Racial Disparities in the Association between Alcohol Use Disorders and Health in Black and White Women

Abstract

The burden of adverse health attributed to Alcohol Use Disorders (AUD) is higher among black compared to white women. We investigated whether socioeconomic status (education and income); healthcare factors (insurance, alcoholism treatment); psychosocial stressors (stressful life events, racial discrimination, alcoholism stigma) could account for black-white disparities in the association between AUD and physical and functional health among current drinker women aged 25 years and older (N = 8,877) in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). We used generalized linear regression model to test the interaction between race and 12-month DSM-IV AUD in Wave 1 (2001-2002) associated with health in Wave 2 (2004-2005), adjusted for covariates (age group, smoking, alcohol consumption, cardiovascular disease, diabetes, body mass index, and arthritis). Black women with AUD had poorer health compared to white women with AUD (β=−3.18, SE=1.28, p<.05), an association that partially attenuated after adjusting for education and income (β=−2.71, SE=1.27, p<.05), and attenuating further after adjusting for health care and psychosocial factors (β=−2.64, SE=1.27, p<.05). In race-specific analysis, AUD was associated with poorer health for black but not white women. Accounting for black-white differences in AUD and physical and functional health among women requires investigation beyond traditional mechanisms.

The effects of gender identity change efforts on Black, Latinx, and White transgender and gender nonbinary adults: Implications for ethical clinical practice

“…These negative health outcomes may not reach the level of a diagnosis, yet may still put individuals at risk for suicide attempts (Newcomb et al, 2019; Phillips et al, 2020) and intimate partner violence (Kidd et al, 2021). Black individuals are disproportionately impacted by alcohol use with social consequences and chronic health conditions, despite drinking the same or less than White peers (Mulia et al, 2009; Ransome et al, 2017). Diagnostic criteria and scores on standardized measures may not be the metric for determining treatment; instead clinicians could assess for substance use, psychological distress, and family and partner relationships within the context of GICE exposure.…”

Association Between Opioid Use Disorder and Seizure Incidents Among Alcohol Use Disorder Patients

“…30 Another study argued that minorities were less likely to be treated for OUD. 31 Ransome et al 32 demonstrated that Black women with AUD have more adverse health effects than White women with AUD, with much of the difference due to socioeconomic status, healthcare factors, and psychosocial stressors. This study found that White patients have a higher incidence of seizure, AUD, and OUD.…”

Substance Use Disorder Detection Rates Among Providers of General Medical Inpatients

“…As a group, patients in this study sample had at least a moderate level of motivation to reduce or stop their use, suggesting that they might be amenable to brief interventions if detected. Furthermore, the findings of racial disparities in alcohol, cocaine, and opioid use disorder detection are alarming when considering that racial minorities experience more adverse substance-related health and social consequences [54][55][56] and barriers to accessing and completing treatment 57,58 relative to White persons. Universal screening may be one way to minimize the impact of unconscious bias that contributes to racial disparities.…”