Results (Continued) Death rates from alcohol intoxication were also highest among blacks (5.1),...
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Results (Continued) Death rates from alcohol intoxication were also highest among blacks (5.1), compared to Hispanics (3.8) or whites (3.8). In contrast, hospitalizations and deaths for alcohol-related chronic medical conditions (e.g. cirrhosis of the liver) occurred most frequently among Hispanics and least frequently among whites. Hospitalization rates for these conditions were 38.7 for Hispanics, compared to 30.3 for blacks and 18.3 for whites. Death rates for these conditions follow a similar pattern, with rates of 7.2, 5.7 and 3.1 among Hispanics, blacks and whites, respectively. Discussion In NYC, racial disparities in problem drinking and its sequelae follow three distinct patterns: Whites have the highest reported prevalence of heavy and binge drinking; Blacks have the highest rates of hospitalization for medically managed alcohol detoxification and death from intoxication; and Hispanics have the highest rates of hospitalization and death from chronic medical complications of alcohol use. There are several possible explanations for the incongruence of findings from these three data sources: 1.Black and Hispanic problem drinkers may be underrepresented in the sample from which the prevalence estimates were derived; 2.Differential access to quality health care may have a profound effect on the early identification and treatment of problem drinking, and the prevention of alcohol-related morbidity and mortality; 3.There may be differential reporting by race within and across data sources. Introduction Data from the New York City (NYC) Department of Health and Mental Hygiene’s Community Health Survey (CHS) estimate a significantly higher prevalence of problem drinking among whites than among blacks and Hispanics. This finding, which is contrary to common beliefs, led to the examination of other data sources to inform the Department of racial/ethnic differences regarding alcohol risk factors, morbidity and mortality in New York City. Methods Three independent data sets were analyzed to determine the prevalence of problem drinking and its sequelae in New York City. The prevalence of problem drinking was evaluated with data from the 2002 NYC CHS, a random telephone survey of approximately 10,000 New Yorkers. Two overlapping aspects of problem drinking were examined: heavy drinking (defined as the consumption of more than 30 drinks per month for women or more than 60 drinks per month for men), and binge drinking (defined as the consumption of 5 or more drinks on a single occasion at least once during the past month). Age-adjusted hospitalization rates (per 100,000 population) for medically managed alcohol detoxification and for alcohol- related chronic conditions were produced from the 2001 New York State hospital discharge data set collected from licensed, Article 28, medical providers through the Statewide Planning and Research Cooperative System (SPARCS). Age-adjusted mortality rates (per 100,000 population) attributable to alcohol intoxication or to alcohol- related chronic conditions were drawn from the 2001 New York City Vital Records. Results The prevalence of heavy drinking was 7.4% (95% CI: 6.3-8.7) in whites, compared to 3.3% (95% CI: 2.5-4.4) among Hispanics and 3.9% (3.0-5.1) in blacks. Prevalence of Heavy Drinking 0 1 2 3 4 5 6 7 8 9 10 W hite Black H ispanic Percent 0 5 10 15 20 25 W hite B lack H ispanic Percen Prevalence of Binge Drinking Rates of Hospitalization for Medically Managed Alcohol Detoxification 0 100 200 300 400 500 600 700 800 W hite B lack H ispanic Rate per 100, Rates of Hospitalization for Alcohol-Related Chronic Conditions 0 5 10 15 20 25 30 35 40 45 W hite B lack H ispanic Rate per 10 0 1 2 3 4 5 6 W hite B lack H ispanic Rate per 10 Rates of Death from Alcohol Intoxication Rates of Death from Alcohol- Related Chronic Conditions 0 1 2 3 4 5 6 7 8 W hite B lack H ispanic Rate per 100 RACIAL/ETHNIC DISPARITIES IN PROBLEM DRINKING AND ITS SEQUELAE IN NYC KH McVeigh, F Mostashari, BD Kerker, X Lu, T Singh New York City Department of Health and Mental Hygiene
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Transcript of Results (Continued) Death rates from alcohol intoxication were also highest among blacks (5.1),...
Results (Continued)
Death rates from alcohol intoxication were also highest among blacks (5.1), compared to Hispanics (3.8) or whites (3.8).
In contrast, hospitalizations and deaths for alcohol-related chronic medical conditions (e.g. cirrhosis of the liver) occurred most frequently among Hispanics and least frequently among whites.
Hospitalization rates for these conditions were 38.7 for Hispanics, compared to 30.3 for blacks and 18.3 for whites.
Death rates for these conditions follow a similar pattern, with rates of 7.2, 5.7 and 3.1 among Hispanics, blacks and whites, respectively.
DiscussionIn NYC, racial disparities in problem drinking and its sequelae follow three distinct patterns:
Whites have the highest reported prevalence of heavy and binge drinking;
Blacks have the highest rates of hospitalization for medically managed alcohol detoxification and death from intoxication; and
Hispanics have the highest rates of hospitalization and death from chronic medical complications of alcohol use.
There are several possible explanations for the incongruence of findings from these three data sources:
1. Black and Hispanic problem drinkers may be underrepresented in the sample from which the prevalence estimates were derived;
2. Differential access to quality health care may have a profound effect on the early identification and treatment of problem drinking, and the prevention of alcohol-related morbidity and mortality;
3. There may be differential reporting by race within and across data sources.
Future studies are needed to determine the relative contribution of these and other explanations to the observed disparities.
These findings dramatically illustrate how disparities in poor health outcomes can be independent of reported risk behaviors.
IntroductionData from the New York City (NYC) Department of Health and Mental Hygiene’s Community Health Survey (CHS) estimate a significantly higher prevalence of problem drinking among whites than among blacks and Hispanics. This finding, which is contrary to common beliefs, led to the examination of other data sources to inform the Department of racial/ethnic differences regarding alcohol risk factors, morbidity and mortality in New York City.
MethodsThree independent data sets were analyzed to determine the prevalence of problem drinking and its sequelae in New York City. The prevalence of problem drinking was evaluated with data from the 2002 NYC CHS, a random telephone survey of approximately 10,000 New Yorkers. Two overlapping aspects of problem drinking were examined: heavy drinking (defined as the consumption of more than 30 drinks per month for women or more than 60 drinks per month for men), and binge drinking (defined as the consumption of 5 or more drinks on a single occasion at least once during the past month).
Age-adjusted hospitalization rates (per 100,000 population) for medically managed alcohol detoxification and for alcohol-related chronic conditions were produced from the 2001 New York State hospital discharge data set collected from licensed, Article 28, medical providers through the Statewide Planning and Research Cooperative System (SPARCS).
Age-adjusted mortality rates (per 100,000 population) attributable to alcohol intoxication or to alcohol-related chronic conditions were drawn from the 2001 New York City Vital Records.
ResultsThe prevalence of heavy drinking was 7.4% (95% CI: 6.3-8.7) in whites, compared to 3.3% (95% CI: 2.5-4.4) among Hispanics and 3.9% (3.0-5.1) in blacks.
Binge drinking was reported by 19.4% (95% CI: 17.8-21.2) of whites, 14.5% (95% CI: 12.7-16.4) of Hispanics and 10.7% (95% CI: 9.1-12.5) of blacks.
Blacks had much higher rates of hospitalization for medically managed alcohol detoxification (739.1) than did Hispanics (404.4) or whites (289.2).
Prevalence of Heavy Drinking
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RACIAL/ETHNIC DISPARITIES IN PROBLEM DRINKING AND ITS SEQUELAE IN NYCKH McVeigh, F Mostashari, BD Kerker, X Lu, T Singh
New York City Department of Health and Mental Hygiene
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