Alcohol use in South Asians in the UK is under-recognised, and alcohol-related harm is disproportionately high, warn researchers in an editorial published on bmj.com today.
They argue that some subgroups of South Asians in the UK have a major problem with alcohol and seem to be more susceptible to its effects. Yet the government's health strategy for alcohol continues to perpetuate the myth that alcohol-related harm is low in all UK South Asians.
The evidence base is limited, write Dr Rashid Zaman and colleagues, but if place of birth is used as a proxy for ethnicity, alcohol-related mortality in England and Wales is about the national average for Eastern European men and women, Sri Lankan men, and East African men, whereas men and women born in the Middle East, North Africa, West Africa, Bangladesh, Pakistan, China, and the West Indies and women born in India, Sri Lanka, and East Africa have lower mortality.
Surprisingly, men born in India reportedly drink less than the general population, yet Indian men have higher rates of alcohol-related admission to hospital in England than do British white men.
In fact, the degree and pattern of alcohol use among UK South Asians varies greatly, explain Dr Rashid Zaman and colleagues. Differences in religion, culture, history, and socioeconomic position all play a part, while differences between generations and increased alcohol consumption from acculturation further complicate the picture.
Understanding how these differences interact with biology is the key to making sense of the evidence and developing equitable services to tackle the problem, they say.
Strategies should include outreach workers developing trusted links with the relevant South Asian communities and actively promoting community services, specialist inpatient services, and residential rehabilitation services.
Delivering tailored health messages that are consistent with differing health beliefs and world views would also improve awareness.
They believe the UK's current health strategy for alcohol is failing a substantial proportion of citizens, and they call for more research to improve our understanding of alcohol-related harm among different ethnic groups.