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

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.