Cited by 366Substance Abuse Treatment and OutcomesRacial and Ethnic Identity ResearchAlcohol Consumption and Health Effects

The DOI matches its Crossref record; 296 of the 297 references it cites were found in a registry or an index; none of the 309 sources its claims cite is checked for support yet.

Less drinking, yet more problems: understanding African American drinking and related problems

Open access

Abstract

Researchers have found that, compared to European Americans, African Americans report later initiation of drinking, lower rates of use, and lower levels of use across almost all age groups. Nevertheless, African Americans also have higher levels of alcohol problems than European Americans. After reviewing current data regarding these trends, we provide a theory to understand this apparent paradox as well as to understand variability in risk among African Americans. Certain factors appear to operate as both protective factors against heavy use and risk factors for negative consequences from use. For example, African American culture is characterized by norms against heavy alcohol use or intoxication, which protects against heavy use but also provides within-group social disapproval when use does occur. African Americans are more likely to encounter legal problems from drinking than European Americans, even at the same levels of consumption, perhaps thus resulting in reduced consumption but more problems from consumption. There appears to be one particular group of African Americans, low-income African American men, who are at the highest risk for alcoholism and related problems. We theorize that this effect is due to the complex interaction of residential discrimination, racism, age of drinking, and lack of available standard life reinforcers (e.g., stable employment and financial stability). Further empirical research will be needed to test our theories and otherwise move this important field forward. A focus on within-group variation in drinking patterns and problems is necessary. We suggest several new avenues of inquiry.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review documents that African Americans report lower alcohol use and higher abstinence than European Americans but nonetheless experience more alcohol-related problems. It proposes an integrative theory in which cultural, historical, religious, parental, environmental, and genetic factors can protect against heavy use while also increasing risk for negative consequences, with low-income African American men at highest risk.

Key findings

  • African Americans report lower alcohol use across development: youth past-30-day use was 10% vs. 18% for European Americans and lifetime use 34% vs. 42%; young adults reported current drinking 49.6% vs. 67.7%, binge drinking 27.9% vs. 46.1%, and heavy drinking 5.7% vs. 17.3%; adults ages 26–70 reported current/past-30-day drinking 46.6% vs. 59.4%, binge drinking 20.5% vs. 22.2%, and heavy drinking 4.9% vs. 6.9%.
  • Despite lower use, African Americans experience more alcohol-related problems: Mulia et al. found low-to-moderate heavy drinkers were three times more likely to report negative social consequences and five times more likely to report dependence symptoms than European Americans with similar drinking patterns; liver cirrhosis mortality was 1.27 times more likely among African Americans than European Americans, and alcohol-related disease/disorder mortality was 10% higher.
  • Proposed explanations include conservative drinking norms, parental monitoring, religiosity, racial socialization, and the ADH1B*3 allele as protective against heavy use, but these can also produce within-group social disapproval, legal consequences, and stronger alcohol responses; environmental risks include eight times as many liquor stores per capita in African American communities after controlling for socioeconomic status, and African American men underestimated intake by 31% with a mean drink alcohol content of 0.79 oz vs. 0.66 oz for European American men.
  • The paper identifies low-income African American men as the highest-risk subgroup and theorizes this via limited access to standard life reinforcers: poverty was 23% vs. 8% for European Americans, unemployment twice as high, unemployment among 20-year-old high school dropouts 62.8% vs. 24.5%, and job callbacks 14% vs. 34% without a criminal record and 5% vs. 17% with a criminal record.

Methods

  • Narrative/integrative review and theoretical paper; no new empirical data are collected. It reviews historical, cultural, social, biological, and behavioral literature to answer why African Americans drink less, why they experience more consequences, and which African American subgroup is at greatest risk.
  • Synthesizes findings from national randomized samples and community convenience samples, with tables referenced as listing reviewed studies.
  • Main analysis is conceptual synthesis, including an application of behavioral choice theory and standard life reinforcers (SLRs) to explain risk among low-income African American men; no statistical meta-analysis is reported.

Limitations

  • The paper states that further empirical research is needed to test its theories; there have been too few studies of individual differences within African Americans, many individual-difference studies used community-based convenience samples, no large-scale genetic study has directly tested ADH1B*3 with consumption, and no longitudinal study has examined low-income African American men across development.
  • The paper states that its central hypothesis about limited SLR access contributing to problem drinking among poor African American men has not been tested.
  • Evident from the text: as a narrative review, no systematic search strategy, inclusion criteria, or quality appraisal is described, and the tables referenced in the text are not included in the provided material.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1037/a0032113

Cites

296 of 296 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

192 Not checked yet · 52 Own interpretation · 14 No basis given

Verify all 309 references — free account

Show all 169 claims

  • It may state two separate claims as one. 72
  • Probably not a substantial claim. 19
  • The quote only partly states this claim. 1
89 of 89
  • The paper relies on this without support.

    No integrative theory has been developed to explain why African Americans tend to drink less than European Americans but experience higher rates of problems.

