the gender gap in substance abuse decreased as well. And the trajectory for female alcohol abuse now outpaces that of men.”
In fact, women with a university degree are almost twice as likely to drink daily as those without. “I ask myself every day if I’m an alcoholic,” says one rising corporate star, a graduate of Queen’s University, who wishes to go unnamed. “I’m thirty-two, and I drink every night. All my friends drink every night. We wouldn’t dream of skipping a day. We haven’t had our kids yet, and we all drink the same way we did in university.”
Says Katherine Brown, director of policy at Britain’s Institute of Alcohol Studies: “Young professional women drink a lot more than women in manual and routine jobs—what you call blue collar. Is it marketing, keeping up with the machismo, children?” Brown believes that a crucial driver is the norms of the university years. “It’s an alcohol-soaked environment,” she says. “At the university I went to—Exeter—Carlsberg was a sponsor of events held on campus. The focus was on getting really, really drunk and the most horrendous things used to happen. It was an alcogenic environment—sporting events, pub crawls, often carrying a bucket around for those being sick. All social events revolved around drinking, and acting the fool was celebrated. Now, it’s the ‘done’ thing for a city woman to come home after a stressful day and open a bottle of wine. Is it the Sex and the City generation? Who knows. Nobody questions it.”
Walk into most social gatherings and the first thing you’re asked is “Red or white?” In fact, we live in a culture where knowing your wines is a mark of sophistication. And thanks to media reports of the past several years, we have happily absorbed the news that drinking has its health benefits. For many, red wine ranks up there with vitamin D, omega-3s, and dark chocolate. If one glass is good for you, a double dose can’t do much harm, can it? Actually, a double dose has its drawbacks. The largest health benefit comes from one drink every two days.
Which raises a simple question: why are we aware of the dangers related to trans fats and tanning beds, and blissfully unaware of the more serious side effects associated with our favorite drug? It’s a headscratcher, to say the least.
Last year, a study in the respected journal Addiction challenged the broadly accepted assumption that a daily glass of red wine offers protection against heart disease. Says Jürgen Rehm, director of social and epidemiological research at Toronto’s Centre for Addiction and Mental Health and coauthor of the paper: “While a cardioprotective association between alcohol use and ischemic heart disease exists, it cannot be assumed for all drinkers, even at low levels of average intake. And, the protective association varies by gender—with higher risk for morbidity and mortality in women.”
Alcohol is a carcinogen, and the risks of drinking far outweigh the protective factors. For some time there has been a clear causal link between alcohol and a wide variety of cancers, including two of the most frequently diagnosed: breast and colorectal. Rehm asks a simple question: “What would the breast cancer rate be without alcohol?”
Women have many other physical vulnerabilities when it comes to drinking. “Politically, we are equal,” says Dr. Joseph Lee, medical director of the renowned Hazelden Center for Youth and Families in Plymouth, Minnesota. “But hormonally, metabolically, men and women are different—and this has implications for tolerance and physical impacts over the long run.”
Women’s vulnerabilities start with the simple fact that, on average, they have more body fat than men. Since body fat contains little water, there is less to dilute the alcohol consumed. In addition, women have a lower level of a key metabolizing enzyme, alcohol dehydrogenase, which helps the body break down and eliminate alcohol. As a result, a larger proportion of what women drink enters the bloodstream. Furthermore, fluctuating hormone levels mean that the intoxicating effects of alcohol set in faster when estrogen levels are high.
The list goes on. Women’s chemistry means they become dependent on alcohol much faster than men. Other consequences—including cognitive deficits and liver disease—all occur earlier in women, with significantly shorter exposure to alcohol. Women who consume four or more alcoholic beverages a day quadruple their risk of dying from heart disease. Heavy drinkers of both genders run the risk of a fatal hemorrhagic stroke, but the odds are five times higher for women.
Gender is a strong predictor of alcohol use. One groundbreaking project is GENACIS—Gender, Alcohol and Culture: An International Study. With forty-one participating countries, this project offers an extraordinary opportunity to improve our understanding of how gender and culture combine to affect how women and men drink. Sharon Wilsnack, who oversees the GENACIS project, is also the lead author of the world’s longest-running study of women and drinking, the National Study of Life and Health Experiences of Women. Between 1981 and 2001, she and her team interviewed the same women every five years. One of their findings: the strongest predictor of late-onset drinking is childhood