Health disparities in service use for alcohol use disorders have not been adequately studied. To assess such utilization among whites, blacks, and Hispanics, researchers examined data from two nationally representative surveys conducted in 1995 (n=5345, response rate 77%) and 2000 (n=7612, response rate 58%).
Of people who ever had alcohol abuse or dependence, 16% of blacks, 16% of whites, and 15% of Hispanics ever sought help (from Alcoholics Anonymous, a specialty treatment program, a hospital or clinic, a private physician, or a social services provider).
The types of services sought were similar across groups. However, Hispanics were less likely than whites to seek specialty treatment (6% versus 10%).
In a multivariable analysis adjusted for demographics and social pressures to stop drinking, blacks and Hispanics with more dependence symptoms were less likely than whites with more symptoms to use alcohol services. Of those who considered seeking help, Hispanics were more likely than whites to report a logistical or financial reason for not seeking help (58% vs. 36%), but blacks and Hispanics were as likely as whites to report cultural reasons (e.g., language).
Comments: These data suggest that race and/or ethnicity may affect help seeking and receipt of alcohol services. But the most striking finding of this study is already known: most people with alcohol use disorders do not seek or receive help. Much work, including efforts that address patient motivation, clinician recognition of problems, the quality of alcohol services, and barriers encountered by help seekers, is required to get help to those in need.
Richard Saitz, MD, MPH
Reference: Schmidt LA, Ye Y, Greenfield T, et al. Ethnic disparities in clinical severity and services for alcohol problems: results from the National Alcohol Survey. Alcohol Clin Exp Res. 2007;31(1):48–56.