Studies have shown that alcohol consumption rates are similar for African Americans (AA) and Caucasians in CA. These finding are based on statewide, random digit-dial telephone surveys (RDDTS) such as the Behavioral Risk Factor Surveillance System (BRFSS) and the California Health Interview Survey. Although the findings from these studies are reliable, the validity is questionable because AA RDDTS samples are biased and non-representative. Specifically, low-income AA are more likely than other groups to lack landline telephones and so cannot participate in RDDTS;hence Black RDDTS samples tend to consist of the higher socioeconomic status (SES) members of the community (i.e., those with low alcohol consumption rates). Moreover, the majorities of AA's are highly distrustful of health researchers and so refuse to participate in telephone surveys. Thus, the current work proposes to assess the true prevalence of alcohol use among CA AA adults. The specific goals of the proposed study are three-fold: (1) test the hypothesis that this community-based sample is more representative of the CA Black population than CA RDDTS samples (2) test the hypothesis that this community sample has significantly higher alcohol use rates than AA and than White CA RDDTS samples, these even higher among Blacks who lack landline telephones and (3) fully explore and exploit the data from this sample by testing a variety of statistical models that clarify the nature of CA Blacks'use of alcohol and elucidate the potentially unique community (e.g., neighborhood-level segregation and SES), social (e.g., racial discrimination) and cultural (e.g., acculturation, religiosity) factors affecting that use. Data will be acquired on CA AA's alcohol use from a random, statewide, probability sample of 2,000 AA adults surveyed in person, in their communities, by AA from those communities. Because of the nested nature of this data, hierarchical linear modeling will be employed to examine the proposed relations. The findings from the proposed research will have important clinical implications that reflect the NIMH priorities.
Specifically, this project will examine an array of social (e.g., racial discrimination), contextual (area segregation, area SES), and cultural (acculturation) variables that impact the use of alcohol, which are absent from the RDDTS, thus informing both clinicians and intervention researchers who emphasize physical and psychological health. In addition data from the current study can inform statewide alcohol-control efforts - and indeed may be relevant to such efforts for other CA minorities.
