A study has found that African-American and Hispanic adults have twice the odds of reporting receiving counseling about alcohol use from a physician, compared with white adults. What causes this disparity in counseling is not known, but this may be a rare instance of minority populations receiving better and more appropriate health care than the majority.
However, the finding may also mean that physicians are more likely to assume that African-Americans and Hispanics have alcohol issues. "Yet blacks are less likely to be binge drinkers than whites," said study author Kenneth Mukamal, M.D., an associate professor at Harvard Medical School and an internist at Beth Israel Deaconess Medical Center in Boston.
The study evaluated data from an extensive national telephone survey performed in 1999. More than 15,000 people took part in the survey. Participants were asked about their alcohol use, among other topics, and about what preventive counseling services they received.
Compared with non-Hispanic whites, the odds of being counseled about alcohol use were 1.83 for non-Hispanic blacks and 2.17 for Hispanics roughly twofold higher.
When Mukamal analyzed survey results for diet counseling, he found no substantial difference in the odds of receiving such counseling based on race or ethnicity, suggesting that the disparity in counseling about alcohol use did not extend to other preventive health counseling issues.
According to Mukamal, a difference in who gets alcohol counseling can lead to false excess reporting of alcohol abuse among blacks and Hispanics and may mean that problems with alcohol use are being missed among whites. "This will lead to perpetuation of stereotypes," he said.
"Everyone visiting the doctor should have this conversation, especially those with chronic conditions, regardless of their race or ethnicity," said Luisa N. Borrell, Ph.D., assistant professor of epidemiology with Columbia University's Mailman School of Public Health. "In contrast, it is interesting that the study also reports that there was no racial or ethnic difference in receiving diet counseling when the prevalence of overweight or obesity is higher among minorities."
It would be naive to disregard the possibility of racial bias or stereotype toward blacks and Hispanics in medical settings and assume that the difference in who gets counseling about alcohol use is coincidental, Borrell said.