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

J Racial Ethn Health Disparities. 2024 Oct;11(5):2945-2957. doi: 10.1007/s40615-023-01753-9. Epub 2023 Aug 21.

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.

Keywords: Alcohol dependence; Illicit drug dependence; Nicotine dependence; Psychological distress; Racial disparities; Veterans.

MeSH terms

  • Adolescent
  • Adult
  • American Indian or Alaska Native / psychology
  • Asian / psychology
  • Black or African American / psychology
  • Cross-Sectional Studies
  • Ethnicity / psychology
  • Female
  • Health Status Disparities*
  • Hispanic or Latino / psychology
  • Humans
  • Male
  • Middle Aged
  • Psychological Distress
  • Substance-Related Disorders* / epidemiology
  • Substance-Related Disorders* / ethnology
  • United States / epidemiology
  • Veterans* / psychology
  • White / psychology
  • Young Adult