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The research is the first to use an intersectional approach to examine disparities in the completion of alcohol treatment
RESEARCH TRIANGLE PARK, N.C. — Completion rates for alcohol treatment are significantly lower for racially and ethnically minoritized women compared to White men, according to a new study led by scientists at the Alcohol Research Group's (ARG) National Alcohol Research Center, a program of the Public Health Institute, in collaboration with nonprofit research institute RTI International.
The study, published in Alcohol: Clinical and Experimental Research, sought to measure disparities in treatment completion more precisely by using an intersectional approach that examined race, gender, and ethnicity together and compared the results when measured by race and ethnicity alone and gender alone.
When examining race and gender disparities separately, results were consistent with previous studies. The findings showed lower completion rates among Black, Hispanic/Latinx, and American Indian and Alaska Native (AIAN) adults compared to White individuals and found a modest disparity for women when compared to men.
However, an intersectional approach that examined groups defined jointly by race, ethnicity, and gender showed a much broader range of disparities, particularly for minoritized women:
- When compared to White men, Black, Hispanic/Latinx, AIAN, and Asian American and Pacific Islander (AAPI) women had treatment completion rates that were 12.4, 9.1, 10.3, and 4.8 percentage points lower, respectively.
- Compared to White men, disparities in treatment completion were twice as large for Black women than Black men (12.4% vs. 5.9%), five times larger for Hispanic/Latina women than Hispanic/Latino men (9.1% vs. 1.8%), and almost twice as large for AIAN women than AIAN men (10.3% vs. 6.0%).
- Race-only and gender-only models showed higher completion rates for AAPI adults, whereas the intersectional analysis revealed that this was only true for AAPI men, and that there was a disparity for AAPI women.
"In the US, 40% of adults in treatment for an alcohol use disorder do not end up finishing treatment. So, it is critical to have a more nuanced understanding of who is ending their treatment early to prevent certain groups from being left behind," said lead author and research associate Joanne Delk. "By analyzing treatment completion through an intersectionality lens, we were able to identify multiple inequities that were hidden in previous research."
In their analysis, the researchers adjusted for variations in the severity of need for treatment across groups and found that this did not explain the disparities.
The research team calls for greater attention to targeted, multi-level interventions to address disparities and increase equity in outpatient treatment completion.
“People who complete specialty alcohol treatment have a better chance of achieving long-term recovery,” said co-author Katherine Karriker-Jaffe, Ph.D., a behavioral health expert at RTI. “It is critical that everyone is able to receive the care and support they need. We hope this research can inform strategies to eliminate these treatment disparities to improve care for women of color.”
About RTI International
RTI International is an independent, nonprofit research institute dedicated to improving the human condition. Clients rely on us to answer questions that demand an objective and multidisciplinary approach — one that integrates expertise across the social and laboratory sciences, engineering and international development. We believe in the promise of science, and we are inspired every day to deliver on that promise for the good of people, communities and businesses around the world. For more information, visit www.rti.org.
About the Alcohol Research Group
For over 60 years, the Alcohol Research Group (ARG) has been actively engaged in critically needed alcohol and other drug-related public health research. We study drinking and other drug use and how these and other factors such as gender, race/ethnicity, sexual identity, socioeconomic disparities, and environmental differences affect health. ARG is also home to the NIAAA-funded National Alcohol Research Center and training program. Visit arg.org.
ARG is a program of the Public Health Institute, an independent nonprofit organization, dedicated to promoting health, well-being, and quality of life for people throughout California, across the nation and around the world. Visit phi.org.
