Acculturation and drinking patterns among U.S. Hispanics.
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Biomedical subjects
Publications and source records attributed to R Caetano.
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Survey respondents' views about alcoholism as an illness, support for treatment, treatment recommendation and stigma surrounding alcoholics are examined. Subjects (N = 482) comprise a random sample of the population of Contra Costa County, California. About 91% of the respondents agree with the notion that alcoholism is an illness, but 40% also agree that alcoholics drink because they want to. More women than men support the idea that to recover alcoholics will have to quit drinking forever. The contrary is true of the idea of controlled drinking. Education and income are negatively associated with items on loss of control and controlled drinking. Respondents who have had their lives deeply affected by an alcoholic and those who report a drinking problem of their own do not differ in their opinions about alcoholism from those who do not have these characteristics. Alcoholics Anonymous is the most common form of treatment recommended by the respondents. In general, results show considerable support for treatment as well as ambivalence regarding the disease concept.
This paper examines the relationship between attitudes toward appropriate drinking and acculturation among U.S. Hispanics. Respondents comprise a multi-stage probability sample of the U.S. Hispanic population. A total of 1453 individuals were interviewed. The overall response rate is 72%. In accordance with previous findings establishing a positive association between drinking and acculturation, it was hypothesized that the more acculturated individuals would have more liberal attitudes, allowing more drinking especially for women. The results support this hypothesis. Generally, respondents who are more acculturated have more liberal attitudes independent of sex and age. However, these results are more consistent when attitudes refer to specific gender and age groups than when attitudes refer to specific drinking contexts.
This paper reviews the concepts of dependence on alcohol as embodied by the Alcohol Dependence Syndrome and as proposed in the Diagnostic and Statistical Manual of the American Psychiatric Association (D.S.M.-III). Evidence in support of the unidimensionality of this concept is still controversial, and the elements necessary to diagnose dependence under each of these two proposals are different. Alcohol Dependence in the D.S.M.-III has indicators of social and occupational impairment which are not part of the Alcohol Dependence Syndrome. Knowledge on the concept of dependence will advance more rapidly if researchers begin to develop comparative studies of these two models. Future work should also include studies in the general population, with women, ethnic minorities and cross-cultural research. Longitudinal research to establish the evolution of dependence both in clinical and general populations should also be developed.
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Self-reported intoxication among Hispanics in northern California was studied through three independent surveys of the general population conducted between 1977 and 1980 in three counties of the San Francisco Bay area. All of the surveys followed the same sampling plan and only probability techniques were employed. A total of 634 adult respondents who identified themselves as Hispanics served as subjects. In the sample, 20% of the men and 5% of the women reported becoming intoxicated at least once a month, rates twice as high as in the general U.S. population. Consistent with this increased frequency of intoxication, Hispanics also had attitudes toward intoxication more liberal than those found in another study of the California general population. Intoxication was more frequent among the young and among heavier drinkers, and it was also a significant predictor of alcohol-related problems. It is suggested that intoxication be studied carefully because of its association with alcohol-related problems.
The data for this research come from three independent community surveys conducted between 1979 and 1980 in the San Francisco Bay Area. All surveys followed the same sampling plan and only probability techniques were employed. Of a total of 4,150 adult respondents, 1,206 identified themselves as Blacks and are analyzed in this report. A total of 29% of the females and 16% of the males are abstainers. Frequent heavier drinkers comprise 22% of the males but only 6% of the females. Among males, heavier drinking and alcohol problems are highest among those in their thirties and, therefore, cannot be associated with a youthful lifestyle as it happens in the United States general population. Characteristics such as income, employment status, and education are not associated with drinking. Religion, however, is associated with drinking patterns, and Fundamentalists have significantly more abstainers and light drinkers than other religious groups. These findings are also discussed in the light of Black culture and minority status. It is suggested that drinking patterns among Blacks are influenced more by internal norms originated from common cultural and socio-political characteristics than from norms associated with class affiliations in the larger society.
