Résumé :
|
[BDSP. Notice produite par INIST-CNRS tR0xuyh7. Diffusion soumise à autorisation]. Objectives : While lower socioeconomic status (SES) is related to higher risk for alcohol dependence, minority race-ethnicity is often associated with lower risk. This study attempts to clarify the nature and extent of social inequalities in alcohol dependence by investigating the effects of SES and race-ethnicity on the development of alcohol dependence following first alcohol use. Design : Cross-sectional analysis of data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=43 093). Survival analysis was used to model alcohol dependence onset according to education, race-ethnicity and their interaction. Setting : United States, 2001-2. Results : Compared with non-Hispanic white people, age-adjusted and sex-adjusted risks of alcohol dependence were lower among black people (odds ratio (OR)=0.70,95% confidence interval (Cl)=0.63 to 0.78), Asians (OR 0.65, Cl=0.49 to 0.86) and Hispanics (OR=0.68, Cl=0.58 to 0.79) and higher among American Indians (OR=1.37, Cl=1.09 to 1.73). Individuals without a college degree had higher risks of alcohol dependence than individuals with a college degree or more ; however, the magnitude of risk varied significantly by race-ethnicity (X2 for the interaction between education and race-ethnicity=19.7, df=10, p=0.03) ; odds ratios for less than a college degree were 1.12,1.46,2.24,2.35 and 10.99 among Hispanics, white people, black people, Asians, and American Indians, respectively. There was no association between education and alcohol dependence among Hispanics. Conclusions : Race-ethnicity differences in the magnitude of the association between education and alcohol dependence suggest that aspects of racial-ethnic group membership mitigate or exacerbate the effects of social adversity.
|