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Racial discrimination and alcohol use and negative drinking consequences among Black Americans: a meta-analytical review.

ABSTRACT: BACKGROUND AND AIMS:Findings of the association between racial discrimination and alcohol use and related consequences are inconsistent, and the role of potential moderators in the association is largely unknown. This meta-analysis aimed to synthesize the discrimination-alcohol literature among Black Americans, estimate the magnitude of associations and explore differences as a function of sample characteristics. METHODS:Empirical studies reporting the association of racial discrimination with alcohol-related behaviors in an all-black sample were identified via systematic literature search. A random-effects meta-analysis was conducted using 33 effect sizes extracted from 27 studies, all of which used US samples (n = 26?894). RESULTS:Significant positive associations were found for racial discrimination with alcohol consumption [k = 9, confidence interval (CI) = 0.08, 0.17, I2 = 49%, r = 0.12], heavy/binge drinking (k = 12, CI = 0.02, 0.10), I2 = 27%, r = 0.06), at-risk drinking (k = 4, CI = 0.06, 0.23, I2 = 0%, r = 0.14) and negative drinking consequences (k = 5, CI = 0.09, 0.25, I2 = 94%, r = 0.25), but not with alcohol use disorder (k = 3, CI = -0.01, 0.20, I2 = 90%, r = 0.10). Only alcohol consumption and negative drinking consequences showed significant between-study heterogeneity and had a sufficient quantity of studies for moderation analysis (i.e., 4 or more studies). The positive association of racial discrimination with negative drinking consequences was stronger among younger samples; the association with alcohol consumption did not differ by age or proportion of men. CONCLUSIONS:Experiences of racial discrimination are associated with diverse alcohol-related behaviors among Black Americans, with a stronger association with problematic alcohol use, particularly among younger individuals.

SUBMITTER: Desalu JM

PROVIDER: S-EPMC6510626 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Racial discrimination and alcohol use and negative drinking consequences among Black Americans: a meta-analytical review.

Desalu Jessica M JM Goodhines Patricia A PA Park Aesoon A

Addiction (Abingdon, England) 20190303 6

<h4>Background and aims</h4>Findings of the association between racial discrimination and alcohol use and related consequences are inconsistent, and the role of potential moderators in the association is largely unknown. This meta-analysis aimed to synthesize the discrimination-alcohol literature among Black Americans, estimate the magnitude of associations and explore differences as a function of sample characteristics.<h4>Methods</h4>Empirical studies reporting the association of racial discri ...[more]

PMID: 30714661

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Project description:ImportanceMetabolic syndrome (MetS) is a common health condition that predisposes individuals to cardiovascular disease (CVD) and disproportionately affects Black and other racially and ethnically minoritized people. Concurrently, Black individuals also report more exposure to racial discrimination compared with White individuals; however, the role of discrimination in the development of MetS over time and associated mediators in these pathways remain underexplored.ObjectiveTo evaluate the association between racial discrimination and MetS in rural Black individuals transitioning from late adolescence into early adulthood and to identify potential mediating pathways.Design, setting, and participantsThis longitudinal cohort study included Black adolescents enrolled in the Strong African American Families Healthy Adults (SHAPE) Project between June 2009 and May 2021. Families resided in rural counties of Georgia, where poverty rates are among the highest in the nation. Analyses included 322 of the 500 participants who originally enrolled in SHAPE and who were eligible to participate. Guardians provided information about socioeconomic disadvantage. Analyses were conducted in April 2023.ExposuresYouths reported exposure to racial discrimination annually from ages 19 to 21 years.Main outcomes and measuresMetS was the main health outcome and was measured at ages 25 and 31 years. MetS was diagnosed according to the International Diabetes Federation guidelines, which requires central adiposity (ie, waist circumference ≥94 cm for males and ≥80 cm for females) and at least 2 of the 4 additional components: signs of early hypertension (ie, systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg); elevated triglyceride levels (ie, >150 mg/dL); elevated fasting glucose level (ie, ≥100 mg/dL); or lowered high-density lipoprotein levels (ie, <40 mg/dL in men and <50 mg/dL in women). At age 25 years, markers of inflammatory activity (ie, soluble urokinase plasminogen activator receptor [suPAR]) and sleep problems were collected to consider as potential mediators.ResultsIn 322 participants (210 [65.2%] female) ages 19 to 21 years, more frequent exposure to racial discrimination was associated with higher suPAR levels (b = 0.006; 95% CI, 0.001-0.011; P = .01) and more sleep problems at age 25 years (b = 0.062; 95% CI, 0.028-0.097; P < .001) as well as a 9.5% higher risk of MetS diagnosis at age 31 years (odds ratio [OR], 1.10; 95% CI, 1.01-1.20; P = .03). Both suPAR (b = 0.015; 95% CI, 0.002-0.037) and sleep problems (b = 0.020; 95% CI, 0.002-0.047) at age 25 years were significant indirect pathways. No significant interactions between sex and discrimination emerged.Conclusions and relevanceThis study suggests that racial discrimination in late adolescence is associated with MetS among Black young adults through biobehavioral pathways. Thus, health interventions for MetS in Black adults will need to contend with sleep behaviors and inflammatory intermediaries as well as address and reduce exposure to racial discrimination to narrow disparities and promote health equity.

Dataset Information

Racial discrimination and alcohol use and negative drinking consequences among Black Americans: a meta-analytical review.

Publications

Racial discrimination and alcohol use and negative drinking consequences among Black Americans: a meta-analytical review.

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