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Exploring Racial/Ethnic Disparities in Substance Dependence and Serious Psychological Distress among US Veterans

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Abstract

Objectives

There are substantial racial/ethnic disparities in substance use and mental health among civilian populations, but few studies have examined these disparities in veterans using a nationally representative sample. Thus, we examined differences in substance dependence and serious psychological distress (SPD) by race/ethnicity among a national sample of US veterans.

Methods

We pooled cross-sectional data from the 2015–2019 waves of the National Survey on Drug Use and Health (N = 7,653 veterans aged 18–64 years). Regression models were utilized to examine racial/ethnic differences in DSM-IV substance dependence and SPD with a Benjamini–Hochberg correction applied.

Results

Compared to non-Hispanic White veterans: American Indian/Alaska Native veterans had significantly higher odds of past-year alcohol dependence (AOR = 2.55, 95% CI: 1.28, 5.08); Asian American veterans had significantly lower odds of past-year alcohol dependence (AOR = 0.12, 95% CI: 0.02, 0.62); non-Hispanic Black (AOR = 0.60, 95% CI: 0.48, 0.77), Hispanic (AOR = 0.47, 95% CI: 0.34, 0.65), and veterans of more than one race (AOR = 0.55, 95% CI: 0.36, 0.83) had significantly lower odds of past-month nicotine dependence; Asian American veterans had significantly lower odds of past-year illicit drug dependence (AOR = 0.05, 95% CI: 0.01, 0.35); and non-Hispanic Black veterans had significantly lower odds of past-year SPD (AOR = 0.69, 95% CI: 0.55, 0.85) after correction for multiple comparisons.

Conclusion

Overall, racial/ethnic disparities in substance dependence and SPD among veterans are not as stark as in civilian populations, but some disparities remain.

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Data availability

All data generated or analyzed during this study are included in this published article and the Open Science Framework.

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Acknowledgements

The authors would like to acknowledge the peer-reviewers as well as individuals who commented on early versions of the manuscript.

Funding

This work was supported by the National Institute of Health’s Initiative for Maximizing Student Development Program (T32,5R25GM095459-10) to Dr. Margarita L. Dubocovich; Centers for Disease Control and Prevention (R01-CE003144) to Drs. Linda S. Khan and Gregory G. Homish; the National Institute on Drug Abuse (R01-DA034072) to Dr. Gregory G. Homish; and the National Center for Advancing Translational Sciences (UL1TR001412) to Dr. Timothy Murphy. Research reported in this paper is also supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under award number T32AA007583 to Dr. Gregory G. Homish and Dr. Kenneth Leonard. This research is also supported by the National Institute on Drug Abuse award number R01DA034072 to Dr. Gregory G. Homish and by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001412 to the University at Buffalo. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Graduate Research Assistant, Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY, USA

    Schuyler C. Lawson & Mehreen Arif

  2. Assistant Professor, Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana-Champaign, Champaign, IL, USA

    Rachel A. Hoopsick

  3. Project Director, Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY, USA

    D. Lynn Homish

  4. Professor and Chair, Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY, USA

    Gregory G. Homish

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Contributions

Schuyler Lawson and Rachel Hoopsick conceptualized the project, the design of the study, the analysis of the results, and the writing of the manuscript. Mehreen Arif contributed to writing and editing the manuscript revisions. All other co-authors discussed the results and contributed to the final manuscript by providing extensive feedback.

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Correspondence to Schuyler C. Lawson.

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Lawson, S.C., Arif, M., Hoopsick, R.A. et al. Exploring Racial/Ethnic Disparities in Substance Dependence and Serious Psychological Distress among US Veterans. J. Racial and Ethnic Health Disparities (2023). https://doi.org/10.1007/s40615-023-01753-9

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