Military Work and Drinking: Risks and Prevention

Principal Investigator: Genevieve Ames
Sponsor: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
(2/1/1999 - 1/31/2005)

Proposal Abstract

Objectives: This was a prevention-oriented study focused on the influence of the military culture and work environment on individual and collective drinking norms and thereafter drinking behavior of careerists in the United States Navy. Integrating ethnographic, survey and archival data we met the following study goals: (1) observed drinking patterns in both work- and non-work-related contexts for Navy officers and enlisted personnel. (2) analyzed the effects of alcohol consumption patterns on alcohol-related problems both within and outside of work using available objective measures (e.g., archival records of disciplinary action, demerits, absenteeism, alcohol and other treatment, and DUIs) and self-reports in the survey. (3)examined drinking and drinking problems as relate to, age, gender, ethnicity, religion, and family drinking history, and normative beliefs. (4)assessed the relationship between physical, social, and cultural characteristics of the workplace and drinking patterns and problems as organized under around social control (policies, procedures for enforcement) , alcohol availability, and work-related stress and alienation. (5) gained understandings of the effect of regimented or military-style culture at large (e.g., socializing and conformity to rituals, symbolic behavior, role and status, role modeling, age cohorts, etc.) on drinking patterns. (6) investigated how gender and ethnicity influence drinking and drinking problems within the context of military workplaces. A randomly drawn roster provided by the Department of Defense contained the names and addresses of 6,518 potential survey participants: final response was 60.2%. In the ethnography, we collected 81 tape-recorded, semi-structured open-ended interviews with quota sample of enlisted personnel, officers, medical personnel and officers.

Findings/Conclusions: The multivariate analyses showed an association between elements of the work environment (policy, alcohol availability, stress) and positive normative beliefs for drinking behavior, especially during deployment liberty. Normative beliefs, in turn, were associated with both heavy and heavy episodic (binge) drinking during deployment, and year-round alcohol abuse and heavy drinking.

Findings from the ethnography investigated the cultural context of survey findings. We demonstrated why inconsistent alcohol policy enforcement, work-related stress and length of deployment encouraged and promoted heavy and heavy episodic drinking, and how these factors are embedded in cultural and extenuating contexts of free range behavior and heavy episodic drinking on deployment liberty, heavy drinking as a means of letting off steam and in response to stress of shipboard confinement for long periods of time, and to relieve frustration with months of being away from family and friends at home.

Traditionally, the deployment experience, and all that goes on during many months at sea, including liberty, is crucial in creating a career sailor or officer A weak link in this process, however, is the high risk drinking that is part of the tradition of deployment liberty. As we found, those drinking and behavioral norms developed and reinforced on deployment, carry forward to year round drinking and alcohol abuse rates while sailors are on shore duty, and may be setting lifetime drinking patterns as well. Many more senior enlisted personnel, medical staff, alcohol counselors, and some line officers think about drinking problems in the context of individual personality, personal family circumstances, weakness, or exuberance of youth rather than attributable to factors of the Navy work environment, rituals and traditions. Explanations that point to the individual or other causes outside the realm of the work environment are convenient as it is much easier to regard problem drinking as an individual choice issue, and that is the message of treatment, than it is to rearrange traditional activities for a shipload of sailors in a foreign port. In light of this study's findings, it is easier to understand the continuance of heavy drinking rates in the U.S. Navy over many years, as well as the cultural and environmental barriers faced by the Navy's alcohol deglamorization and other prevention programs in addressing their goal of lowering heavy drinking and alcohol abuse rates. The Navy and other military forces might consider broad swept policy and environmental changes as complementary goals for their current approach to prevention.

Implications for Prevention: Sailors move rapidly from one geographic area to another and from one chain of command to another on an ongoing basis. This is particularly the case early in the career. The sailors enter and move through processes in a corkscrew fashion. Many models for public health and measurement cannot be used--at least not by Navy health promotion and substance abuse prevention personnel at the front end of the corkscrew. New ideas in measurement are needed that are informed by qualitative methods that might be able to show a shift in Navy cultural norms.
The formative part of Navy Health Promotion initiatives for recruits and trainees based upon qualitative information needs to be improved. Sailors spend less than 1% of their careers in healthcare facilities (hopefully). A comprehensive prevention plan must therefore be out in the environment, ultimately empowered by policy, or in the case of Navy Health Promotion personnel, line authority. The design of initiatives among these targeted groups should be carried out by researchers with scholarship behind the design. Dr. Ames, along with Drs. Cunradi and Moore, were invited to Great Lakes Recruit Training Command in Great Lakes, IL, and to Norfolk Naval Base, Atlantic Fleet Command, for Risk Prevention Seminars where they presented research findings and guidelines, consultation and planning for prevention efforts in the accession and training commands, and made recommendations on environmental prevention of alcohol-related problems among career Navy personnel.