Alcohol Use Disorder and Suicidal Thoughts: Racial and Ethnic Differences

A new study examined racial and ethnic differences in the likelihood a patient with alcohol use disorder (AUD) would be diagnosed with suicidal thoughts and hospitalized during an emergency department visit.

Researchers used data from the 2019 Healthcare Cost and Utilization Project’s National Emergency Department Sample. The sample included 33.1 million visits at 989 emergency departments in 40 states. Of these visits, 45% involved males and the mean patient age was 41.8. The racial and ethnic breakdown was as follows: White (54.5%), AI/AN (0.5%), Black (20.6%), Hispanic (16.3%), Asian/PI (2.1%), and Other (3.6%).

The researchers found that American Indian and Alaska Native, Black, and Hispanic patients with AUD were less likely to be diagnosed with suicidal thoughts and hospitalized than White patients. Among all groups in the study, American Indian and Alaska Native patients had the lowest hospitalization rates. 

The authors hypothesized that implicit bias or stereotyping by providers as well as hospital characteristics (facility teaching status, trauma level designation, urban-rural designation, and type of owner) may have contributed to the differences. Other research studies have found  that people of color are less likely to be diagnosed with mental illness than White patients. A 2021 study that compared non-Hispanic White and non-Hispanic American Indian patients hospitalized for dual diagnosis and alcohol/nicotine use disorders found that Native American patients were much less likely to receive a mental illness diagnosis.¹ 

This study highlights the need for culturally appropriate emergency department services, especially for American Indian and Alaska Native patients. It also indicates a need for ongoing research and evaluation to identify racial and ethnic disparities in emergency department services, and social and structural factors that contribute to these disparities.

Cunningham, J. K., Solomon, T. G. A., Ritchey, J., & Weiss, B. D. (2023). Alcohol use disorder visits and suicide ideation diagnosis: Racial/ethnic differences at emergency departments. American Journal of Preventive Medicine. Advance online publication. https://doi.org/10.1016/j.amepre.2023.06.011

References

1. Cunningham, J. K., Solomon, T. G., Ritchey, J., & Muramoto, M. L. (2021).  Dual diagnosis and alcohol/nicotine use disorders: Native American and White hospital patients in 3 States. American Journal of Preventive Medicine, 62(2), 107-116.