    “no integrative theory has been developed to explain why African Americans tend to drink less than members of the dominant, European American culture, but experience higher rates of problems.”
  • The paper relies on this without support.

    Most research has been conducted using a comparative research design, failing to examine individual differences within the African American community.

    “most research has been conducted using a comparative research design, comparing the rate of African American use to that of the standard European American majority, thus failing to examine or explain individual differences in consumption or risk within the African American community.”
  • The paper relies on this without support.

    No large scale genetic study has been conducted among African Americans to directly test the hypothesis that ADH1B*3 is associated with lower consumption per occasion, reduced frequency of consumption, or less frequent binge or heavy drinking.

    “To date, no large scale genetic study has been conducted among African Americans to directly test the hypothesis that the presence of ADH1B*3 is associated with lower consumption per occasion, reduced frequency of consumption, or less frequent membership in binge drinker or heavy drinker groups.”
  • The paper relies on this without support.

    Racial inequities cause distress among lower-income African American men.

    “the experiences of distress associated with racial inequities”
  • The paper relies on this without support.

    Limited access to standard life reinforcers is not likely to improve with age for low-income African American men.

    “the limited access to SLRs is not likely to improve with age”
5 of 5

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Citations

Cites

Show all 297 references

Research works printed but not linked: 15

  1. Belgrave FZ Townsend TG Cherry VR Cunningham DM The influence of an Africentric world-view and demographic variables on drug knowledge, attitudes, and use among African American youth Journal of Community Psychology 1997 25 421 433
  2. Broman C Perceived discrimination and alcohol use among Black and White college students Journal of Alcohol and Drug Education 2007 51 8 16 Retrieved from http://www.unomaha.edu/~healthed/JADE.html
  3. Brook JS Brook DW Pahl K Liddle HA Row CL The developmental context for adolescent substance use intervention Adolescent substance abuse: Research and clinical advances 2006 New York: NY Cambridge University Press 25 51
  4. Feagin JR Feagin CB Racial and Ethnic Relations 1999 6th Ed. Upper Saddle River, NJ Prentice Hall
  5. Fiske ST Taylor SE Social Cognition 1991 New York, NY McGraw Hill
  6. Hesselbrock VM Hesselbrock MN Miller KM Carroll WR Developmental perspectives of the risk of developing substance problems Rethinking substance abuse: What the science shows, and what we should do about it 2006 New York, NY Guilford Press 97 114
  7. James SH Johnson SL Doing drugs: Patterns of African American addiction 1996 Austin, TX University of Texas Press
  8. Levin JS Taylor RJ Gender differences in religiosity over the life cycle among Black Americans The Gerontologist 1993 33 16 23 8440497
  9. Lincoln CE Harris HW Blue HC Griffith EEH Black religion and racial identity Racial and ethnic identity: Psychological development and creative expression 1995 New York, NY Routledge 209 211
  10. Martin JK Tuch SA Roman PA Dixon J Patterns of problem drinking among employed African American men: Preliminary results from a national study Challenge: A Journal of Research on African-American Men 2004 11 33 66
  11. McKay NY Personal Narratives Group Nineteenth-century Black women’s spiritual autobiographies: Religious faith and self-empowerment Interpreting women’s lives: Feminist theory and personal narratives 1989 Bloomington, IN University Press 139 154
  12. Sher KJ Children of alcoholics: A critical appraisal of theory and research 1991 Chicago, IL University of Chicago Press
  13. Spillane NS Smith GT Kahler CW Perceived access to important reinforcers as a function of alcohol consumption among American Indians Alcoholism: Clinical and Experimental Research (in press) PMC4068243 22823415
  14. Stewart C Power TG Ethnic, social class, and gender differences in adolescent drinking: Examining multiple aspects of consumption Journal of Adolescent Research 2003 18 575 598
  15. Wilson WJ The truly disadvantaged 1987 Chicago University of Chicago Press

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Metadata

Authors
Zapolski, T. C. B., Pedersen, S. L., McCarthy, D. M., & Smith, G. T.
Affiliations
  • University of Kentucky (US)
  • University of Pittsburgh (US)
  • University of Missouri (US)
Venue
Psychological Bulletin
Published
2014-01
Volume
140
Issue
1
Pages
188-223
ISSN
  • 0033-2909 (ISSN-L)
  • 1939-1455
OpenAlex
W2068626373
Cited by
366
References
297
Citations by year
2026: 21 · 2025: 29 · 2024: 32 · 2023: 28 · 2022: 31 · 2021: 47 · 2020: 30 · 2019: 37 · 2018: 28 · 2017: 28 · 2016: 33 · 2015: 18 · 2014: 4
FWCI
13.36
Type
journal article
Language
en
Open access
Locations
  • Psychological Bulletin (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Alcohol Abuse and Alcoholism (R01 AA016166, F31 AA017571, T32 AA007453, K01 AA021135, R01 AA019546)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
alcohol problems, heavy drinking, alcoholism, housing discrimination, racism, within-group variation, risk and protective factors
MeSH terms
Alcohol Drinking, Alcoholism, Black or African American, Female, Humans, Male, Racism

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