title: Alcohol dependence and health care utilization in African Americans.
abstract: OBJECTIVE
  Ethnic and cultural differences in patterns of alcohol use disorders must be understood in order to address improvement in prevention of such disorders and accessibility to health care services. The purpose of this study was to evaluate factors that influence the utilization of medical and mental health services among alcohol-dependent and non-alcohol-dependent African Americans.
  
  
  METHODS
  A cohort of 454 African Americans was evaluated. Alcohol-dependent participants were recruited from various inpatient treatment facilities in the Washington, DC, metropolitan area and through advertisement and word of mouth. Non-alcohol-dependent participants were recruited by advertisements. Each participant was administered the Semi-Structured Assessment for the Genetics of Alcoholism to assess alcohol dependency and the Family History Assessment module to access family history of alcoholism. Xl Test and analysis of variance were used to analyze the data.
  
  
  RESULTS
  Alcohol dependence was more prevalent among men, those with lower income, those with less education, and they utilized mental health counseling as opposed to medical-based therapy. Increased reports of medical conditions such as migraine (p<.001), loss of consciousness (p=.001), and sexually transmitted diseases: (p<.001) were also associated with alcohol dependency. Other factors, including visits to inpatient treatment programs, were directly related to incidence of alcohol dependency regardless of gender status (p<.001).
  
  
  CONCLUSIONS
  This study suggests an association exists among alcohol dependence, medical conditions, health care, and mental care utilization among African Americans. Future research may benefit from investigating if an association exists between alcohol use disorders and health care utilization for other ethnic groups.
authors.affiliation: Alcohol Research Center, Department of Pharmacology, College of Medicine, Howard University, Washington, District of Columbia 20059, USA. vjmarshall@howard.edu
authors.forename: Vanessa J
authors.initials: VJ
authors.lastname: Marshall
authors.forename: Nnenna
authors.initials: N
authors.lastname: Kalu
authors.forename: John
authors.initials: J
authors.lastname: Kwagyan
authors.forename: Denise M
authors.initials: DM
authors.lastname: Scott
authors.forename: Gloria E
authors.initials: GE
authors.lastname: Cain
authors.forename: Karen
authors.initials: K
authors.lastname: Hill
authors.forename: Victor
authors.initials: V
authors.lastname: Hesselbrock
authors.forename: Clifford L
authors.initials: CL
authors.lastname: Ferguson
authors.forename: Robert E
authors.initials: RE
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000208:ethnology* / Q000628:therapy; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult