Drinking, Alcohol Use Disorder, and Treatment Access and Utilization Among U.S. Racial/Ethnic Groups

Abstract

Data from approximately 140 articles and reports published since 2000 on drinking, alcohol use disorder (AUD), correlates of drinking and AUD, and treatment needs, access and utilization were critically examined and summarized. Epidemiological evidence demonstrates alcohol-related disparities across U.S. racial/ethnic groups. American Indians/Alaska Natives generally drink more and are disproportionately affected by alcohol problems, having some of the highest rates for AUD. In contrast, Asian Americans are less affected. Differences across Whites, Blacks and Hispanics are more nuanced. The diversity in drinking and problem rates that is observed across groups also exists within groups, particularly among Hispanics, Asian Americans, and American Indians/Alaska Natives. Research findings also suggests that acculturation to the U.S. and nativity affect drinking. Recent studies on ethnic drinking cultures uncover the possible influence that native countries’ cultural norms around consumption still have on immigrants’ alcohol use. The reasons for racial/ethnic disparities in drinking and AUD are complex and are associated with historically-rooted patterns of racial discrimination and persistent socioeconomic disadvantage. This disadvantage is present at both individual and environmental levels. Finally, these data indicate that admission to alcohol treatment is also complex and is dependent on the presence and severity of alcohol problems but also on a variety of other factors. These include individuals’ sociodemographic characteristics, the availability of appropriate services, factors that may trigger coercion into treatment by family, friends, employers and the legal system, and the overall organization of the treatment system. More research is needed to understand facilitators and barriers to treatment to improve access to services and support. Additional directions for future research are discussed.

Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample

“…Another limitation of prior literature on gender disparities is that there has been very little formal investigation of the factors driving gender disparities in alcohol services utilization, which is in stark contrast to the large and expanding literature on racial/ethnic alcohol disparities (Chartier and Caetano, ; Grant et al., ; Vaeth et al., ). To achieve equity in alcohol services utilization between women and men, we must have a thorough understanding of the determinants of gender disparities in use of such services.…”

A Critical Review and Meta‐Analysis of the Associations Between Acculturation and Alcohol Use Outcomes Among Hispanic Americans

“…Compared to non‐Hispanic Whites, Hispanic Americans showed lower prevalence rates of lifetime, past year, and past month alcohol use (Villalobos and Bridges, ). Hispanic adults had high estimates of binge drinking across national surveys, however (McKinney and Caetano, ; Vaeth et al., ). Data from the National Alcohol Surveys in 2005 and 2010 revealed that Hispanic Americans had similar composite scores for heavy drinking as White Americans, but Hispanic men reported higher rates of alcohol‐related problems associated with injuries, work, and legal consequences than their White counterparts (Witbrodt et al., ).…”

“…A large body of research has examined acculturation as a determinant of alcohol use (Vaeth et al., ). Acculturation is the process of psychological, behavioral, sociocultural change, and adaptation that happens when intercultural contact occurs between individuals or among groups of people (Schwartz et al., ; Zamboanga et al., ).…”

“…Acculturation can be considered from a unidimensional or bidimensional perspective. In many studies concerning alcohol use, acculturation is conceptualized as a unidimensional process (Vaeth et al., ). This perspective assumes that people who adhere to the mainstream American way of life lose their traditional Latino way of life (for review, see Lafromboise et al., ).…”

Shared additive genetic variation for alcohol dependence among subjects of African and European ancestry

“…Alcohol dependence (AD) is a global problem that affects individuals from all racial/ethnic groups and all levels of socioeconomic standing. Previous studies suggest that there is considerable variation in patterns of drinking and alcohol use disorders across different US racial/ethnic groups (Caetano, Clark & Tam ; Chartier & Caetano ; Vaeth, Wang‐Schweig & Caetano ). For example, analysis of college‐aged students (i.e.…”