Impact of race and ethnicity on counseling for alcohol consumption: a population-based, cross-sectional survey.
BACKGROUND
Counseling for alcohol use is of proven utility, but whether disparities in provision of counseling exist is uncertain.


METHODS
Using the 1999 Behavioral Risk Factor Surveillance System, a population-based telephone survey, we examined participant-reported physician counseling for alcohol use among 15,498 adults in 5 U.S. states. Participants reported their usual alcohol intake, risky drinking (intake of 5 or more drinks on occasion, greater than 60 drinks per month, or driving after drinking), and whether a doctor had spoken with them about alcohol use.


RESULTS
Race and ethnicity were strongly associated with reported receipt of alcohol counseling. Compared with whites, black and Hispanic adults had 2-fold higher odds of reporting receiving counseling among all participants, among problem drinkers, and among abstainers. There were modest differences according to sex, income, self-reported health, and education, but not body mass index. Multivariable adjustment and restriction to participants who reported a recent checkup did not alter these findings. No such disparity was noted for general diet counseling.


CONCLUSIONS
Clear racial and ethnic differences exist in physician counseling for alcohol use, with higher prevalence estimates among racial and ethnic minority populations. Although the cause of these differences is uncertain, systematic application of preventive medical services such as alcohol screening and counseling is needed for all patients.
Mukamal
Kenneth J
KJ
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. kmukamal@bidmc.harvard.edu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000208:ethnology*; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004032:Diet; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D044469:Racial Groups / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology