African Americans Complete Alcohol Treatment at Lower Rates than Whites
Alcohol-related health problems are two to five times as prevalent among ethnic and racial minorities as they are among whites, despite similar lifetime prevalences of frequent problem drinking. The reasons for this have not been well understood, although they have obvious implications for reducing racial and ethnic health disparities—a national priority. RAND DPRC undertook a series of analyses to shed light on one possible contributor to the disparity in alcohol-related health problems: differences between white and minority alcohol treatment outcomes. The analyses were performed on intake and discharge records from all publicly funded outpatient and residential alcohol treatment recovery programs in Los Angeles County from 1998 to 2000. Sophisticated statistical analyses were used to isolate the contributions of different factors to the problem. These are a few of the major findings:
- African Americans complete treatment at lower rates than whites (18 vs. 27 percent outpatient; 31 vs. 46 percent residential), whereas Hispanics and whites complete treatment at similar rates (see the graph).
- Forty percent of the outpatient treatment completion disparity between African Americans and whites could be explained by patient characteristics, particularly economic resources; only 7 percent of the residential disparity could be so explained.
- Approximately a third of the outpatient treatment completion disparity could be explained by differences in the neighborhoods of the treatment facilities attended by African Americans vs. whites.
- African Americans and Hispanics are much less likely to receive residential treatment (as opposed to outpatient) than whites. The completion rate disparity between African Americans and whites could be cut by one-fifth if African Americans were to receive residential treatment at the same rate as whites do.
These findings suggest some of the contributors to a significant alcohol treatment disparity between whites and minorities in Los Angeles County and begin to indicate what might be done about it. However, there is much about the disparity—such as the roles of
patient economic resources and treatment facility neighborhoods—that is
not yet understood, and it is uncertain whether these factors are the
same in other locations.
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A multilevel decomposition approach to estimate the role of program location and neighborhood disadvantage in racial disparities in alcohol treatment completion
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Are racial disparities in alcohol treatment completion associated with racial differences in treatment modality entry? Comparison of outpatient treatment and residential treatment in Los Angeles County, 1998 to 2000
Bluthenthal RN, Jacobson JO, Robinson PL
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