Black Drinkers Research Articles

Examination of cross-group contact at work and school in relation to acute and retrospective discrimination experiences and drinking to cope for Black and White young adult drinkers.

Black drinkers experience more alcohol problems compared to White drinkers at comparable levels of alcohol use (Mulia et al., 2009; Witbrodt et al., 2014; Zapolski et al., 2014). Research has found that Black compared to White drinkers endorse drinking to cope more frequently via retrospective report (Bradizza et al., 1999; Cooper et al., 2008). Additional research is needed to understand contributors to these racial differences. The primary aim of the present study was to examine how quality and frequency of cross-group contact at work and/or school relates to experiencing discrimination and, in turn, drinking to cope. Seventy-two young adult drinkers (Mage = 25, 72% female, 28% male; 64% Black, 36% White) completed baseline questionnaires and a subset (n = 50) completed a 17-day ecological momentary assessment (EMA) protocol. Cross-group contact frequency and quality was assessed at baseline while discrimination and coping motives were assessed via retrospective report at baseline and acutely via EMA. Accounting for sociodemographic covariates, path analyses utilizing retrospective measures revealed a significant indirect pathway from race to coping motives through quality of work/school cross-group contact and discrimination experiences related to assumptions of inferiority. Identical path analyses utilizing the acute EMA data revealed a significant indirect pathway from race to coping motives through quality of work/school cross-group contact. Improving cross-group contact at work and school may reduce drinking to cope. Additional research examining multiple domains of discrimination, quality of cross-group contact, and alcohol problems over time is needed to further understanding of social determinants of health inequities in alcohol problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Association of short-term changes in drinking after onset of a serious health condition and long-term heavy drinking

BackgroundLiterature on changes in drinking following diagnosis of chronic health conditions is limited, especially differential response to specific conditions or across demographic subgroups. Methods Data were analyzed from the 2020 National Alcohol Survey of the U.S. adult population (n = 9968). Predictors of change in drinking following first diagnosis of hypertension, heart disease, diabetes, and cancer, and how the short-term post-disease change in drinking was associated with a change in long-term heavy (5 +) drinking from the decade before diagnosis to the decade following diagnosis were analyzed. Results The majority of respondents reported no change in drinking after diagnosis. Men were more likely than women to reduce drinking after hypertension (OR=1.47) but less likely to quit after heart disease (OR=0.46). Black and Hispanic/Latinx drinkers were more likely than white or other drinkers to reduce (OR=2.68, 2.35, respectively) or quit (OR=2.69, 2.34) after hypertension, and more likely to quit after diabetes (OR=3.44, 2.74) and cancer (OR=5.00, 5.27). Black drinkers were more likely to quit after heart disease (OR=3.26). Heavier drinkers were more likely to reduce or quit drinking than lighter drinkers. For all disease types, those who quit drinking after disease onset were less likely to report heavy drinking in the following decade. Conclusions Just cutting down had little effect on subsequent long-term heavy drinking compared to quitting. These data are important for informing efforts aimed at harm reduction in patients diagnosed with a chronic health condition and suggest specific demographic subgroups.

Ethnic-racial identity and hazardous drinking among black drinkers: A test of the minority stress model

Black Americans who consume alcohol experience negative alcohol-related outcomes, indicating a need to identify psycho-sociocultural factors that may play a role in drinking and related problems to inform prevention and treatment. Although lower levels of ethnic-racial identity (ERI) are related to negative drinking outcomes, this is the first known test of whether psychological distress and drinking to cope with distress play a role in these relations. Participants were 155 Black current drinking undergraduates at a racially/ethnically diverse university. ERI was significantly, negatively correlated with drinking frequency, drinking problems, coping motivated drinking, depression, and social anxiety. ERI was unrelated to drinking quantity. ERI was indirectly related to drinking and related problems via the sequential effects of depression and coping motivated drinking, but not via depression or coping motives alone. ERI was indirectly related to drinking via the sequential effects of social anxiety and coping motivated drinking, and indirectly related to drinking problems via social anxiety but not via coping motives alone. In line with minority stress-based models, ERI is related to less negative drinking outcomes (less frequent drinking, fewer problems) via less psychological distress (depression, social anxiety) and less coping motivated drinking. Also, social anxiety was robustly related to drinking frequency and problems among Black drinkers, a group that has been underrepresented in the social anxiety-drinking literature. This finding indicates that anxiety about social situations may play an especially important role in drinking behaviors in this group.

