Education and race-ethnicity differences in the lifetime risk of alcohol dependence.
OBJECTIVE
While lower socioeconomic status (SES) is related to higher risk for alcohol dependence, minority race-ethnicity is often associated with lower risk. This study attempts to clarify the nature and extent of social inequalities in alcohol dependence by investigating the effects of SES and race-ethnicity on the development of alcohol dependence following first alcohol use.


METHODS
Cross-sectional analysis of data from the National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093). Survival analysis was used to model alcohol dependence onset according to education, race-ethnicity and their interaction.


METHODS
United States, 2001-2.


RESULTS
Compared with non-Hispanic white people, age-adjusted and sex-adjusted risks of alcohol dependence were lower among black people (odds ratio (OR) = 0.70, 95% confidence interval (CI) = 0.63 to 0.78), Asians (OR = 0.65, CI = 0.49 to 0.86) and Hispanics (OR = 0.68, CI = 0.58 to 0.79) and higher among American Indians (OR = 1.37, CI = 1.09 to 1.73). Individuals without a college degree had higher risks of alcohol dependence than individuals with a college degree or more; however, the magnitude of risk varied significantly by race-ethnicity (chi(2) for the interaction between education and race-ethnicity = 19.7, df = 10, p = 0.03); odds ratios for less than a college degree were 1.12, 1.46, 2.24, 2.35 and 10.99 among Hispanics, white people, black people, Asians, and American Indians, respectively. There was no association between education and alcohol dependence among Hispanics.


CONCLUSIONS
Race-ethnicity differences in the magnitude of the association between education and alcohol dependence suggest that aspects of racial-ethnic group membership mitigate or exacerbate the effects of social adversity.
Gilman
S E
SE
Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. sgilman@hsph.harvard.edu
Breslau
J
J
Conron
K J
KJ
Koenen
K C
KC
Subramanian
S V
SV
Zaslavsky
A M
AM
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000437:Alcoholism / Q000208:ethnology* / Q000209:etiology; D044466:Asian People / Q000523:psychology; D044383:Black People / Q000523:psychology; D004522:Educational Status; D004812:Epidemiologic Methods; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D007198:Indians, North American / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012923:Social Class; D014481:United States / Q000453:epidemiology; D001741:Black or African American