Alcohol use and related problems among ethnic minorities in the United States

Alcohol Research & Health, Wntr, 2003 by Frank H. Galvan, Raul Caetano

Alcohol use patterns and the prevalence of alcohol-related problems vary among ethnic groups. Among the elements thought to account for these ethnic differences are social or cultural factors such as drinking norms and attitudes and, in some cases, genetic factors. Understanding ethnic differences in alcohol use patterns and the factors that influence alcohol use can help guide the development of culturally appropriate alcoholism treatment and prevention programs. KEY WORDS: ethnic differences; minority group; cultural patterns of drinking; prevalence; AODR (alcohol and other drug related) mortality; AOD associated consequences; sociocultural aspects of AOD use; cultural sensitivity; treatment outcome; Hispanic; African American; Native American; Asian American

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Ethnic minorities currently make up about 29 percent of the U.S. population (U.S. Census Bureau 2001). (1) This article reviews the main research findings on the alcohol consumption patterns and related problems of the four main ethnic minority groups in the United States: Hispanics, Blacks, Asian Americans, and Native Americans. Comparison data are often given for Whites, who make up the majority group in the United States. An understanding of the similarities and differences in alcohol consumption that exist among these ethnic groups and the differences that distinguish them from Whites can guide the development of alcoholism prevention and treatment programs to meet the needs of members of these groups. Although recent alcohol research has emphasized the heterogeneity that exists within each ethnic group (Caetano et al. 1998), detailed examination of within-group differences is beyond the scope of this article.

ALCOHOL CONSUMPTION PATTERNS AMONG U.S. MINORITY GROUPS

Patterns of alcohol consumption have been found to vary across ethnic groups. Surveys of nationally representative samples of people age 18 and older conducted in 1984 and 1995 found that the rates of alcohol abstention remained stable among White men but increased among Black and Hispanic men (see table 1) (Caetano and Clark 1998a).

This study also found that frequent heavy drinking (defined as drinking five or more drinks at a sitting at least once a week (2) ) decreased among White men but remained stable among Black and Hispanic men. (3) Among women, abstention rates increased among all three groups, with the highest increases occurring among Blacks and Hispanics compared with Whites. Women's rates of frequent heavy drinking mirrored those of men, with a decrease in heavy drinking among White women and stability of rates for Black and Hispanic women.

Several factors were associated with the likelihood of current frequent heavy drinking for the three groups (Caetano and Clark 1998a). Among White men, risk factors for frequent heavy drinking were lower educational attainment and being separated, divorced, or never married. Factors associated with a lower likelihood of frequent heavy drinking for White men were being older than 50 years of age and reporting that religion was important in their lives. No specific risk factors were found for Black men; protective factors included being retired and defining religion as important in their lives. Among Hispanic men, unemployment was the only identified risk factor.

Among White women, never having married was a risk factor for frequent heavy drinking, and being older than 50 was a protective factor. Among Black women, lower income and unemployment were risk factors. Black women between the ages of 50 and 59 were less likely to report frequent heavy drinking than those between 18 and 29. A risk factor for Hispanic women was unemployment; protective factors included older age, retirement, and defining religion as important in their lives.

Data from the 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES) found drinking patterns for Native Americans to be similar to those of Blacks and Hispanics (specifically, Mexican Americans) (Dawson 1998). Compared with Whites, Native Americans are less likely to drink--that is, a greater percentage of the population abstains--but they consume more alcohol when they do drink, as is the case for both Blacks and Mexican Americans.

Heterogeneity in drinking patterns is also found among different nationalities within specific ethnic groups (Dawson 1998). Blacks whose ancestry is Caribbean consume less alcohol compared with Blacks in general. Hispanic Americans of Central American, South American, or Caribbean ancestry consume less alcohol than Hispanics in general (including Hispanics of Mexican or Mexican American ancestries). Among Asians, Japanese Americans consume more alcohol than Asian Americans of other national origins (Dawson 1998). Heterogeneity in drinking patterns also varies by place of birth. For example, Asians and Pacific Islanders born in the United States have lower alcohol abstention rates than those born elsewhere (Makimoto 1998).

Differences in alcohol consumption are also found among Native Americans. Those living on reservations drink less frequently than Native Americans living in off-reservation towns, but reservation dwellers may engage in binge drinking (drinking five or more drinks per day) more frequently and consume more alcohol per occasion when they do drink (May and Gossage 2001).