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Prevalence of Substance Use Among Racial & Ethnic Subgroups in the U.S.

Chapter 6 Conclusions

This report provides further evidence that substance abuse is a major health problem affecting racial/ethnic subgroups in the United States. Using data on eleven U.S. racial/ethnic subgroups from the combined 1991 through 1993 National Household Surveys on Drug Abuse, the report shows that there are substantial racial/ethnic differences in the prevalence of licit and illicit substance use, alcohol dependence, and need for illicit drug abuse treatment. Relative to the total U.S. household population aged 12 and older, Native Americans, Mexicans, Puerto Ricans, and non-Hispanic blacks have high prevalences of illicit drug use, heavy cigarette use, alcohol dependence, and need for illicit drug abuse treatment, while Asian/Pacific Islanders, Caribbeans, Central Americans, and Cubans have low prevalences. For example, the percentage of individuals aged 12 and older using any illicit drug in the past year equals about 20% among Native Americans, 13% among Mexicans, Puerto Ricans, and non-Hispanic blacks, and 8% or less among Asian/Pacific Islanders, Caribbeans, Central Americans, and Cubans, compared with about 12% in the total NHSDA surveyed population (Table 4.4). The effects of gender, age, and other sociodemographic variables on illicit drug use, heavy cigarette use, alcohol dependence, and need for illicit drug abuse treatment are generally similar across racial/ethnic subgroups. Within each racial/ethnic subgroup, those with the highest prevalences tend to be males, young adults aged 18 to 25, and socioeconomically disadvantaged families and individuals.

This report describes but does not explain racial/ethnic differences in substance use, alcohol dependence, and need for illicit drug abuse treatment. A number of alternative explanations—focusing on such explanatory factors as relative socioeconomic disadvantage, discrimination, and the values and traditions of specific racial/ethnic subgroups—are discussed in the research literature. The detailed analyses of Chapter 5 suggested that measures of socioeconomic disadvantage and other sociodemographic covariates did not fully account for racial/ethnic differences in substance use, because racial/ethnic differences within socioeconomic subclasses are generally similar to racial/ethnic differences in the total surveyed population. Even so, more refined measurements of socioeconomic status and race/ethnicity together with multivariate statistical modeling techniques (see discussion below) might show that the relative degrees of socioeconomic disadvantage of racial/ethnic subgroups account for a large part of racial/ethnic differences in substance use. Unfortunately, the different dimensions of socioeconomic status are difficult to measure finely enough to definitively test the hypothesis of socioeconomic disadvantage. Even a sample as large as that of the combined 1991-1993 NHSDAs might not suffice to model the complex interactions between the dimensions of socioeconomic status and race/ethnicity.

Although the reasons for racial/ethnic differences in substance use and drug-related outcomes are poorly understood, some policy implications of this report's findings seem clear: Decision-makers should be aware of racial/ethnic differences in the prevalence of substance use when decisions are made to allocate resources for substance abuse prevention and treatment. Resources might be effectively targeted to racial/ethnic subgroups that have high prevalences relative to the total U.S. population. Within each racial/ethnic subgroup, prevention and treatment resources might be targeted to those subclasses of individuals and families that tendto have the highest prevalence of substance use. Regardless of racial/ethnic subgroup, individuals residing in the West or in metropolitan areas with populations greater than 1 million, individuals with no health insurance coverage, unemployed individuals, individuals with 9 to 11 years of schooling, and never-married individuals have relatively high prevalences of illicit drug use. Moreover, regardless of racial/ethnic subgroup, adolescents who dropped out of school or who reside in households with fewer than two biological parents have relatively high prevalences of past-year use of cigarettes, alcohol, and illicit drugs. To the extent that the use of English rather than of Spanish in the NHSDA interview gauges acculturation in American society, the results of this report also suggest that relatively acculturated Hispanics, such as those who have lived in the U.S. long enough to become fluent in English, are in greater need of illicit drug abuse prevention and treatment services than less acculturated Hispanics.

The descriptive results presented in this report have value mainly because the large sample size of the combined 1991 through 1993 NHSDAs permits an analysis of behavioral differences among racial/ethnic categories that are more refined than the usual distinction among Hispanics, non-Hispanic whites, non-Hispanic blacks, and others. Yet the advance of research on racial/ethnic differences in substance use will also depend on in-depth epidemiological studies, especially longitudinal or panel surveys and surveys targeting high-risk individuals within specific racial/ethnic categories. Longitudinal studies will be needed to ascertain how racial/ethnic differences affect substance use behavior at each stage of individual and familial life cycles. Surveys of high-risk individuals will be needed to find out how racial/ethnic differences interact with other factors associated with drug use, such as broken families, deviant peer groups, and dropping out of school at an early age.

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This page was last updated on May 19, 2008.