May 27, 2010

Substance Use among Hispanic Adults

Over the past several decades, the population of the United States has become increasingly diverse. According to the U.S. Census Bureau, about one third of the population belongs to a racial/ethnic minority group; this percentage is projected to increase to 54 percent by 2050.¹ As the country becomes more diverse, it becomes increasingly important to address health and health care disparities related to race/ethnicity, as well as age and gender, socioeconomic status, geography, and disability. The Nation's success in reducing these disparities today, to a large extent, will determine the health of our Nation tomorrow.

One area of concern is assessing substance use and abuse and ensuring access to substance abuse treatment. Substance abuse affects millions of people every year and imposes untold health, social, and economic costs on individuals, families, and communities. Although it affects people in all racial/ethnic groups, research has shown that there is considerable variation among these groups. Gaining a better understanding of the behavioral health needs of particular racial/ethnic groups can help inform public health policy, build prevention and treatment programs that target the different needs of these populations, and ultimately expand access to services for individuals who need them.

This report uses data from the National Survey on Drug Use and Health (NSDUH) to examine substance use and treatment need among Hispanic adults aged 18 or older.² Other reports in this series will examine similar issues among Hispanic adolescents and among adults and adolescents in other racial/ethnic groups. According to the U.S. Census Bureau, 47 million people—15.4 percent of the total U.S. resident population in 2008—identify themselves as Hispanic.³ This report is based on NSDUH data from 2004 to 2008.

Combined 2004 to 2008 data indicate that more than three fifths of Hispanic adults (62.3 percent) were of Mexican origin, 14.1 percent were of Central or South American origin, 10.2 percent were of Puerto Rican origin, 4.7 percent were of Spanish origin (from Spain), 4.3 percent were of Cuban origin, 2.5 percent were of Dominican origin, 1.7 percent were of two or more Hispanic subgroups, and 0.3 percent were of some other Hispanic subgroup.

More than two fifths of Hispanic adults (43.3 percent) were born in the United States.⁴ U.S.-born Hispanic adults tended to be younger than those born in other countries; for example, 27.5 percent of Hispanic adults born in the United States and 14.5 percent of those born abroad were aged 18 to 25.

One third of Hispanic adults (33.9 percent) were without health insurance, a percentage higher than the national average of 15.0 percent for adults.⁵

Combined 2005 through 2008 data indicate that the poverty rate among Hispanics was twice as high as the national average for adults (22.3 vs. 11.5 percent).⁶

The rate of past month alcohol use increased among Hispanic adults between 2004 and 2008 (43.7 vs. 47.6 percent) (Figure 1). Rates of binge alcohol use and illicit drug use did not change significantly among Hispanic adults over the 5-year period.^{7, 8}

Figure 1. Trends in Past Month Substance Use among Hispanic Adults: 2004 to 2008

Combined 2004 to 2008 data indicate that, in the past month, 46.1 percent of Hispanic adults used alcohol, 26.3 percent engaged in binge alcohol use, and 6.6 percent used an illicit drug (Figure 2). Rates of past month alcohol use and illicit drug use were lower among Hispanic adults than the national averages. The rate of past month binge alcohol use among Hispanic adults, however, was higher than the national average.

Figure 2. Past Month Substance Use among Hispanic Adults Compared with the National Average for Adults: 2004 to 2008

Among Hispanic adults, substance use varied greatly by subgroup. Past month alcohol use ranged from a high of 60.8 percent among adults of Spanish origin (from Spain) to a low of 40.3 percent among those of Dominican origin (Figure 3). Past month binge alcohol use ranged from a high of 28.7 percent among adults of Puerto Rican origin to a low of 20.8 percent among those of Central or South American origin, and illicit drug use ranged from a high of 13.1 percent among adults of Spanish origin to a low of 3.9 percent among those of Dominican origin.

Figure 3. Past Month Substance Use among Hispanic Adults, by Hispanic Subgroup*: 2004 to 2008

Among Hispanic adults, those who were born in the United States had higher rates of past month alcohol use, binge alcohol use, and illicit drug use than those who were not born in the United States (Figure 4). These findings generally held within each age group that was examined (data not shown).

Figure 4. Past Month Substance Use among Hispanic Adults, by Nativity: 2004 to 2008

Rates of past month alcohol use, binge alcohol use, and illicit drug use were lower among young Hispanic adults than among young adults in the general population (50.5 vs. 61.1 percent, 35.8 vs. 41.6 percent, and 14.6 vs. 19.7 percent, respectively) (Figure 5).

Figure 5. Past Month Substance Use among Hispanic Adults Aged 18 to 25 Compared with the National Average for Adults Aged 18 to 25: 2004 to 2008

Compared with the national averages for women, adult Hispanic females had lower rates of past month alcohol use, binge alcohol use, and illicit drug use (Table 1). Patterns varied by age group.

Among women aged 18 to 44 who were pregnant at the time of the survey interview, Hispanics had lower rates of alcohol use and illicit drug use than the national average (5.9 vs. 11.2 percent and 2.5 vs. 4.0 percent, respectively) (Figure 6). The rate of past month binge alcohol use among pregnant Hispanic women did not differ significantly from the national average for pregnant women.

Figure 6. Past Month Substance Use among Hispanic Pregnant Women Aged 18 to 44 Compared with the National Average for Pregnant Women Aged 18 to 44: 2004 to 2008

Compared with the national averages, adult Hispanic males had lower rates of past month alcohol use and illicit drug use but a higher rate of binge alcohol use (Table 2). Patterns varied by age group.

Compared with the national averages for uninsured adults, uninsured Hispanic adults were less likely to have used alcohol, binged on alcohol, or used an illicit drug in the past month (41.5 vs. 52.3 percent, 28.3 vs. 33.1 percent, and 7.3 vs. 15.1 percent, respectively) (Figure 7).

Figure 7. Past Month Substance Use among Uninsured Hispanic Adults Compared with the National Average for Uninsured Adults: 2004 to 2008

The rates of past month alcohol use, binge alcohol use, and illicit drug use among Hispanic adults living in poverty were lower than the national averages for adults living in poverty (Figure 8).

Figure 8. Past Month Substance Use among Hispanic Adults Living in Poverty Compared with the National Average for Adults Living in Poverty: 2005 to 2008

Combined 2004 to 2008 data indicate that an estimated 2.5 million Hispanic adults—8.7 percent—were classified as being in need of treatment for an alcohol use problem in the past year.⁹ While the difference between the rate for Hispanics and the national average (8.7 versus 8.1 percent) was relatively small, it was statistically significant.

About 7.9 percent of Hispanic adults in need of alcohol treatment in the past year (195,000 persons) received it at a specialty facility.¹⁰ This rate was similar to the national average (8.2 percent).

An estimated 843,000 Hispanic adults—or 2.9 percent—were classified as being in need of treatment for an illicit drug use problem in the past year. This rate was similar to the national average of 2.9 percent.

About 18.3 percent of Hispanic adults in need of illicit drug treatment in the past year (155,000 persons) received it at a specialty facility. This rate was also similar to the national average.

As the Federal Government and States move forward with the interrelated tasks of reducing disparities and reforming health care, it will be important to monitor data on substance use and treatment need among racial/ethnic minorities. The findings in this report highlight variations in substance use and treatment need between Hispanic adults and adults in the Nation as a whole and suggest subgroups that may benefit from increased attention from the prevention and treatment systems.