How Can We Better Understand and Address the Issue of Alcoholism in the British Sikh Punjabi Community? Based on the Above, How Can the Medical School Curriculum Be Improved So Clinicians Can Better Meet the Needs of the British Sikh Punjabi Community and Diverse Communities in General? a Narrative Literature Review

Abstract

Aims

Alcoholism within the British Sikh Punjabi (BSP) community is a severe issue caused by a complex array of psychosocial, political, and cultural factors. The current biomedical model taught at UK medical schools fails to address psychosocial aspects of disease, restricting the ability for doctors to treat patients holistically. As a result, doctors under-diagnose and under-treat patients with alcohol use disorders (AUD). There is a need to understand how medical education can address the needs of communities like the BSP to ensure better treatment and management in the future.

Aims and Objectives

To explore the factors affecting alcohol consumption amongst the BSP community, as well as the barriers and facilitators they experience towards help-seeking. The results will help to make recommendations on how current alcohol-related teaching in medical school curriculums may be improved, and specifically, how to produce more culturally competent future doctors.

Methods

Two narrative literature reviews were conducted. 37 studies were included. The first search underwent thematic analysis with reference to a Public Health England framework, and the second underwent inductive thematic analysis. Key themes were discussed, analysed, and consequently the results from both literature searches were compared to produce appropriate recommendations.

Results

The first review found that alcoholism is increasing in prevalence in the BSP population. The eleven themes identified corresponded to drivers, determinants, and consequences of consumption. A prominent theme identified included ‘economic and social structures influencing alcoholism within the BSP community’, which addressed the impact of gender roles, acculturation, and racial discrimination on alcohol consumption. The second review identified two themes and three subthemes. The ‘current level of alcohol-related teaching in the curriculum’ theme highlighted that approximately 14 hours is dedicated to this crucial topic. Overall, these findings indicated the need for multifaceted interventions to change the current provision of education.

Conclusion

Currently, the BSP population fail to access treatment services due to fear of shame and stigma. Thus, doctors must be empathetic and sensitive to this, and be aware of how to explore psychosocial aspects of patient's lives and how this influences their AUD. Providing culturally competent services will ensure that holistic interventions are implemented, leading to earlier detection, prevention, and management of alcohol-related harms. This will ensure that individuals from the BSP community feel comfortable in help-seeking. Recommendations were targeted at medical schools and their students, with a predominant focus on the provision of culturally competent services.