Disparities in patterns of alcohol use among reservation-based and geographically dispersed American Indian populations

Background: High rates of alcohol use and alcohol-related morbidity and mortality among American Indians (AI) are major public health concerns. The purpose of this paper is to describe patterns of alcohol consumption among three distinct samples of American Indians (AIs) compared to a U.S reference population. Methods: Data were drawn from two epidemiologic studies: 1) a study of 2,927 AIs living on or near reservations from two culturally distinct tribes in the Southwest (SW-AI) and Northern Plains (NP-AI); and 2) the National Longitudinal Alcohol Epidemiologic Study (NLAES), which included data from a geographically dispersed sample of AIs (n = 780) as well as the US reference population (all-race excluding AIs, n = 30,063). Multivariate analyses were used to assess drinking patterns. Results: After controlling for demographic characteristics, the prevalence of drinking during the past year was similar among males in the NP-AI, NLAES-AI and the US populations. SW-AI males and females were significantly less likely to drink during the past year (Odds Ratios of 0.74 and 0.41, respectively), while the odds of NP-AI females being current drinkers were twice that of US females. Among those who drank during the past year, the AIs consumed a larger quantity of alcohol per drinking day than the US reference population. However, the reservation-based AIs consumed alcohol less frequently (Odds Ratios between 0.18-0.40,p < 0.01) than the NLAES-AI and US populations. Conclusions: Patterns of alcohol consumption varied substantially between the two reservation-based AI populations, the geographically dispersed sample of AIs, and the US reference population. Careful consideration of these variations may improve the effectiveness of alcohol prevention and treatment programs as they may reflect important underlying differences in the cultures of alcohol consumption across these populations.