Previous research has shown that white, compared to black, adolescents have higher rates of alcohol use, and show more rapid increases in alcohol use. Yet little is known about racial differences in types of alcohol consumed. A study of changes that may occur regarding type of alcohol beverage consumed during adolescence, when initial experimentation may transition to greater use, has found that black and white girls report significantly different risk profiles.
Results will be published in the January 2014 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"A few cross-sectional national surveys and a two-year longitudinal study of high school students have described racial differences in types of alcohol consumed," said Tammy Chung, associate professor of psychiatry at the University of Pittsburgh Medical Center as well as corresponding author for the study. "However, to my knowledge this is the first study to track changes over multiple years in adolescence regarding type of alcohol consumed by an individual, and to also look at changes in types of alcohol consumed, by race."
"This study is timely because only by understanding racial differences in the type of alcohol consumed can researchers and community decision-makers better tailor policies and preventive interventions to reduce the negative consequences of excessive alcohol use," added Mildred Maldonado Molina, associate professor in the department of health outcomes and policy at the University of Florida. "And certainly more studies are needed to understand youth's choice of alcoholic beverages, whether beer, wine, or liquor."
"When designing our study, we chose predictors to represent personal risk factors for early alcohol use, such as early pubertal maturation; important social influences, such as family and peers; and the broader social environment, such as neighborhood conditions," explained Chung. "One study goal was to find out whether neighborhood conditions uniquely predicted alcohol use – which it did, for both black and white girls – when accounting for the relatively strong effects of parent and peer influences on drinking."
Chung and her colleagues used data from the Pittsburgh Girls Study (PGS), a large community sample of urban girls. The PGS (n=2,451) annually follows four female age cohorts – five to eight years of age at Wave 1 – as part of a longitudinal design. Data for this study were drawn from 2,171 girls (n=1,236 black girls, 935 white girls), who provided data on alcohol use for at least one wave from ages 11 to 18 years. Analysis identified distinct profiles that represented changes in type of alcohol beverages consumed across ages 11 to 18 years, and also examined predictors – such as caretaker alcohol use, perceived peer alcohol use, ease in accessing alcohol, and perceived neighborhood risk indicated by witnessing drug dealing – of the alcohol-use profiles.
"We found that prevalence of alcohol use was higher among white, relative to black, girls during adolescence," said Chung. "Among drinkers, black girls tended to consume liquor, whereas white girls generally reported consuming beer and liquor. There was a greater variety of drinking patterns among white girls, compared to black girls. For example, black girls reported either low likelihood of alcohol use in adolescence, or increasing likelihood of alcohol use over time, whereas white girls who drank included those who mainly had sips of wine, or started alcohol use in early versus mid-adolescence."
Chung added that black and white girls also reported different risk profiles. "For example, white girls reported greater ease in accessing alcohol, but black girls were more likely to report adverse neighborhood conditions," she said. "However, similar predictors for black and white girls were also identified: ease in accessing alcohol, report of friends' alcohol use, and poor neighborhood conditions were associated with heavier drinking profiles in both groups."
"It was surprising that this study found that African American girls on average reported an earlier onset of drinking than white girls," observed Maldonado Molina, "although this might be due to including 'sips' and 'tastes' and not requiring consumption of at least a full drink. It was also surprising that although African American girls reported lower access to alcohol, they reported higher perception of peer alcohol use."
Chung said that a key message from this study for clinicians is the importance of routine alcohol screening for early identification of youth alcohol use and intervention. "Among black girls who report drinking, intervention might focus on use of liquor and liquor-related harm, whereas among white girls, limiting access to alcohol is an important intervention target," she said.
"Results also highlight the importance of monitoring youth access to alcohol," said Chung. "In particular, white girls reported greater ease in accessing alcohol than black girls, which is particularly worrisome because rather than experimenting – that is, trying and stopping – white girls in the study tended to continue alcohol use after starting to drink.
"Furthermore, researchers, parents, and clinicians should be aware that girls' preferences of alcoholic beverages change as they become adults," added Maldonado Molina.