Racial/Ethnic and Gender Differences in Receipt of Brief Intervention Among Patients with Unhealthy Alcohol Use in the U.S. Veterans Health Administration

Abstract: Brief intervention (BI) for unhealthy alcohol use is a top prevention priority for adults in the U.S, but rates of BI receipt vary across patients. This paper examines BI receipt across race/ethnicity and gender in a national cohort of patients from the Department of Veterans Affairs (VA)—the largest U.S. integrated healthcare system and a leader in implementing preventive care for unhealthy alcohol use. Among 779,041 VA patients with documented race/ethnicity and gender who screened positive for unhealthy alcohol use between 10/1/09 and 5/30/13, the use of BI (documented advice to reduce or abstain from drinking) was examined across race/ethnicity and gender. The authors found Rates of BI were lowest among Black women (67%), Black men (68%), and Asian/Pacific Islander women (68%), and highest among white men (75%), Hispanic men (75%), and Asian/Pacific Islander men (75%). A significant race/ethnicity by gender interaction suggested that the associations between race/ethnicity and gender with BI depended on each other. Gender differences were largest among Asian/Pacific Islander patients but not among American Indian/Alaska Native patients. The authors conclude that receipt of BI for unhealthy alcohol use varied by race/ethnicity and gender, and the impact of one factor depended on the other. Black women, Black men, and Asian/Pacific Islander women had the lowest rates of receiving recommended alcohol-related care. They found these disparities in a healthcare system that has implemented universal alcohol screening and incentivized BI for all patients with unhealthy alcohol use, suggesting that reducing disparities in alcohol-related care may require targeted interventions.