Women, health and alcohol at midlife: performing postfeminist healthism to manage well-being
Research article
Key Study Insights
The study’s most powerful insight is that postfeminist healthism – the cultural imperative for women to take individual responsibility for achieving idealised health, wellbeing, and femininity – functions as a mechanism that keeps midlife women justifying and managing their alcohol use rather than reducing it.
Women’s awareness of alcohol’s health risks does not translate into reduced alcohol use. Instead, that awareness is incorporated into a performance of responsibility, a way of demonstrating that they are knowledgeable, self-monitoring, and in control. But this ultimately serves to legitimise continued alcohol use.
A second critical insight is that the alcohol industry’s ‘responsible drinking’ messaging maps directly and precisely onto postfeminist healthism ideals. This is not a coincidence. The alcohol industry benefits from a cultural framework that places responsibility for alcohol harm entirely on individual women, making the commercial and social environments that promote and normalise alcohol use invisible and therefore uncontested.
A third insight is that health-investing behaviours, such as exercise, diet, wellness devices, mindfulness, etc. are actively used by women to offset their alcohol use, constructing a kind of moral ledger in which healthy behaviours compensate for potentially unhealthy ones. This allows women to maintain a self-image as healthy and responsible even when their alcohol use is relatively heavy. The alcohol industry reinforces this through products carrying health and nutrient claims (‘low sugar’, ‘low carb’, ‘natural’), which create a ‘health halo’ for alcoholic beverages.
What the Study Did
The researchers conducted 17 individual interviews and eight friendship group discussions with 50 midlife women aged 35–59 in Aotearoa New Zealand. They asked women to talk about alcohol and the role it played in their lives, with a focus on their health and wellbeing.
The participants were largely middle-class and Pākehā (NZ European), which means the findings may not fully capture the experiences of women from different ethnic, class, and cultural backgrounds.
The researchers analysed the data using feminist Foucauldian-informed discourse analysis. This is an approach concerned with how dominant cultural meanings shape how people understand themselves and justify their behaviour.
The analysis identified three subject positions that women drew on to make sense of and justify their alcohol use:
- the self-monitoring, controlled alcohol user: someone who demonstrates bodily awareness and controlled consumption;
- the self-investing, heavier alcohol user: someone whose exercise, diet, and wellness practices offset their alcohol use; and
- the self-aware alcohol user: someone whose psychological self-knowledge and insight into their own motivations frames their alcohol use as considered and intentional.
All three positions function to make continued alcohol use compatible with postfeminist healthism ideals.
Why the Researchers Conducted this Study
Prior research had explored how midlife women who stop or reduce their alcohol use draw on postfeminist and healthism frameworks to justify that decision. But no research had yet examined how women who continue to use alcohol at moderate to heavy levels draw on those same frameworks to make sense of their alcohol use and its risks.
This gap mattered because alcohol use among midlife women has increased in some countries, evidence linking alcohol use to serious long-term harms, including cancer, is growing, and public health and media discourse emphasising these risks has intensified.
Understanding how women who continue to use alcohol negotiate these messages, and what cultural frameworks they draw on to do so, is essential for developing policies and interventions that actually speak to women’s lives and have a realistic chance of reducing and preventing alcohol harm.
In short: the study set out to understand not just what midlife women think about alcohol and health, but how they use cultural ideas about femininity, responsibility, and wellbeing to make sense of and justify their alcohol use.
Lessons for Action-Taking
What alcohol policy advocates, prevention practitioners, and people challenging the alcohol industry and alcohol norm can learn from this study:
1. The ‘responsible’ alcohol use concept is an industry tool and it works. The study shows that the alcohol industry’s ‘responsible drinking’ messaging aligns precisely with postfeminist healthism ideals that women have already internalised. Women use the concept to position their alcohol use as self-aware and controlled, regardless of actual consumption levels.
This is not a coincidence. The alignment directly serves industry interests: it positions alcohol use as unproblematic as long as women are monitoring themselves, keeping responsibility with the individual and structural change off the agenda.
Advocates need to directly challenge and deconstruct the responsible use concept as an industry strategy, not a public health framework.
2. Information alone does not reduce alcohol use – and may even reinforce it. The women in this study were highly articulate about alcohol’s health risks, including cancer. Yet this knowledge did not lead them to reduce their alcohol use. It was instead used to perform a knowledgeable, responsible subject position that justified continued use.
Health promotion campaigns based primarily on information and warning labels are therefore likely to be ineffective, and may even be co-opted into the self-monitoring framework the alcohol industry benefits from.
Advocates should push for structural and regulatory interventions over information campaigns.
3. Wellness culture and health-investing behaviours function as justifications for alcohol use. The study documents how women compensate for their alcohol use through exercise, healthy eating, digital health tracking, and wellness practices and use these behaviours to rationalise that their alcohol use is not problematic.