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This research reports the drinking patterns and alcohol problems in three ethnic groups of the U.S. population: Whites, Blacks and Hispanics. Respondents were sampled randomly from the general population of three counties of the San Francisco Bay Area, in northern California. Both Black and Hispanic females have higher rates of abstention than White females, but at the aggregate level male's drinking patterns are similar across ethnic groups. However, among males the patterning of drinking and the prevalence of alcohol problems by age change dramatically according to ethnicity. Among White males drinking and problems decrease abruptly from the twenties to the thirties, as has been traditionally found in the U.S. general population. Among Black males the trend is exactly the opposite of that for Whites, while among Hispanic males there also is a decrease but not quite so large as that for Whites, and the frequency of heavy drinking and problems is always higher than for the other two groups. The types of problem reported by respondents do not vary by ethnicity but the sociodemographic correlates of both number of drinks consumed per month and number of alcohol problems do differ among the ethnic groups. Both Hispanics and Blacks have more liberal attitudes toward alcohol use than Whites. These results suggest that Whites, Blacks and Hispanics each have a characteristic way of using alcoholic beverages. The less restrictive views towards alcohol use in the Black and Hispanic culture, as well as the different patterning of drinking and problems by age, are of importance for prevention: Whites, Blacks and Hispanics have different groups of people at risk for developing alcohol problems and prevention should be planned accordingly.
The literature on drinking patterns and alcohol problems among Hispanic Americans is critically reviewed. The picture provided by studies which have been examined indirect indicators of alcohol problems is contradictory. Some results suggest that Hispanics in the U.S.A. are over-represented among alcohol-related deaths and among those arrested for drunk driving and in treatment in alcoholism programs. Other studies do not provide evidence of over-representation. Studies in the general population indicate that there is more heavy drinking and alcohol-related problems among Hispanics than among other ethnic groups in the U.S.A. general population. However, very few of these studies were specifically designed to evaluate alcohol use and problems among this ethnic group, and these results are based on the analysis of a small number of Hispanic respondents. In the conclusions this and other methodological limitations are discussed and new areas for study are proposed.
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The clinical Alcoholism Interview Schedule (CAIS) is being developed as a standardized instrument for initial assessment of alcoholic patients and as a research tool. Fifty questions cover key areas of clinical concern, and accompanying guidelines describe the method of administration. An initial study of inter-rater reliability has been conducted with five raters independently rating taped interviews with each of ten patients. Agreement was assessed both by percentage agreement and by weighted Kappa. Detailed results, which are presented, in general show a fairly satisfactory level of reliability except for certain identified items which include the Jellinek classification of type of alcoholism.
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This article reviews the clinical research conducted with U.S. Hispanics and discusses priorities for alcohol treatment research in this ethnic group. Specific areas in which research is needed include epidemiological descriptions of client characteristics, access and utilization of alcohol treatment, the structure of alcohol programs, pathways to treatment, alcohol dependence and treatment effectiveness, and treatment matching in alcohol treatment. Methodological requirements, research funding strategies, and professional training needed for implementing the research needs identified in the article are also discussed. A concerted effort by funding institutions is needed to emphasize the importance of this research, and an increased commitment of funds for research and professional training is necessary. Such funds should be earmarked for research with minorities and training for minority professionals.
This paper examines the diffusion of Jellinek's disease concept of alcoholism in Latin America and its impact on research and prevention in those countries. After Jellinek's visit to Chile in 1956, epidemiological research in that country received a great impulse. Marconi published a series of papers where he put forward concepts of alcoholism based on Jellinek's work. These ideas were well received by alcohol epidemiologists and became standard definitions employed in a series of epidemiological studies in Chile, Argentina, Peru, Brazil, Costa Rica, and Mexico. Since then the disease concept has been the main idea governing professionals' understanding of alcohol problems in Latin America.