Substance Abuse in African Americans: In Search of a Culturally Competent Research Agenda
Sharma, Manoj, Atri, Ashutosh, Journal of Alcohol & Drug Education
The Healthy People 2010 guidelines identify substance abuse as a major public health problem in need of effective interventions for diverse populations including racial and ethnic minorities (United States Department of Health and Human Services [USDHHS], 2000). However, the literature with regard to substance abuse in the African American community is rather scant (Bass & Kane-Williams, 1993; Dent, Sussman, Ellickson, Brown, & Richardson, 1996). Further compounding this problem is the way that African Americans are classified in our country, which does not adequately capture the diversity within this group (Sellers, Smith, Shelton, Rowley, & Chavous, 1998). At least four different groups with differing sets of needs, cultures, socio-economic status, self concept, and substance abuse patterns are imbibed in this single categorization. The first subgroup consists of the blacks that have been living in the country for three or four generations or longer. The second subgroup is comprised of individuals that have migrated from the Caribbean countries. The third subgroup is made up of individuals who are first generation immigrants from Africa, which too has a lot of diversity. The final subgroup consists of multiracial individuals, many of whom are often misclassified as African Americans.
Most of the studies done on blacks have involved a comparison of American and immigrant blacks and have failed to focus on all possible groups of immigrant blacks (Dodoo, 1997). Dodoo (1997) also examines that even though there has been some focus on Caribbean blacks, other blacks--most importantly the Africans--are conspicuously missing from the literature. Hence, the first need in substance abuse literature is to correctly identify the subgroups inherent in the term "African American."
During the past decade, some concern has been raised regarding the adverse outcomes experienced by some African American youth due to substance use and abuse. Although African American youth consume fewer drugs than white youth, they are more likely to experience social problems as a result of their use (Scheier & Botvin, 1998). Research into modifiable constructs that can prevent this from happening needs to be undertaken. In exploring the role of personal and racial identity on drug attitudes among African American males, Townsend and Belgrave (2000) found that earlier research suggested that alcohol and drug initiation began early in this ethnic group. More research is needed in comprehending factors for alcohol and drug initiation that are unique to this racial group.
In studies exploring the ethnic disparities in the unmet needs for alcoholism, drug abuse and mental health care a greater unmet need for alcoholism and drug abuse treatment and mental health care among African American and Hispanics relative to whites has been well documented (Wells, Klap, Koike, & Sherbourne, 2001). It is noteworthy that whites are more likely than African Americans or Hispanics to use alcohol, smoke or consume illicit drugs (USDHHS, 2000). Treatment gap for illicit drug use and treatment gap for problem alcohol use are the twin objectives of Healthy People 2010 that relate directly to this significant concern for ethnic disparities and their unmet needs and aim to reduce the same.
Presently, a major limitation of the prevention literature has been the paucity of research that examines the extent to which substance use risk factors identified in studies of white adolescents generalize to African American youth. To circumvent this absence of information on the racial differences in risk factor exposure and vulnerability, current preventive interventions are based on two main assumptions that 1) the risk factors for African American and white adolescents' substance use are identical; and 2) that African American and white adolescents are equally exposed and equally vulnerable to these risk factors.
It has been reported that African Americans differ significantly in their exposure to more than half of the 55 risk factors examined. …