A retrospective analysis of ethnic and gender differences in alcohol consumption among emergency department patients: a cross-sectional study

BMC Emergency Medicine

Bharath Chakravarthy²  Kristin Alix²  Wirachin Hoonpongsimanont²  Craig L. Anderson²  Cristobal Barrios¹  Christopher Eric McCoy²  Uzor C. Ogbu²  Victor Cisneros²  Shahram Lotfipour² 

[1] Department of Surgery, University of Orange, Orange, CA, USA;Department of Emergency Medicine, University of California, Irvine Health Affairs, Irvine, 333 The City Blvd West, Suit 640, Orange 92868, CA, USA

关键词: Ethnicity;    Race;    Emergency department;    Screening;    Gender;    Epidemiology;    Alcohol use;   

Others  :  1230996
DOI  :  10.1186/s12873-015-0050-5

 received in 2014-12-31, accepted in 2015-09-21,  发布年份 2015

【 摘 要 】

Background

Previous studies of alcohol use have recognized several trends in consumption patterns among gender and age yet few have examined ethnic differences. This study examines the intra- and inter-ethnic differences in alcohol consumption among a population of patients seen in the emergency department.

Methods

This is a cross-sectional study conducted in the emergency department in a large urban setting. Information on drinking behavior and ethnicity was collected using the Computerized Alcohol Screening and Brief Intervention (CASI) tool. We explored differences in drinking patterns using a multivariate multinomial logistic regression model.

Results

We analyzed the drinking habits of 2,444 patients surveyed between November 2012 and May 2014. The results indicate that when compared to non-Hispanic whites, Asians have the lowest odds of drinking within normal limits or excessively, followed by other Latinos, and Mexicans. Age and gender consistently showed statistically significant associations with alcohol-use. The odds of drinking within normal limits or excessively are inversely associated with age and were lower among females. The predicted probabilities show a marked gender-specific difference in alcohol use both between and within ethnic/racial groups. They also highlight an age-related convergence in alcohol use between men and women within ethnic groups.

Discussion

The results of this study show intra-racial/ethnic variability associated with sex and education. The highlighted differences within and between ethnic groups reinforce the need to use refined categories when examining alcohol use among minorities.

Conclusion

The results of this study confirm some alcohol consumption trends among ethnic minorities observed in literature. It provides empirical evidence of the marked gender differences and highlights an age-related convergence for gender-specific alcohol use. Health-care personnel should be aware of these differences when screening and counseling.

