Week_5_survey_Schmidt - ALCOHOLISM CLINICAL AND...

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Ethnic Disparities in Clinical Severity and Services for Alcohol Problems: Results from the National Alcohol Survey Laura A. Schmidt, Yu Ye, Thomas K. Greenfeld, and Jason Bond Background: This study reports lifetime estimates of the extent of unmet need for alcohol services across the 3 largest ethnic groups in America, and examines factors that may contribute to ethnic differences in service use. Prior studies report mixed Fndings as to the existence of ethnic disparities in alcohol services, with some suggesting that minorities are over-represented in treatment settings. Methods: Drawing on the most recent National Alcohol Surveys, we compare rates and factors associated with the lifetime service use for alcohol problems among Whites, Blacks, and Hispanics who meet lifetime criteria for alcohol abuse or dependence. Results: While bivariate analyses revealed few ethnic differences in service use, there were signif- icant differences by ethnicity in multivariate models that included alcohol problem severity and its interactions with ethnicity. At higher levels of problem severity, both Hispanics and Blacks were less likely to have utilized services than comparable Whites. Hispanics, on the whole, reported higher- severity alcohol problems than Whites. Yet, they were less likely to have received specialty treatment and multiple types of alcohol services, and were more likely to cite economic and logistical barriers as reasons for not obtaining care. Conclusions: ±uture efforts to study ethnic disparities in alcohol services should utilize analytic approaches that address potential confounding between ethnicity and other factors in service use, such as alcohol problem severity. Our Fndings suggest that Hispanics and Blacks with higher-severity alcohol problems may utilize services at lower rates than comparable Whites, and that, particularly for Hispanics, this may in part be attributable to Fnancial and logistical barriers to care. Key Words: Ethnic Differences, Ethnic Disparities, Alcohol Problems, Health Services, Treatment. T HERE IS GROWING national attention to dispari- ties in minority access to health care services, including services for alcohol problems (Ibrahim et al., 2003; National Institute on Alcohol Abuse and Alcoholism, 2001; Smedley et al., 2002; United States Department of Health and Human Services, 2000). Studies show that, in recent years, as rates of alcohol problems and dependence have remained stable or even declined among Whites, they have increased in America’s largest minority groups, among Hispanics and Blacks (Caetano and Clark, 1998; Grant et al., 2004). ±urthermore, national surveys found that only between 9 and 15% of Americans with alcohol abuse or dependence have obtained treatment for the problem (Green-Hennessy, 2002; Kessler et al., 1996; Woodward et al., 1997), suggesting a high level of unmet need overall.
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This note was uploaded on 09/08/2010 for the course SCWK 242 at San Jose State.

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Week_5_survey_Schmidt - ALCOHOLISM CLINICAL AND...

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