In summary, these findings on volume of drinking and binge drinking by age suggest that older US Hispanic men are at a considerable risk of developing alcohol-related problems because of their continued drinking. Additionally, data from the 2007 NSDUH (SAMHSA 2008a) suggest a greater unmet need for alcohol treatment for some ethnic groups. Asians (0.1 percent) and Hispanics (5.5 percent) with a need for alcohol treatment were less likely to receive specialty alcohol treatment (i.e., alcohol and drug rehabilitation program, hospital or mental health center) compared with Whites (8.0 percent) and Blacks (14.0 percent). Schmidt et al. (2007) also reported less specialty alcohol or drug program use for Hispanics than Whites, whereas Blacks were less likely to use a private physician for alcohol problems and to attend Alcoholics Anonymous (AA). Further, and more alarming, Blacks and Hispanics with higher severity alcohol problems were less likely to use any treatment services compared with Whites who have similar severity of alcohol problems.
The majority (approximately 90 percent) of all primary liver cancers are hepatocellular carcinomas (HCC) (Altekruse et al. 2009). Alcohol-related and non–alcohol-related liver cirrhosis usually precede HCC and are the two most common risk factors (Altekruse et al. 2009; El-Serag 2011; Pelucchi et al. 2006). The relative risk for developing this cancer increases with increased levels of alcohol consumption (Pelucchi et al. 2006). By ethnic group, 2003–2005 age-adjusted incidence rates for HCC per 100,000 persons were highest among Asians (11.7), followed by Hispanics (8.0), Blacks (7.0), Native Americans (6.6), and Whites (3.9) (Altekruse et al. 2009). Death rates for HCC per 100,000 people also are higher among minority groups (i.e., 8.9, 6.7, 5.8, 4.9, and 3.5 for Asians, Hispanics, Blacks, Native Americans, and Whites, respectively). A CDC report (2009a) based on 2005–2006 data from the National Violent Death Reporting System presented findings on alcohol and suicide across ethnic groups.
Conversely, indicators of social capital (such as community engagement and social cohesion) may serve to buffer against social isolation and depression, resulting in lower drug- and alcohol-related mortality. The higher level of risky drinking for Native Americans and Hispanic men and the increased occurrence of alcohol consequences for Native Americans, Hispanics, and Blacks may indicate a greater need for alcohol treatment in these populations. For Native American men, Beals et al. (2005) reported more help seeking from specialty alcohol or drug treatment providers relative to the U.S. population, but there were no differences for women. Comparatively, Alaska Natives report less use of psychiatrists, medical doctors, and psychologists for alcohol problems than Whites, Blacks, and Hispanics (Hesselbrock et al. 2003). However, the differences in alcohol services for Alaska Natives may represent a lower availability of some professionals in Alaska.
Acculturation
However, other studies find that ethnic differences in drinking alone do not fully explain alcohol-related disparities (Herd 1994; Jones-Webb et al. 1997; Mulia et al. 2009), requiring the examination of other possible factors. The present analyses used data from a cross-sectional study with a sample of 200 participants from the Project on Health among Emerging Adult Latinos (Project HEAL). A quota sampling design was used to enroll participants in Maricopa County, Arizona and Miami-Dade County, Florida. The target quota for Arizona was 100 participants and within Arizona we aimed to enroll 15 non-college student women, 15 non-college student men, 35 college student women, and 35 college student men. Prospective participants were recruited (1) in-person by distributing flyers, (2) posting flyers with tear-off tabs, (3) social media, and (4) by emailing an announcement that described the study aims and procedures to organizations and individuals who may have had access to the target sample. It should be noted that at each respective study site most participants who were not current college students were recruited in-person by research personnel with experience in recruiting Hispanic participants for research studies.
Ethnicity and Health Disparities in Alcohol Research
Four studies found a nonsignificant relationship between urbanicity/metropolitan status and DUI fatalities40,47 and deaths of despair.72,75 The heterogeneity in these results suggests there may be important effect modifiers for further consideration. Additional research shows that ethnic groups are differentially affected by alcohol-attributed violence, including intimate partner violence (IPV). General rates of male-to-female and female-to-male partner violence are highest among Black couples (23 and 30 percent), followed by Hispanic (17 to 21 percent) and White (12 and 16 percent) couples (Caetano et al. 2000). Schafer et al. (2004) reported stronger effects for alcohol problems in predicting IPV for Black couples compared with Hispanic and White couples. Alcohol appears to play an important role in IPV, although it is difficult to establish a direct causal link. Caetano et al. (2001) reported that 30 to 40 percent of men and 27 to 34 percent of women who perpetrate IPV are drinking at the time of the event.
Multivariate analyses
- Once the variables in the models were finalized, each model was run five times using five imputations of income, one at a time.
- Two-way interaction with study site moderating the association between U.S. orientation and alcohol use severity.
- Policies targeting other substances also may contribute to reduced alcohol-related mortality, and these policies may interact with health care services as well.
- However, those that complete treatment appear to benefit equally regardless of their ethnic group (Brower and Carey 2003; Tonigan 2003).
To obtain correct estimates for the regression coefficients for each combination of these interacting variables, we created a four-level combination variable and used in the models. This is because previous what is mesculin analyses of this data set (Caetano et al., 2008a, 2008b) showed that as a group they drink less, report less binge, and have fewer DUI events and lower rates of alcohol abuse and dependence than the other three groups. Their use as a reference group therefore means that odds ratios comparing other groups with Cuban Americans are higher than 1, which is easier to interpret and understand.
For bivariate analyses, crosstabulations with chi-square option for categorical variables were performed to detect significant associations. Multilog (frequency of binge 3 level) and linear regression analyses (alcohol volume) were conducted to identify demographic risk factors. Based on the past literature (Grant, Stinson, Hasin, Dawson, Chou, & Anderson, 2004b), we expect a moderating effect of birthplace on men and women. Models were developed first using a single imputed value for the income variable (average of 10 imputations). Once the variables in the models were finalized, each model was run five times using five imputations of income, one at a time.
Some studies included measures of health care and social services, which are important determinants of mortality.95 Six studies reported associations between area-level health care factors and alcohol-related mortality outcomes. The fields of developmental psychology and epidemiology indicate that emerging adulthood (ages 18–25 years) is a period in which people tend to drink most heavily in comparison to adolescents and older adults (Sussman & Arnett, 2014; Substance Abuse and Mental Health Services Administration SAMHSA, 2018). For instance, in the United States (U.S.), emerging adults report the highest prevalence of all age groups in terms of current alcohol use (56.3%), binge drinking (36.9%), heavy drinking (9.6%), and alcohol use disorder (10.7%; SAMHSA, 2018). Compared to other racial/ethnic groups, Hispanic (inclusive of Latinos, Latinas, and Latinx) emerging adults had the second-highest prevalence of current alcohol use (50.1%), binge drinking (32.9%), and heavy drinking (8.0%), and the third-highest prevalence of alcohol use disorder (10.7%; SAMHSA, 2018).