Momentary associations between stress and alcohol craving in the naturalistic environment: differential associations for Black and White young adults.

Black drinkers compared with White drinkers experience more alcohol-related problems. Examination of social determinants of inequities in alcohol problems is needed. The current study measured (1) associations between acute stress and alcohol craving in the naturalistic environment for self-identified Black and White individuals who drink alcohol and (2) whether a history of attention deficit hyperactivity disorder (ADHD) moderated these associations. Observational study using ecological momentary assessment (EMA) to collect data from participants at six semi-random time-points throughout the day during a 10-day period. A series of three-level multi-level models examined between- and within-person associations for stress and alcohol and tested if these associations differed for Black and White adults. Participants were 229 adult drinkers (aged 21-35 years) who completed a larger study examining alcohol response for Black and White adults with and without a history of childhood ADHD. Momentary stress and alcohol craving, ADHD history and socio-demographic characteristics (i.e. racial identity, sex, age, current education level, household income) were assessed. Participants were required to self-identify as either 'African American or Black' or 'European American or White'. Significant racial identity × stress interactions indicated that associations between stress and craving were stronger for Black compared with White adults across the 10-day period (between-person: B= 0.14, P= 0.007), concurrently within a given EMA time-point (within-person: B= 0.04, P= 0.001) and prospectively from time-point to time-point (within-person: B= 0.05, P= 0.001). Results remained while accounting for income × stress interactions. Acute stress appears to be more strongly related to alcohol craving in self-identified Black compared with self-identified White individuals. This provides support for policy changes to eliminate structural inequities that increase stress exposure and the development of just-in-time culturally responsive interventions focused on coping with acute stress for Black individuals.

Racial Discrimination and Hazardous Drinking among Black Drinkers: The Role of Social Anxiety in the Minority Stress Model

ABSTRACT Objective: Black Americans who consume alcohol experience worse alcohol-related outcomes. Thus, identifying psycho-sociocultural factors that play a role in hazardous drinking among Black individuals is vital to informing prevention and treatment efforts to reduce these disparities. Racial discrimination is related to hazardous drinking among Black adults, suggesting that some may drink (and continue to drink despite drinking-related problems) to alleviate negative affect (e.g., depression, anxiety) associated with discrimination. Yet, despite the social nature of both racial discrimination and drinking, no known research has examined the role of social anxiety in the relations among racial discrimination experiences and hazardous drinking. Method: Participants were 164 Black current drinking undergraduates. Results: Racial discrimination was significantly, positively correlated with hazardous drinking, depression, and social anxiety. Discrimination was indirectly related to hazardous drinking via social anxiety, but not depression. Further, discrimination was indirectly related to hazardous drinking via social anxiety alone and via the sequential effects of social anxiety and drinking to cope, but not via coping motives alone. It was also related to hazardous drinking via the sequential effects of depression and drinking to cope but not depression alone. Alternative model testing indicated that social anxiety was not related to hazardous drinking via discrimination, strengthening confidence in directionality of proposed relations. Conclusions: Negative affect (social anxiety, depression) appears to be related to hazardous drinking among those who experience more discrimination due in part to drinking to cope. Social anxiety plays an important role in the relation between discrimination and hazardous drinking among Black adults.

Intersection of familial risk and environmental social control on high-risk drinking and alcohol dependence in a US national sample of adults

BackgroundEffects of a family history of alcoholism may be moderated by area-level social control factors. We examine whether increased neighborhood alcohol availability (low social control environment) or increased presence of religious adherents in the county (high social control environment) interact with family history in relation to alcohol outcomes. MethodsWeighted data from 12,686 adult drinkers (51% male; mean age 44; 80% White, 9% Black, 11% Hispanic) in three US National Alcohol Surveys were linked with data on area-level off-premise alcohol availability and adherence to religions with strong prohibitions against drinking. Family history density had four levels (family history negative, extended family only, first-degree relative(s) only, high family density). Dichotomous outcomes were past-year high-risk drinking and alcohol dependence. Logistic regression models with interaction terms assessed whether associations of family history with alcohol outcomes differed significantly by area-level social control. Stratified models assessed differences by sex and by race/ethnicity. ResultsIn the full sample, effects of first-degree relatives and high family density on high-risk drinking strengthened as alcohol availability increased. This was replicated in the subsample of women and suggested in relation to dependence among men and Black drinkers. For White drinkers, higher religious social control reduced effects of first-degree relatives on high-risk drinking. ConclusionsLow social control—in particular, greater density of off-premise alcohol outlets—appears to exacerbate effects of a family history of alcoholism on high-risk drinking. Policy makers should consider differential benefits of decreasing alcohol availability for people from high-risk families to reduce high-risk drinking and alcohol problems.

In-the-Moment Drinking Characteristics: An Examination Across Attention-Deficit/Hyperactivity Disorder History and Race.

Adults with a history of childhood attention-deficit/hyperactivity disorder (ADHD) and Black drinkers are at elevated risk for alcohol problems and alcohol use disorder. Processes that increase risk for these distinct populations have not focused on in-the-moment behaviors that occur while drinking. The present study examined in-the-moment drinking characteristics (i.e., location, social context, day, time, drink type, speed of consumption) that may differ for individuals with and without ADHD histories or for Black and White drinkers. We also examined the interplay among these in-the-moment drinking characteristics to further understanding of contexts when risk may be momentarily increased. As part of a larger study, 135 individuals (Mage =27.81, 69.6% male, 45.9% ADHD, 69.6% White) completed a 10-day ecological momentary assessment protocol that included self-initiated reports following consumption of an alcoholic drink. Hypotheses were tested using multilevel modeling. Controlling for multiple demographic covariates, Black drinkers drank significantly more quickly than White drinkers and were more likely to consume hard liquor-containing beverages. Differences in drinking speed remained significant when adjusting for Black drinkers' greater likelihood to consume liquor-containing beverages and momentary experience of discrimination; however, Black drinkers' increased likelihood to consume liquor-containing beverages was no longer significant when adjusting for momentary experience of discrimination. Individuals with ADHD histories did not differ from those without ADHD histories in any in-the-moment drinking characteristics. ADHD and race did not interact to predict any drinking characteristic. Differences in speed of alcohol consumption and propensity to consume liquor-containing beverages may contribute to increased risk for alcohol problems experienced by Black drinkers compared to White drinkers.

Changes in heavy drinking following onset of health problems in a U.S. general population sample

