May 20, 2010

Substance Use among Asian Adults

Over the past several decades, the population of the United States has become increasingly diverse. According to the U.S. Census Bureau, about one third of the population belongs to a racial/ethnic minority group; this percentage is projected to increase to 54 percent by 2050.¹ As the country becomes more diverse, it becomes increasingly important to address health and health care disparities related to race/ethnicity, as well as age and gender, socioeconomic status, geography, and disability. The Nation's success in reducing these disparities today, to a large extent, will determine the health of our Nation tomorrow.

One area of concern is assessing substance use and abuse and ensuring access to substance abuse treatment. Substance abuse affects millions of people every year and imposes untold health, social, and economic costs on individuals, families, and communities. Although it affects people in all racial/ethnic groups, research has shown that there is considerable variation among these groups. Gaining a better understanding of the behavioral health needs of particular racial/ethnic groups can help inform public health policy, build prevention and treatment programs that target the different needs of these populations, and expand access to services for individuals who need them.

This report uses data from the National Survey on Drug Use and Health (NSDUH) to examine substance use and treatment need among non-Hispanic Asian (hereafter referred to as Asian) adults aged 18 or older.² Other reports in this series will examine similar issues among Asian adolescents and among adults and adolescents in other racial/ethnic groups. According to the U.S. Census Bureau, 13 million people—4.4 percent of the total U.S. resident population in 2008—identify themselves as non-Hispanic Asians of one race.³ This report is based on NSDUH data from 2004 to 2008.

Combined 2004 to 2008 data indicate that almost one in four (24.0 percent) Asians reported being Asian Indian, 23.1 percent were Chinese, 21.1 percent were Filipino, 8.9 percent were Japanese, 7.7 percent were Vietnamese, and 7.6 percent were Korean.

About one fifth of Asian adults (19.1 percent) were born in the United States.⁴ U.S.-born Asian adults tended to be younger than those born in other countries; for example, 35.1 percent of Asian adults born in the United States were aged 18 to 25 compared with 11.6 percent of Asian adults born abroad.

Nearly one seventh of Asian adults (13.3 percent) were without health insurance, a percentage lower than the national average of 15.0 percent for adults.⁵

Combined 2005 through 2008 data indicate that the poverty rate among Asians did not differ significantly from the national average (11.5 and 10.9 percent, respectively).⁶

Among Asian adults, rates of past month alcohol use, binge alcohol use, and illicit drug use in combined 2007 and 2008 were not significantly different from rates in combined 2004 and 2005 (Figure 1).^{7, 8}

Figure 1. Past Month Substance Use among Asians Aged 18 or Older: 2004-2005 versus 2007-2008

Combined 2004 to 2008 data indicate that, in the past month, 39.8 percent of Asian adults used alcohol, 13.2 percent engaged in binge alcohol use, and 3.4 percent used an illicit drug (Figure 2). Rates of past month alcohol use, binge alcohol use, and illicit drug use were lower among Asian adults than the national averages for adults.

Figure 2. Past Month Substance Use among Asians Aged 18 or Older Compared with the National Average: 2004 to 2008

Substance use varied greatly among Asian subgroups. Past month alcohol use ranged from a high of 51.9 percent among Korean adults to a low of 32.1 percent among Asian Indian adults (Figure 3). Past month binge alcohol use ranged from a high of 25.9 percent among Korean adults to a low of 8.4 percent among Chinese adults, and illicit drug use ranged from a high of 6.2 percent among Japanese adults to a low of 2.1 percent among Chinese and Asian Indian adults.

Figure 3. Past Month Substance Use among Asians Aged 18 or Older, by Asian Subgroup: 2004 to 2008

Among Asian adults, those who were born in the United States had higher rates of past month alcohol use, binge alcohol use, and illicit drug use than those who were not born in the United States (Table 1). These patterns held within each age group for which estimates could be generated, although not all differences were statistically significant.

Rates of past month alcohol use, binge alcohol use, and illicit drug use were considerably lower among young Asian adults than the national average for young adults (48.5 vs. 61.1 percent, 25.7 vs. 41.6 percent, and 9.1 vs. 19.7 percent, respectively) (Figure 4).

Figure 4. Past Month Substance Use among Young Asian Adults Aged 18 to 25 Compared with the National Average: 2004 to 2008

Compared with the national averages for adult females, adult Asian females had lower rates of past month alcohol use, binge alcohol use, and illicit drug use (Table 2). This pattern held within most age groups.

Compared with the national averages for adult males, adult Asian males had lower rates of past month alcohol use, binge alcohol use, and illicit drug use (Table 3). This pattern held within most age groups, and most comparisons were statistically significant.

Uninsured Asian adults were less likely than the national average for uninsured adults to have used alcohol in the past month (35.2 vs. 52.3 percent), to have binged on alcohol in the past month (18.6 vs. 33.1 percent), and to have used illicit drugs in the past month (6.6 vs. 15.1 percent) (Figure 5).

Figure 5. Past Month Substance Use among Asians Aged 18 or Older Who Were Uninsured Compared with the National Average: 2004 to 2008

The rates of past month binge alcohol use and illicit drug use among Asian adults living in poverty were lower than the national average for adults living in poverty (13.0 vs. 25.2 percent and 5.8 vs. 11.7 percent, respectively); the rate of past month alcohol use among Asian adults living in poverty, however, did not differ significantly from the national average (Figure 6).

Figure 6. Past Month Substance Use among Asians Aged 18 or Older Living in Poverty Compared with the National Average: 2005 to 2008

Combined 2004 to 2008 data indicate that an estimated 451,000 Asian adults—4.8 percent—were classified as being in need of treatment for a substance use problem in the past year.⁹ This rate was lower than the national average of 9.6 percent for adults. Of Asian adults in need of substance use treatment in the past year (28,000 persons), 1 in 16 (6.1 percent) received it at a specialty facility.¹⁰ Although this rate appears lower than the national average (10.4 percent), the difference is not statistically significant.

As the Federal Government and States move forward with the interrelated tasks of reducing disparities and reforming health care, it will be important to monitor data on substance use and treatment need among racial/ethnic minorities. The findings in this report highlight variations in substance use and treatment need between Asian adults and adults in the Nation as a whole and suggest subgroups that may benefit from increased attention from the prevention and treatment systems.