208820 Unpacking racial/ethnic disparities in alcohol treatment: The “Hispanic” treatment gap

Tuesday, November 10, 2009: 8:48 AM

Laura A. Schmidt, PhD , Institute for Health Policy Studies and Department of Anthropology, History and Social Medicine, University of California, San Francisco, San Francisco, CA
Tammy Tam, PhD , Alcohol Research Group, Public Health Institute, Emeryville, CA
Nina Mulia, DrPH , Alcohol Research Group, Public Health Institute, Emeryville, CA
Prior studies show that Hispanic Americans have some of the highest levels of unmet need for alcohol treatment in the US population, particularly among those with a high-severity of alcohol dependence. Often due to limited sample sizes, scientists studying this phenomenon have fallen into usage of the all-inclusive designation, “Hispanic American.” This could, however, be problematic if heterogeneous subgroups of Hispanics were to differ across key determinants of alcohol treatment need and utilization—perhaps due to differences in drinking cultures and languages of origin, immigration experiences and access to public services. Using data from the National Epidemiological Study on Alcohol and Related Conditions, we compare factors impacting alcohol treatment utilization among cultural and immigrant subgroups commonly captured under the rubric of “Hispanic.”

We find that rates of treatment utilization vary across Hispanic subgroups. For example, even though rates of AUDs are similar, twice as many Puerto Rican Americans with an AUD have sought care for a drinking problem in the past year than Mexican Americans (16 versus 8%), and 13% of US-born Hispanics have sought care compared to 5% of immigrants. Factors that enable treatment entry also vary, with US born Hispanics having a twice-greater odds of legal and social problems that precipitate treatment compared to immigrants. Economic and attitudinal barriers to treatment differ across these subgroups as well. We conclude that the nature of treatment seeking and magnitude of the treatment gap vary among Hispanic subgroups and therefore, policy solutions to the problem may differ as well.

Learning Objectives:
1. Discuss debates concerning the racial/ethnic categorization of US population groups. 2. Describe racial/ethnic differences in the unmet need for alcohol treatment and the reasons why such differences might exist. 3. Discuss policy solutions to racial/ethnic disparities in treatment utilization that might be better attuned to the specific barriers to care faced by different cultural and immigrant groups in America.

Keywords: Substance Abuse Treatment, Hispanic

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a principal investigator of this NIAAA-funded study with expertise in racial disparities in substance abuse treatment access and utilization
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.