Blog Health Equity

Health disparities in alcohol use

Written by Rajadhar Reddy, undergraduate in neuroscience at University of Texas at Dallas and participant in the Institute for Public Health Summer Research Program 

I turn 21 next week, so writing a blog post on alcohol feels a bit ironic. But as alcohol consumption is the fourth leading preventable cause of death in the United States, perhaps a cautionary tale is in order.

Prevalence of Binge Drinking Among US Adults, 2015, CDC. Binge drinking is defined as 4+ drinks for a woman or 5+ drinks for a man on a single occasion in the last 30 days.

On June 20, Kathleen Bucholz, PhD, Vivia McCutcheon, PhD, and Manik Ahuja, PhD, hosted the Summer Research Program for a journal club on alcohol use disorder (AUD). Dr. Bucholz discussed the challenges of conducting epidemiological research on AUD. Dr. McCutcheon reminded us of the human side of AUD, describing the loss of control that patients experience. Dr. Ahuja presented data from the National Survey on Drug Use and Health (NSDUH), demonstrating the clear socioeconomic and ethnic disparities in AUD prevalence and treatment in the US.

Finally, our own Amber Lee, a Summer Research Program participant with Dr. Bucholz, summarized our assigned articles. One article, a critical review of drinking and AUD across various U.S. ethnic groups, echoed Dr. Ahuja’s presentation of the disparities found in NSDUH. The second study found similar disparities—except this study was done in Sweden, where extensive social services remove most of the barriers of access and cost seen in American healthcare.

In public health, European health systems are often regarded as exemplars for health equity, but while nationalized healthcare has resulted in impressive outcomes, we forget that inequities persist in both multi-payer and single-payer systems.

During our discussion, we asked several challenging questions. How do American and Swedish contexts differ? How does stigma manifest externally and internally for individuals with AUD?  How do the struggles of foreign-born residents color their experiences with alcohol? Is alcohol dependence more related to psychosocial factors or evolutionary genetics? We did not arrive at a conclusion to any of these questions in our one-hour session, highlighting the incredibly complex nature of our societal relationship with substance use.