Unkindness linked to alcohol, drug abuse in black populations, study finds

"It's no surprise that people who believe they receive frequent unfair treatment from strangers feel enough emotional pain that leads them to self-coping behaviors such as alcohol and drug use, but this study shows that there is significant relationship between this poor treatment and chronic substance abuse," says Haslyn E.R. Hunte, an assistant professor of health and kinesiology who studies health outcomes and discrimination. "There is a connection here, and while more work is needed to understand the cause and effect, especially if a substance abuse problem could be one of the reasons people are treated unfairly, people need to realize how they treat others can affect them deeply.

"Based on this study, clinicians treating people for substance abuse should be more attuned to how discrimination plays a role in their clients' health, just as the loss of a loved one or losing a job."

In this study, discrimination was defined as individual experiences of unfair treatment, such as being treated with less respect or courtesy than others. Such discrimination can be directed at those people who are obese or who smoke, or because of one's age, gender or race.

"It's small behaviors leading to big problems," Hunte says. "Treating someone poorly for how they look or are different from others can lead to clinical dependencies that are costly and even dangerous to society. For example, a person with a dependency is more likely to drive under the influence."

In this study, 90 percent reported everyday discrimination and 62 percent reported major discrimination, which would include feeling discriminated against during specific major life events such as in hiring or loan application processes. Those who reported the highest levels of discrimination were more likely to report an alcohol or drug-use disorder. Other studies have reported discrimination and its relationship to infrequent drug and alcohol use, but this study focuses on problematic usage patterns.

The findings, which were co-authored by Adam Barry, an assistant professor of health education at the University of Florida at Gainesville, is currently available online and will be published in the December issue of the American Journal of Public Health. The analysis was based on the 2001 National Study of American Life, which was funded by the National Institute of Mental Health. It includes survey and interview results from 3,570 African-Americans and more than 1,400 black Carribeans. The researchers also controlled for more traditional stressors such as grief and financial issues.

This population is of concern because blacks report higher levels of discrimination and tend to live in communities where there are more promotions, such as billboards and signs, advertising alcoholic beverages, says Hunte, who also is a member of Purdue's Center for Poverty and Health Inequality. He will be collaborating with other researchers on how perceptions of discrimination are shaped by individuals' personalities and coping.

More information: "Perceived Discrimination and DSM-IV-Based Alcohol and Illicit Drug Use Disorders" by Haslyn E.R. Hunte and Adam E. Barry, American Journal of Public Health.

Abstract:
Objectives: We examined the relationship between everyday and major discrimination and alcohol and drug use disorders in a nationally representative sample of African-Americans and Black Carribeans.
Methods: With data from the National Survey of American Life Study, we employed multivariate logistic regression analyses - while controlling for potential confounders - to examine the relationship between everyday and major discrimination and substance use disorders on the basis of Diagnostic and Statistical Manual of Mental Disorders criteria.
Results: Every 1 unit increase in the everyday discrimination scale positively predicted alcohol (odds ratio {OR} = 1.02; P <.01) and drug use (PR = 1.02; P <.05) disorders. Similarly, each additional major discrimination event positively predicted alcohol (OR = 1.10; P <.05) and drug use (OR = 1.15; P <.05) disorders.
Conclusions: To our knowledge, this study is the first to examine problematic usage patterns rather than infrequent use of alcohol and drugs in a national sample of African-American and Black Caribbean adults and the first to examine this particular relationship in a national sample of Black Carribeans.

Journal reference: American Journal of Public Health

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