Heavy episodic drinking is a well-established risk factor for heart disease, diabetes, certain cancers, stroke, hypertension and injuries, however, little is known about whether health problems precipitate changes in subsequent drinking patterns. Retrospective cohort analyses of heavy drinking by decade were conducted using data from the 2010 U.S. National Alcohol Survey (n=5240). Generalized estimating equations models were used to predict any, monthly, and weekly heavy (5+) drinking occasions across decades of life following a diagnosis of hypertension, heart problems, diabetes, stroke, cancer, or serious injury. Experiencing heart problems was associated with higher odds of reduced weekly heavy drinking (adjusted odds ratio (ORadj)=3.5; 95% confidence interval (CI); 1.7–7.4). The onset of diabetes was also associated with higher odds of reducing any heavy drinking over the decade (ORadj=1.7; 95% CI; 1.1–2.6). Cancer survivors were less likely to report no heavy drinking (ORadj=0.5; 95% CI; 0.3–0.8) or no weekly heavy drinking (ORadj=0.3; 95% CI; 0.2–0.7). Hypertension, stroke and injury were not found to have any significant associations. Reduced heavy drinking was more likely to be reported by Black drinkers following heart problems and Whites following a diabetes diagnosis. Increased heavy drinking following a cancer diagnosis was significant among women and Whites. Future studies on alcohol's heath and mortality risks should take into consideration effects of health problems on drinking patterns. Additionally, study results support increased prevention efforts targeting heavy drinking among cancer survivors, especially White women, and individuals with or being treated for hypertension.

Racial/Ethnic Disparities in the Self-Reported Number of Drinks in 2 Hours Before Driving Becomes Impaired.

We used data on self-reported impaired driving and the number of drinks the person states he or she can have in 2 hours before impairment to evaluate predictors of individuals' impairment thresholds by race/ethnicity. Data come from the 2000, 2005, and 2010 US National Alcohol Surveys, with oversamples of Black and Hispanic populations. We estimated negative binomial models overall, by gender, and for those who reported impaired driving. Analyses focused primarily on 8553 respondents who drank alcohol and drove a car in the past year. In models that controlled for relevant available measures including body weight, sociodemographics, and drinking patterns, we found perceived impairment thresholds to be 30.3% (95% confidence interval = 23%, 38%) higher for Black drinkers and 26.3% (95% confidence interval = 18%, 35%) higher for Hispanic drinkers compared with White drinkers. The greater number of standard drinks before perceived impairment reported by Black and Hispanic drivers implies a likely relative underreport of impaired driving and potentially higher severity of impairment when driving relative to White drivers.

The Prevalence of Harmful and Hazardous Alcohol Consumption in Older U.S. Adults: Data from the 2005–2008 National Health and Nutrition Examination Survey (NHANES)

Alcohol consumption and its interaction with disease, medication use, and functional status may result in serious health problems, but little information exists about the national prevalence of alcohol-related health risk in older adults. To estimate the prevalence of harmful and hazardous alcohol use and the prevalence of consumption in excess of National Institute of Alcohol Abuse and Alcoholism (NIAAA) recommendations, in people aged 65 and older, and by sex and race/ethnicity sub-group. Cross-sectional, using data from the 2005-2008 National Health and Nutrition Examination Survey of the non-institutionalized U.S. population. One thousand and eighty-three respondents aged 65 and older who consume alcohol. Participants' alcohol consumption was classified as Harmful, Hazardous, or Healthwise, in the context of their specific health status, using the Alcohol-Related Problems Survey classification algorithm. Overall, 14.5 % of older drinkers (95 % CI: 12.1 %, 16.8 %) consumed alcohol above the NIAAA's recommended limits. However, when health status was taken into account, 37.4 % of older drinkers (95 % CI: 34.9 %, 40.0 %) had Harmful consumption and 53.3 % (95 % CI: 50.1 %, 56.6 %) had either Hazardous or Harmful consumption. Among light/moderate drinkers, the proportions were 17.7 % (95 % CI: 14.7 %, 20.7 %) and 28.0 % (95 % CI: 24.8 %, 31.1 %), respectively. Male drinkers had significantly greater odds of Hazardous/Harmful consumption than female drinkers (OR = 2.14 [95 % CI: 1.77, 2.6]). Black drinkers had worse health status and significantly greater odds of Hazardous/Harmful consumption than white drinkers (OR = 1.49; 95 % CI: 1.02, 2.17), despite having no greater prevalence of drinking in excess of NIAAA-recommended limits. Most older Americans who drink are light/moderate drinkers, yet substantial proportions of such drinkers drink in a manner that is either harmful or hazardous to their health. Older adults with risky alcohol consumption are unlikely to be identified by health care providers if clinicians rely solely on whether patient consumption exceeds the NIAAA-recommended limits.

