Method: This study included a large sample of veterans receiving VA healthcare in FY1998-2000, who also completed the 1999 LHSV (total N=19,959). Survey items assessed the self-report of race/ethnicity, past-month frequency of binge drinking (drinking five or more drinks in one setting), socio-demographic characteristics, and SF-36 physical and mental health summary measures. Survey data were linked to healthcare administrative records to identify indicators of poor health (e.g. service-connected disability, and drug use disorder) and prior VA healthcare use (in FY98). The binge drinking item was categorized to reflect SAMHSA heavy drinking criteria. Bivariate and multivariate tests identified risk factors for past-month heavy drinking among blacks, Hispanics, whites, and Native Americans.
Results: Blacks exhibited the highest rates (22.3%) of past-month heavy drinking, followed by Hispanics (18.0%), Native Americans (15.3%), and whites (14.6%; p <.001). Adjusting for sociodemographic and clinical characteristics, logistic regressions found in comparison to whites, blacks (OR=1.45; 95% CI=1.27-1.64) and Hispanics (OR=1.25; CI=1.04-1.52) were at increased risk of heavy drinking. Separate adjusted regression models examining within-group risks showed that significant risk factors for heavy drinking differed across racial/ethnic groups. Prior mental health treatment decreased risk for all groups. Physical health, older age, being unmarried, and female gender were associated with a decreased risk, whereas a drug use diagnosis increased risk. For only whites, higher education decreased risk, and being employed increased risk.
Conclusions and Implications: Blacks and Hispanics were at highest risk for past-month heavy drinking in adjusted analyses. Across racial/ethnic groups, receiving mental health care in the year prior to being surveyed was associated with a decreased risk of heavy drinking. This finding raises the possibility that general mental health care may offer benefit to heavy drinkers, although additional research is needed to explore this issue. Longitudinal surveys may help determine if a temporal relationship exists between the receipt of mental health care and decreased heavy drinking. Although differences in risk factors existed across racial/ethnic groups, future studies with larger samples are needed to confirm those findings.