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标题：Prevalence of Substance Use Disorders Among African Americans and Caribbean Blacks in the National Survey of American Life
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作者：Clifford L. Broman ; Harold W. Neighbors ; Jorge Delva 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2008
卷号：98
期号：6
页码：1107-1114
DOI：10.2105/AJPH.2006.100727
语种：English
出版社：American Public Health Association
摘要：Objectives. We sought to estimate the prevalence of substance disorders for African Americans and Caribbean Blacks in the United States using data from the National Survey of American Life. Methods. A national household probability sample of noninstitutionalized African Americans (n=3570) and Caribbean Blacks (n=1621) was obtained between February 2001 and June 2003 using a slightly modified version of the Composite International Diagnostic Interview. Results. Overall differences in prevalence of substance disorders between the ethnic groups were not significant. Prevalence rates of substance disorders among African Americans exceeded that of Caribbean Blacks among women, those aged 45 to 59 years, and those who were divorced. African Americans in major metropolitan areas had higher prevalence rates, and those in the South had lower ones, compared with those living in other areas. Overall, first-generation Caribbean Blacks were significantly less likely, but second-generation more likely, than were African Americans to meet criteria for overall substance disorders. Conclusions. Failure to distinguish between African Americans and Caribbean Blacks masks important differences in substance use patterns among the Black population in the United States. In the United States, about 51% of older adolescents and adults have used illegal drugs or illegally diverted prescription drugs over their lifetimes, and about 15% have used them over the prior 12 months. 1 In a recent national study among adults, prevalence rates for any substance disorder were 14.6% for lifetime, and 3.8% for the prior 12 months. 2 ^, 3 Studies of racial and ethnic differences have found that Whites have higher prevalence rates of substance abuse disorders than do other racial and ethnic groups, 2 ^, 4 ^, 5 but racial and ethnic minorities have been shown to have substance abuse disorders that persist for longer periods of time. 5 Findings from the National Survey on Drug Use and Health also showed higher drug abuse rates for Whites than for racial or ethnic minorities, except for abuse of crack cocaine and heroin. 6 Despite the lifetime and current prevalence rates of illegal drug use being lower for Blacks, Blacks are overrepresented in the health and criminal justice systems. 7 ^– 9 Previous research on substance abuse among Blacks has lumped the Caribbean Black and African American populations together. This is true of almost all studies, 2 ^– 6 with few exceptions. 10 Previous research, however, is clear in noting that these 2 populations are quite distinct. 11 ^– 15 The differences between the 2 groups exist among most sociodemographic categories. For example, the Caribbean Black population is overwhelmingly northern, whereas the African American population is predominantly Southern. 10 ^, 14 ^, 15 There are also important socioeconomic differences, such as family income and college attendance. 11 ^– 17 Another key difference is that qualitative experiences of racial discrimination are somewhat distinct. 12 ^, 13 ^, 15 ^, 18 Finally, the Caribbean Black population is significantly more likely to be comprised of first-generation immigrants and second-generation children of immigrants, whereas this is not true for the African American population. 11 ^– 16 Although the extant literature provides important information about the prevalence of substance use disorders among racial and ethnic minorities, there are several concerns that limit the policy implications of these findings. For example, studies that have nationally representative samples either rely on data collected more than a decade ago or do not permit diagnoses using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM–IV ). 1 ^, 19 Those that do use DSM–IV diagnostic criteria typically do not present substance use disorders separately by race and ethnicity; instead, they group together all non-Hispanic Black respondents into a catch-all category of “Black” or “African American.” 3 ^– 6 In the past, when the Caribbean Black population was small, this was a practical solution. With the growing population of Caribbean Blacks in the United States, however, aggregating all “Black” respondents into a single category may mask important differences in substance use disorders. We address these limitations by providing estimates of substance use disorders separately for African American and Caribbean Black populations. We present data on substance abuse disorders among African Americans and Caribbean Blacks in the United States diagnosed using DSM–IV criteria, 19 utilizing data from the National Survey of American Life (NSAL). 20