Social status, gender and alcohol-related problems: the black young adult experience

Objectives. Using data from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions, this study examined prevalence of drinking and related problems among five racial/ethnic groups aged 18–30. Design. Logistic regression analyses examined influences of gender and social status on alcohol-related problems among blacks, controlling for demographics. Results. Black drinkers were significantly less likely to be high-risk or risky/heavy episodic drinkers than all groups except Asians; and experienced lower prevalence of alcohol-related problems than whites and American Indians. Controlling for drinking, prevalence of alcohol-related problems among blacks was similar to other groups, except native Americans. Analyses of blacks revealed males, unemployed, and heaviest drinkers had highest prevalence of problems. Strong associations between drinking and problems remained consistent across black sub-groups defined by social status and gender. Conclusion. While blacks are not as engaged in risky/heavy drinking, they are not shielded from problems conditional on drinking patterns. Focus on alcohol-related problems among black males and unemployed is indicated.

Motivational pathways to alcohol use and abuse among Black and White adolescents.

Using data from a biracial community sample of adolescents, the present study examined trajectories of alcohol use and abuse over a 15-year period, from adolescence into young adulthood, as well as the extent to which these trajectories were differentially predicted by coping and enhancement motives for alcohol use among the 2 groups. Coping and enhancement motivations (M. L. Cooper, 1994) refer to the strategic use of alcohol to regulate negative and positive emotions, respectively. Results showed that Black and White youth follow distinct alcohol trajectories from adolescence into young adulthood and that these trajectories are differentially rooted in the regulation of negative and positive emotions. Among Black drinkers, coping motives assessed in adolescence more strongly forecast differences in alcohol involvement into their early 30s, whereas enhancement motives more strongly forecast differences among White drinkers. Results of the present study suggest that different models may be needed to account for drinking behavior among Blacks and Whites and that different approaches may prove maximally effective in reducing heavy or problem drinking among the 2 groups.

Conversation with Timothy Cook.

Conversation with Timothy Cook.

The effects of parental influences and respondents' norms and attitudes on black and white adult drinking patterns

A model predicting drinking patterns among adult respondents from parental influences and respondents' norms and attitudes was tested with data from a nationwide survey of 1,947 black and 1,777 white Americans. The results showed that relationships between parental drinking background, respondents' norms and attitudes, and respondents' drinking behavior are identical for blacks and whites. Among both groups, parental influences are indirect and have a moderate influence on the respondents' norms and attitudes, which in turn are the most powerful predictors of drinking behavior. However, racial differences did emerge in the model, and they illustrate that race moderates relationships between social characteristics and norms, parental demographics and parent drinking attitudes and behavior, and respondents' social characteristics and drinking patterns. These differences were traced to religion, social status, and cultural variation between the two groups.

Stress-Buffer Properties of Alcohol Consumption: The Role of Urbanicity and Religious Identification

Previous rural studies have indicated that life events are most strongly related to depressive symptoms among abstainers and heavy drinkers, and least strongly among moderate drinkers. The generalizability of possible stress-buffering properties of moderate alcohol use were evaluated using data from 554 white residents of 9 rural counties around Nashville, Tennessee, and from 314 white and 306 black residents of Nashville. Information on typical quantity and frequency of alcohol consumption was used to classify respondents as abstainers, occasional, moderate, or heavy drinkers. The event-by-drinking pattern interaction was significant only for the rural sample. There was some suggestive evidence of buffer effects among urban whites, though events were fairly consistently related to depressive symptoms among urban black drinkers. Further controls for religious identification/commitment did not account for the specificity of buffer effects to rural communities.

Sociocultural correlates of black drinking. Implications for research and treatment.

Sociocultural correlates of black drinking. Implications for research and treatment.