Academic journal article Alcohol Research: Current Reviews

Focus On: Ethnicity and the Social and Health Harms from Drinking

Academic journal article Alcohol Research: Current Reviews

Focus On: Ethnicity and the Social and Health Harms from Drinking

Article excerpt

Research has shown differential social and health effects from alcohol use across U.S. ethnic groups, including Whites, Blacks, Hispanics, Asians, and Native Americans. The relationship of ethnicity to alcohol-related social and health harms partially is attributed to the different rates and patterns of drinking across ethnicities. Some ethnic groups have higher rates of alcohol consumption, putting them at greater risk of drinking harms. However, other ethnic minorities experience health harms from drinking that are disproportionate to their consumption. Differences in social and socioeconomic factors and biological differences related to alcohol metabolism also could contribute to alcohol's varying effects across populations. This article reviews current research examining the harms of drinking for U.S. ethnic groups. It examines such social harms as driving under the influence and alcohol-attributed violence but primarily focuses on health harms like fetal alcohol syndrome (FAS), liver diseases, and cancers.

The research reviewed focuses on Whites, Blacks, Hispanics, Asians, and Native Americans (i.e., American Indians and Alaska Natives) in the United States as general ethnic groups, although significant subgroup differences within populations also are evident. There are limitations to using these general categories because ethnicity encompasses a combination of characteristics such as tribe, ancestry, national group, birthplace, and language, which could have distinct relationships to patterns of drinking and alcohol-related harms (Caetano 1986; Cheung 1993; Heath 1990-1991). People with multiethnic backgrounds also are not well represented by these general groups. Nevertheless, studies that examine ethnicity and alcohol-attributed harms provide important information about public health and serve to identify high-risk groups in the population. This article shows that Native Americans, Hispanics, and Blacks are disproportionately affected by the adverse social and health harms from alcohol consumption.

Drinking Patterns and Other Determinants of Risk for Alcohol-Related Harms

Heavy drinking and binge drinking contribute to a variety of alcohol-attributed social and health harms (Naimi et al. 2003; Rehm et al. 2010). Heavy alcohol use, as defined by the National Institute on Alcohol Abuse and Alcoholism's (NIAAAs) Helping Patients Who Drink Too Much: A Clinicians Guide (NIAAA 2005), is defined as consuming more than 4 standard drinks per day (or more than 14 per week) for men and more than 3 per day (or more than 7 per week) for women. One standard drink is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof spirits. Binge drinking is defined as consuming five or more drinks in approximately 2 hours for men and four or more drinks for women (NIAAA 2004).

Other than these patterns of consumption, the volume of alcohol intake, defined as the total alcohol consumed over a time period, is linked to social and health harms. Most diseases (e.g., injury, some cancers, and liver cirrhosis) have a detrimental dose-response relationship with alcohol as risk increases with higher-volume alcohol consumption, whereas coronary heart disease and diabetes display a J- or U-shaped relationship (Howard et al. 2004; Rehm et al. 2010; Roerecke and Rehm 2012). The J and U shapes are characterized by both detrimental and beneficial (e.g., increased high-density lipoprotein "good cholesterol") (Goldberg and Soleas 2001) effects of alcohol use, with higher risks for abstainers and heavy drinkers compared with light or moderate drinkers. However, this relationship is complex and varies by age, gender, and ethnicity (Roerecke and Rehm 2012). Drinking levels that may be protective of cardiovascular health among men also may increase the risk for other harms such as injury, violence, gastrointestinal disease, and some cancers.

Epidemiological studies show that these high-risk patterns of drinking and drinking volume vary by U. …

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