The alcohol industry reinforces this through products with health and nutrient claims (‘low sugar’, ‘low carb’, ‘natural’), playing into women’s concerns about their health and outward appearance to create a ‘health halo’ for alcoholic beverages.
Advocates and practitioners need to expose and counter this strategy, including challenging ‘healthier’ alcohol product marketing as a form of industry manipulation.
4. The alcohol norm is deeply gendered – and policy must respond accordingly. The study shows that alcohol use is socially embedded in midlife women’s lives in highly gendered ways, for example tied to femininity, sociability, self-care, and identity.
Policies that ignore this gendered dimension will fail. The researchers explicitly call for alcohol policies that incorporate a gender and gender-equity lens in both their development and implementation, consistent with WHO recommendations.
Advocates should push for this as a policy standard.
5. Individual responsibility framing protects the alcohol industry. The postfeminist healthism framework places the burden of managing alcohol harm squarely on individual women, making the social, commercial, and economic environments that promote alcohol use invisible.
This directly serves alcohol industry interests. When responsibility for alcohol harm is placed entirely on individual women, the commercial and structural conditions that drive alcohol harm become invisible. This in turn means pressure for government alcohol policy action dissipates.
Advocates should consistently reframe alcohol harm as a commercial and structural issue, not a personal failing.
6. Class and privilege shape whose alcohol use is seen as acceptable. The study notes that middle-class women with time and financial resources can more easily perform health-investing behaviours that offset their alcohol use in the eyes of others and themselves.
Women with fewer resources are more likely to have their alcohol use judged as “irresponsible”.
This class dimension of alcohol harm and stigma should be part of any equity-informed policy approach.
Added Value of the Study
This study is highly valuable for several specific reasons:
The study provides robust qualitative evidence that the alcohol industry’s ‘responsible drinking’ concept is not a public health framework but a commercial strategy that exploits cultural ideals present in women’s lives. This strengthens the case for abandoning ‘responsible’ use as a policy or public health concept and for treating it as what it is: an industry framing that keeps responsibility for alcohol harm with individuals and obscures the social and commercial environments that promote and normalise alcohol use.
The study directly supports the case that information-based campaigns are insufficient policy responses. This is important for advocates pushing back against alcohol industry-sponsored harm reduction initiatives that focus on consumer information rather than structural change.
The study exposes the ‘wellness’ and ‘healthy choice’ alcohol product category, such as low sugar, low carb, low calorie alcoholic beverages, as a deliberate commercial exploitation of healthism ideals, providing evidence for challenging these products and their marketing as a form of alcohol industry manipulation that should be regulated.
The study provides evidence grounding for why alcohol policies must be gender-responsive, not just gender-sensitive in tone, but structurally attentive to the ways in which gendered social expectations, commercial marketing, and cultural norms around femininity shape women’s alcohol use and their responses to health information.
The study supports the broader argument that the commercial determinants of alcohol harm – industry messaging, marketing, product development, and narrative shaping – must be the primary target of public health policy, not individual behaviour. The study makes visible the mechanism by which commercial narratives become internalised as personal values, making the industry’s role invisible and therefore unaccountable.
Finally, the study adds to the growing body of evidence supporting FCTC Article 5.3-style frameworks for alcohol policy: limiting alcohol industry engagement in the development of alcohol-related health policies because the study demonstrates concretely how alcohol industry messaging shapes the cultural context in which women make sense of their alcohol use.
Abstract
Introduction
For many women in Western countries, alcohol is linked with pleasure, sociability and coping, but also health risks. Drawing on postfeminist healthism concepts, this research explored how women at midlife perform health and well-being around consuming alcohol.
Methods
Eight friendship groups and 17 individual interviews were conducted with 50 women (35–59 years) in Aotearoa New Zealand about alcohol and alcohol use. Transcripts were analysed using discourse analysis.
Results
The women drew on discourses underpinned by healthism and postfeminist imperatives, including taking individual responsibility for health and viewing themselves as a ‘psychologised self’, to make sense of – and justify – alcohol use.
These discourses enabled three ‘alcohol consumer’ subject positions for the women:
- self-monitoring, controlled alcohol user;
- self-investing, heavier alcohol user; and
- self-aware alcohol user.
The women were impelled to be continually reflexive and self-surveillant, to enact wellness practices, and to constantly monitor their alcohol consumption in performing postfeminist ideals.
Conclusion
Industry and policy notions of ‘responsible drinking’ portray alcohol use as a potentially healthy activity. Action is needed to change women’s environments to support reduced alcohol consumption, including reducing alcohol’s social embeddedness and addressing activities that promote women’s alcohol use and normalise alcohol consumption.
A multi-faceted gendered lens on policy development and implementation is essential.