ABSTRACT
This chapter explores how risky alcohol consumption represents a form of coping, escapism and pleasure under situations of structural violence. In South Africa, alcohol and its multiple harms represent a significant and multidimensional urban governance problem. Liquor consumption contributes to the country's substantial double burden of infectious and non-communicable disease, violence, injury and HIV/AIDS. Structural violence, Paul Farmer argues, stymies the exercise of individual and collective agency, thus reinforcing the multiple inequalities that are both its cause and effect. Over the past decade, Michael Marmot and colleagues have argued for a shift in attention from the aetiology of disease to the 'more fundamental structures of social hierarchy and the socially determined conditions in which people grow, live, work, and age'. The 2012 Western Cape Liquor Act has been justified with respect to the province's high rates of alcohol-related crime, violence, injury and foetal alcohol syndrome.
