- Funding: NIAAA R01 AA017197
- Principal Investigator: Nina Mulia, DrPH; Laura Schmidt, PhD (UCSF)
This study’s main objectives are to identify gaps in the delivery of alcohol treatment services to racial/ethnic minority populations, and to better understand how disparities in access to appropriate care impact these groups’ chances for recovery from alcohol problems over time. Prior findings from national treatment censuses and general population surveys provide an inconsistent picture of the variation in treatment access and utilization across ethnic groups. However, there are growing indications that the care provided to ethnic minority groups tends to be inappropriate relative to their profiles of need. Given the disproportionately high rates of alcohol-related morbidity and mortality among racial/ethnic minorities, it is important to clarify the role that disparities in access to appropriate treatment play in remission from alcohol problems. The study brings insights from health services research to bear on these issues by adapting models of treatment-seeking to the longitudinal analysis of multiple outcomes that reflect both the appropriateness of treatment received and end-point remission. The project is based on secondary analyses of the National Institute on Alcohol Abuse and Alcoholism’s National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative longitudinal survey conducted between 2001 and 2005. Using new techniques for the longitudinal analysis of complex survey data, analyses will disentangle the effects of race/ethnicity from important covariates, such as severity of need, comorbidities and socioeconomic indicators as well as barriers and enablers of treatment utilization. Analyses will document and inventory the extent of variation across racial/ethnic groups in the patterning of alcohol problems and co-occurring drug and psychiatric disorders over time. Then, informed by clinical practice guidelines, analyses will assess racial/ethnic disparities in the receipt of appropriate care for a given level of need and the impact of such disparities on recovery from alcohol problems.