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Associations Between Race and Ethnicity and Receipt of Advice About Alcohol Use in the Department of Veterans Affairs

The authors are affiliated with the Portland Department of Veterans Affairs (VA) Medical Center, P.O. Box 1034 (P3MHADM), Portland, OR 97207 (e-mail: steven.dobscha{at}med.va.gov) and the Portland VA Center for the Study of Chronic, Comorbid Physical and Mental Disorders.

OBJECTIVE: This study sought to identify racial and ethnic differences in rates of alcohol-related advice given to veterans treated in Veterans Affairs (VA) facilities. METHODS: This was a cross-sectional analysis of data from the VA Survey of the Healthcare Experiences of Patients (SHEP). Participants were 255,522 veterans treated in VA ambulatory clinics in fiscal year 2005. SHEP measures included alcohol consumption questions from the Alcohol Use Disorders Identification Test and an item inquiring whether a VA clinician had given advice about drinking. Logistic regression was used to examine relationships between race and ethnicity categories and receipt of alcohol-related advice. Covariate measures included demographic characteristics and physical and mental component summary scores from the Veterans RAND Health Survey (VR-12). RESULTS: Among veterans who consumed any alcohol, compared with veterans from the other racial or ethnic groups, Asian, Native Hawaiian, or Pacific Islander veterans were less likely to be in the medium and highest alcohol consumption categories and non-Hispanic white veterans were less likely to be in the highest alcohol consumption category (p<.001). In a model adjusting for demographic characteristics, physical and mental health status, and alcohol consumption category, among veterans who consumed any alcohol, those who were non-Hispanic black (odds ratio [OR]=1.65, 95% confidence interval [CI]=1.47–1.84), Hispanic (OR=1.56, CI=1.35–1.80), or non-Hispanic American Indian or Alaska Native (OR=1.56, CI=1.06–2.29) were more likely to report receiving alcohol-related advice, compared with non-Hispanic white veterans. CONCLUSIONS: The results suggest that veterans from certain minority groups are more likely than white veterans to report receiving alcohol-related advice in the VA, after the model is adjusted for demographic characteristics, health status, and alcohol consumption. Further research is needed to understand the underlying reasons for observed differences in receipt of alcohol-related advice and the potential clinical implications.

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