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Lower education increases alcohol use disorder (AUD) odds for Black and American Indian/Native American adults. Employment and poverty did not mediate this association, suggesting other factors contribute to racial disparities in AUD.

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Area of Science:

  • Public Health
  • Epidemiology
  • Sociology

Background:

  • Lower educational attainment is a known risk factor for alcohol-related mortality.
  • The differential impact of education on alcohol use disorder (AUD) across racial and ethnic groups remains understudied.

Purpose of the Study:

  • To investigate the interaction between educational level and race/ethnicity on the odds of developing AUD.
  • To assess the mediating roles of employment and poverty in the relationship between education, race/ethnicity, and AUD.

Main Methods:

  • Utilized data from the 2016-2019 National Survey on Drug Use and Health (NSDUH) for adults aged 26 and older.
  • Employed multivariable logistic regression analyses, stratifying by four education levels (less than high school to 4-year college+).
  • Compared odds ratios (ORs) across racial/ethnic groups and assessed changes in ORs when including employment and poverty as covariates.

Main Results:

  • Alcohol use disorder (AUD) prevalence was highest among American Indian/Native Alaskans (8.06%), followed by non-Hispanic Whites (5.37%) and Blacks (5.09%).
  • Decreasing education levels significantly increased the odds of AUD among Black and American Indian/Native American individuals compared to non-Hispanic Whites.
  • Inclusion of employment and poverty status did not substantially alter the odds ratios, indicating minimal mediation or confounding effects.

Conclusions:

  • Lower educational attainment is a significant risk factor for increased odds of AUD among Black and American Indian/Native American populations.
  • Employment and poverty do not appear to be significant mediators of the observed disparities in AUD related to education and race/ethnicity.
  • Further research is needed to identify the underlying mechanisms driving racial and ethnic disparities in alcohol use disorder.