【 授权许可】

   
2015 Lotfipour et al.

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【 参考文献 】

• [1]Action needed to reduce health impact of harmful alcohol use. Cent Eur J Public Health. 2011; 19(1):41,45.
• [2]Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States. Prev Chronic Dis. 2014; 11:130293.
• [3]Bouchery EE, Harwood HJ, Sacks JJ, Simon CJ, Brewer RD. Economic costs of excessive alcohol consumption in the US, 2006. Am J Prev Med. 2011; 41(5):516-524.
• [4]World Health Organization. Alcohol and injury in emergency departments: summary of the report from the WHO Collaborative Study on Alcohol and Injuries. 2007.
• [5]Bernstein E, Bernstein J, Feldman J, Fernandez W, Hagan M, Mitchell P, Baird J. An evidence-based alcohol screening, brief intervention and referral to treatment (SBIRT) curriculum for emergency department (ED) providers improves skills and utilization. Substance abuse. 2007; 28(4):79.
• [6]Lotfipour S, Cisneros V, Anderson CL, Roumani S, Hoonpongsimanont W, Weiss J, Vaca F. Assessment of alcohol use patterns among Spanish-speaking patients. Substance abuse. 2013; 34(2):155-161.
• [7]Lotfipour S, Cisneros V, Chakravarthy B, Anderson CL, Fox JC, Roumani S, Vaca FE. Assessment of readiness to change and relationship to AUDIT score in trauma population utilitzing computerized alcohol screening and brief intervention. Substance abuse. 2012; 33(4):378-86.
• [8]Lotfipour S, Mortazavi R, Chakravarthy B. Commentary: Alcohol and motor vehicle-related crashes--driver attitudes need further intervention. Ann Emerg Med. 2011; 57(4):406-408.
• [9]Vaca F, Winn D, Anderson C, Kim D, Arcila M. Feasibility of emergency department bilingual computerized alcohol screening, brief intervention, and referral to treatment. Substance abuse. 2010; 31(4):264-269.
• [10]Vaca FE, Winn D, Anderson CL, Kim D, Arcila M. Six-month follow-up of computerized alcohol screening, brief intervention, and referral to treatment in the emergency department. Substance abuse. 2011; 32(3):144-152.
• [11]Chartier K, Caetano R. Ethnicity and health disparities in alcohol research. Alcohol Research & Health. 2010; 33(1–2):152.
• [12]Keyes KM, Liu XC, Cerda M. The Role of Race/Ethnicity in Alcohol-attributable Injury in the United States. Epidemiologic reviews. 2012; 34(1):89-102.
• [13]Maldonado-Molina MM, Delcher C. Commentary on Caetano, Mills, and Vaeth (2012): The Role of Context on Alcohol Consumption Among Mexican Americans. Alcoholism: Clinical and Experiment Research. 2012; 36(4):566-567.
• [14]Caetano R, Clark CL, Tam T. Alcohol consumption among racial/ethnic minorities. Alcohol health and research world. 1998; 22(4):233-241.
• [15]Dawson DA. Beyond black, white and Hispanic: race, ethnic origin and drinking patterns in the United States. J Subst Abuse. 1998; 10(4):321-339.
• [16]Galvan FH, Caetano R. Alcohol use and related problems among ethnic minorities in the United States. Alcohol Res Health. 2003; 27(1):87-94.
• [17]Cherpitel CJ. Drinking Patterns and Problems: A Comparison of Primary Care with the Emergency Room. Subst Abuse. 1999; 20(2):85-95.
• [18]Love AC, Greenberg MR, Brice M, Weinstock M. Emergency department screening and intervention for patients with alcohol-related disorders: a pilot study. J Am Osteopath Assoc. 2008; 108(1):12-20.
• [19]Lotfipour S, Howard J, Roumani S, Hoonpongsimanont W, Chakravarthy B, Anderson CL, Dykzeul B. Increased detection of alcohol consumption and at-risk drinking with computerized alcohol screening. The Journal of emergency medicine. 2013; 44(4):861-866.
• [20]Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. The alcohol use disorders identification test. Guidelines for use in primary care 2nd ed. Geneva: World Health Organization. 2001;14-20.
• [21]Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993; 88(6):791-804.
• [22]Humes K, Jones NA, Ramirez RR. Overview of race and Hispanic origin, 2010: US Department of Commerce, Economics and Statistics Administration, US Census Bureau. 2011.
• [23]Wilsnack RW, Wilsnack SC, Kristjanson AF, Vogeltanz-Holm ND, Gmel G. Gender and alcohol consumption: patterns from the multinational GENACIS project. Addiction. 2009; 104(9):1487-1500.
• [24]Zemore SE. Acculturation and alcohol among Latino adults in the United States: a comprehensive review. Alcoholism: clinical and experimental research. 2007; 31(12):1968-1990.
• [25]Mills BA, Caetano R. The Hispanic Americans Baseline Alcohol Survey (HABLAS): Predictors of alcohol attitudes and expectancies in Hispanic national groups. Alcoholism: clinical and experimental research. 2010; 34(5):790-799.
• [26]Crum RM, Anthony JC. Educational level and risk for alcohol abuse and dependence: differences by race-ethnicity. Ethn Dis. 2000; 10(1):39-52.
• [27]Paschall MJ, Flewelling RL. Postsecondary education and heavy drinking by young adults: the moderating effect of race. J Stud Alcohol. 2002; 63(4):447-455.
• [28]Timberlake DS, Hopfer CJ, Rhee SH, Friedman NP, Haberstick BC, Lessem JM, Hewitt JK. College attendance and its effect on drinking behaviors in a longitudinal study of adolescents. Alcohol Clin Exp Res. 2007; 31(6):1020-1030.
• [29]Satre DD, Gordon NP, Weisner C. Alcohol consumption, medical conditions, and health behavior in older adults. Am J Health Behav. 2007; 31(3):238-248.
• [30]Blazer DG, Wu LT. The epidemiology of at-risk and binge drinking among middle-aged and elderly community adults: National Survey on Drug Use and Health. Am J Psychiatry. 2009; 166(10):1162-1169.
• [31]Keyes KM, Vo T, Wall MM, Caetano R, Suglia SF, Martins SS, Hasin D. Racial/ethnic differences in use of alcohol, tobacco, and marijuana: Is there a cross-over from adolescence to adulthood? Social Science & Medicine. 2015; 124:132-141.
• [32]Allen JP, Litten RZ, Fertig JB, Babor T. A review of research on the Alcohol Use Disorders Identification Test (AUDIT). Alcoholism: clinical and experimental research. 1997; 21(4):613-619.
• [33]Bohn MJ, Babor TF, Kranzler HR. The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings. Journal of Studies on Alcohol and Drugs. 1995; 56(4):423.