Social disadvantage, stress, and alcohol use among Black, Hispanic, and White Americans: findings from the 2005 U.S. National Alcohol Survey

Objective: Despite growing evidence of the adverse health effects of social disadvantage on minority populations, few studies have investigated whether such effects extend to alcohol problems. This study examines social disadvantage as a source of stress and analyzes its association with alcohol use and problems in the three largest racial/ethnic groups in the United States. Method: Data on white, black, and Hispanic Americans (n = 6,631) were obtained from the 2005 U.S. National Alcohol Survey, a nationally representative telephone-based survey of adults ages 18 and older. Social disadvantage was measured by poverty level, frequency of unfair treatment, racial/ethnic stigma consciousness, and cumulative disadvantage. Outcomes included drinking status, at-risk drinking, and problem drinking. Results: Blacks and Hispanics reported greater exposure to social disadvantage than whites, including greater poverty, unfair treatment, racial/ethnic stigma, and cumulative disadvantage. In all three racial/ethnic groups, exposure to disadvantage was associated with problem drinking. Frequent unfair treatment, high racial stigma (among minorities), and multiple sources of extreme disadvantage corresponded to a twofold to sixfold greater risk of alcohol problems, partially explained by psychological distress. Conclusions: These results are consistent with other studies of stress and adverse health consequences associated with social disadvantage. Although there is a clear disparity in exposure to such hardship, experiences of disadvantage appear to have similar effects on problem drinking among both racial/ethnic minorities and whites. Future research should attempt to assess causal directions in the relationships among social and economic hardship, stress, and alcohol problems.
ALTHOUGH ADVERSE HEALTH EFFECTS of poverty have long been recognized (Adler et al., 1994; Lynch and Kaplan, 2000), it is only in recent years that racial discrimination has been identified [...]