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However, in spite of this increase, women in the oldest age group still drink less than those in the youngest age group. The study used a household probability sample of adult Hispanics in five metropolitan areas in the United States. This review of selected published data describes the epidemiology of alcohol use and related behaviors both across and within U.S. ethnic groups. To complement published literature, national survey data available from NIAAA, the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Centers for Disease Control and Prevention (CDC) were used.
Finally, in this sample, the adjusted regression analyses confirm that early onset of drinking is a strong predictor of binge drinking as well as alcohol volume. To examine differences in alcohol consumption among Hispanic national groups in the United States Puerto Ricans, Mexican, Cuban, and Dominican South Central (D/SC) Americans and identify sociodemographic predictors of drinking and binge drinking (four drinks for women and five for men in a 2-hr period). According to the 2001–2002 NESARC, past-year alcohol abuse and alcohol dependence is prevalent in 4.7 and 3.8 percent of the U.S. adult population, while the lifetime prevalence of alcohol abuse and alcohol dependence is 17.8 and 12.5 percent, respectively (Hasin et al. 2007).
Several studies indicate that Native Americans are at greater risk for alcohol-related trauma (e.g., IPV, rape, and assault) compared with other U.S. ethnic groups (Oetzel and Duran 2004; Wahab and Olson 2004). In 1988, the WHOInternational Agency for Research on Cancer (IARC) reviewed the epidemiologic evidence on the association between alcohol consumption and cancer and found a consistent association between alcohol consumption and increased risk for cancers of the oral cavity, pharynx, larynx, esophagus, and liver (IARC 1988). Regardless of ethnicity, the risk of developing these cancers is significantly higher among men than women (National Cancer Institute 2011c, d, e). Regarding cancers of the oral cavity and pharynx, incidence rates among White and Black men are comparable (16.1 and 15.6 per 100,000, respectively); however, mortality rates are higher among Black men (6.0 versus 3.7 per 100,000 for White men) (National Cancer Institute 2011e). For cancer of the larynx, both incidence and mortality rates are higher among Black men than among White men (incidence, 9.8 and 6.0; mortality, 4.4 and 2.0) (National Cancer Institute 2011c). Although these differences may be explained by differential use of alcohol and tobacco in relation to gender and ethnicity, there is some evidence that even after controlling for alcohol and tobacco use, Blacks continue to be at increased risk for squamous cell esophageal cancer and cancers of the oral cavity and pharynx (Brown et al. 1994; Day et al. 1993).
Utilization rates for alcohol treatment may reflect underlying ethnic group differences in the economic and logistic resources that affect treatment use. Zemore et al. (2009) showed greater barriers to treatment use for Spanish-speaking (versus English-speaking) Hispanics. Schmidt et al. (2007) identified concerns about paying for, finding services, and obtaining child care as barriers for Hispanics in obtaining treatment.
Other studies also confirm that the consumption of beer and spirits is different and tends to be more concentrated, with larger amounts (number of drinks) per occasion. Beer consumption accounted for most of the alcohol consumed (67%), most of the alcohol consumed by the heaviest drinkers (42%), and most of the alcohol consumed (81%) in hazardous drinking (five or more drinks) (Rogers & Greenfield, 1999). Dawson (1993) reported that differences in beverage preferences between men (beer mostly) and women (wine and liquor) explain differences in alcohol consumption between genders. This paper reviews recent advances in alcohol research related to ethnic group disparities in alcohol consumption, disorders, consequences, and treatment use, as well as factors that may account for the disproportionate impact of alcohol on some ethnic groups.
Future studies could advance interventions to improve community health by explicitly examining mechanisms contributing to urban and rural differences in mortality outcomes, as there may be specific drivers of cause-specific deaths. For example, physical and mental health care access and economic disinvestment may contribute to deaths due to chronic heavy alcohol use in rural communities, while other SDOH such as alcohol outlet densities and social connection may be more relevant in urban and suburban areas. As discussed below, most of these analyses were descriptive, and very few studies examined specific mechanisms of action linking the built environment or socioeconomic SDOH with the mortality outcomes. Notable results on the SDOH represented in the reviewed studies that were examined as focal contextual variables or covariates are presented in the sections that follow and in Appendix 1. To take into account the multistage sampling design used in the survey, we conducted all analyses with the Software for Survey Data Analysis (SUDAAN) (Research Triangle Institute, 2005). A post-stratification weight to correct for nonresponse and to adjust the sample to known Hispanic population distributions was also used.
Age, gender, and national origin account for several important differences in alcohol use behavior among US Hispanics. Previous research (Caetano, 1991; Hilton, 1991) has indicated that drinking did not seem to decrease as abruptly (after the 20s) strongest vodkas with age among Hispanic men as it did in the US general population. According to Caetano (1991), this can be explained by the fact that in Latin cultures, older and more established men continue to drink because drinking is not seen as a youthful activity as much as it is in the United States. Older men also drink because of their respected status in the family and community; drinking thus is an earned right and an indicator of economic stability.
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