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Prevalence of Substance Use Among Racial & Ethnic Subgroups in the U.S. |
Understanding racial/ethnic differences in the prevalence of substance abuse is becoming increasingly important to policy as the percentage of the U.S. population in racial/ethnic minority groups continues to increase. Based on U.S. Census Bureau projections, about one-third of the U.S. population is expected to be Asian/Pacific Islander, black, Native American, or of Hispanic origin by the year 2010. The socioeconomic disparities among racial/ethnic subgroups in the U.S., combined with the associations between low socioeconomic status and substance abuse, would indicate that an increasing number of members of racial/ethnic minorities may be at risk of substance abuse. Substance abusers face substantial health risks, risks of criminal victimization, and detrimental effects on life chances and prospects for socioeconomic achievement. Understanding racial/ethnic patterns of substance use is necessary if resources for substance abuse prevention and treatment are to be targeted to subgroups and individuals with a high prevalence of substance use.
This report analyzes racial/ethnic patterns of substance use in the U.S. using a more detailed classification of race/ethnicity than has been possible in previous reports that used the National Household Survey on Drug Abuse (NHSDA). In previous research, the small sample sizes of some racial/ethnic subgroups, such as Asian/Pacific Islanders, Hispanic national origin groups, and Native Americans, made it difficult to precisely estimate the prevalence of substance use in these subgroups. This report combines data from three large national surveys, the 1991, 1992, and 1993 NHSDAs, to estimate the prevalences of substance use, alcohol dependence, and need for illicit drug abuse treatment within eleven racial/ethnic subgroups. These subgroups are Native Americans, Asian/Pacific Islanders, non-Hispanic blacks, non-Hispanic whites, and seven subgroups of Hispanics: Caribbeans, Central Americans, Cubans, Mexicans, Puerto Ricans, South Americans, and Other Hispanics. The sample size of more than 87,000 respondents allows us to analyze racial/ethnic differences in substance use while statistically controlling for many sociodemographic characteristics, including age, gender, educational attainment, employment status, and family income. We chose to use the 1991-93 NHSDA data because during these years an oversample of 6 metropolitan areas was selected (Chicago, Denver, Los Angeles, Miami, New York City, and Washington DC) greatly increasing the minority group representation.
·Asian/Pacific Islanders. Asian and Pacific/Islanders are individuals who trace their ancestries to Asia or the Pacific Islands. Individuals of Chinese, Japanese, or Filipino ancestry or origin accounted for about 60% of the Asian/Pacific Islander population (see, e.g., Harrison and Bennett, 1995). This report supports previous research in showing that Asian/Pacific Islanders prevalences of substance use, alcohol dependence, and need for illicit substance abuse treatment, while clearly high enough to warrant attention, are low relative to those of the total U.S. population. For example, the percentages of Asian/Pacific Islanders aged 12 and older who used cigarettes, alcohol, and any illicit drug in the past year equal about 22%, 53%, and 6.5%, as compared with about 31%, 66%, and 12% in the total U.S. population aged 12 and older (see Tables 4.1- 4.3). As in the total U.S. population, males have a higher prevalence than females for every substance, but the gender gap is larger among Asian/Pacific Islanders than in the total U.S. population. For example, the percentages of Asian/Pacific Islander males and females using cigarettes in the past year equal about 30% and 14%, respectively, as compared with 34% and 28% among males and females in the total U.S. population (Table 4.1). Given the extensive ethnic diversity of the Asian/Pacific Islander category used here, these data should be interpreted with caution; averages for the overall group may mask significant variations in the prevalence of substance use among subgroups.
·Hispanics. Hispanic subgroups vary markedly in their prevalences of substance abuse, alcohol dependence, and need for illicit drug abuse treatment. Relative to the total U.S. population, Mexicans and Puerto Ricans have high prevalences of illicit drug use (including marijuana, cocaine, and other illicit drugs), heavy alcohol use, alcohol dependence, and need for illicit drug abuse treatment. In contrast, Caribbeans, Central Americans, and Cubans, have low prevalences, and South Americans and other Hispanics have prevalences that are close to those of the total U.S. population. For example, the percentage of the population aged 12 and older using any illicit drug in the past year equals about 13% among Mexicans and Puerto Ricans, 7.6% among Caribbeans, 5.7% among Central Americans, 8.2% among Cubans, 11% among South Americans and other Hispanics, compared with about 12% in the total U.S. population (Table 4.3). With respect to past-year cigarette use, Puerto Ricans have a relatively high prevalence, Caribbeans and Central Americans have a relatively low prevalence, and Cubans, Mexicans, South Americans, and other Hispanics have intermediate prevalences relative to the U.S. population (Table 4.1).
·Native Americans. Native Americans are persons having origins in and maintaining cultural identification with any of the original peoples of North America, including American Indian tribes and Alaskan Natives. This report supports previous research in suggesting that, relative to the total U.S. population, Native Americans have very high prevalences of past-year substance use (including cigarettes, alcohol, and illicit drugs), alcohol dependence, and need for illicit drug abuse treatment. For example, about 53% of Native Americans aged 12 and older used cigarettes in the past year, versus about 31% in the total U.S. population aged 12 and older. About 20% used an illicit drug in the past year (versus 12%), and about 7.8% were in need of illicit drug abuse treatment (versus 2.7%).
·Sociodemographic differences in substance use among and within racial/ethnic subgroups. Sociodemographic differences among racial/ethnic subgroups explain, at least in part, the subgroups' different prevalences of substance use, alcohol dependence, and need for illicit drug abuse treatment. For example, relative to the total U.S. population, individuals in households with low family income have a high prevalence of past-year use of any illicit drug, and the percentage of population with low family income is higher among Mexicans, non-Hispanic blacks, and Puerto Ricans than in the total U.S. population (Chapter 3). Thus, family income differences partially account for the relatively high prevalences of illicit drug use among Mexicans, Puerto Ricans, and non-Hispanic blacks. Yet none of the sociodemographic variables that are introduced in our analyses, including region, population density, language of interview, family income, health insurance coverage, receipt of welfare, educational attainment, school dropout status, marital status, employment status, and number of children, fully accounts for racial/ethnic differences in substance use (Chapter 5). We also show that, regardless of racial/ethnic subgroup, relatively high prevalences of illicit drug use are found among individuals who reside in the West; reside in metropolitan areas with populations greater than 1 million; would use English rather than Spanish in the NHSDA interview; lack health insurance coverage; are unemployed; have 9 to 11 years of schooling; or have never been married. 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 (Chapter 5).
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