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Five Questions With Judith Arroyo, Ph.D., NIAAA’s Minority Health and Health Disparities Initiatives Coordinator

1. Do you believe the alcohol research field pays sufficient attention to issues facing minority populations?

Yes and no. Under-represented minorities (URMs) will comprise the majority of the U.S. population by the year 2050. In fact, as of last year, there were more URM babies under age 1 than White babies under age 1 in the United States. Clearly, we need to rapidly and substantially increase our knowledge about health disparities in URMs to avoid major public health problems. To date, we have made important strides in some areas, but not in others. For example, we have considerable epidemiologic data on Hispanics and African Americans but less reliable information on American Indians/Alaska Natives (AI/AN) and Asian Americans. In the area of prevention, we don’t have any research on Asian Americans at all. Then, there’s the question of research depth. We need more projects that drill down beyond racial and ethnic labels to investigate differences within ethnic groups, such as those associated with gender, place of birth, national origin, and level of acculturation. Understanding these nuances will give us a sharper and more comprehensive picture of alcohol trends in different minority communities. NIAAA is funding several studies and young investigators in these areas, but we still have a way to go. And that’s the bottom line here overall—we are making progress, but there is still a lot more work to be done.

2. What are the benefits of having scientists from racially and ethnically diverse backgrounds working on this research?

Diverse, multicultural researchers can facilitate this type of research in many ways. Look at research design, for example. URM investigators tend to ask culturally informed questions that enhance the creativity and focus of the research. They are more likely to integrate culturally relevant issues that, while obvious to someone from a given culture, may not be evident to an outsider. When URMs are part of the review groups that evaluate grant proposals, they can offer a unique perspective on the innovation and significance of the proposed minority-focused research. Consider, too, the problem of clinical trial participation. Scientists everywhere are struggling to recruit individuals for studies, and URM-focused research is no exception. Language and cultural barriers add to these challenges. However, the presence of URMs on research staffs can help minority individuals feel more comfortable with the research environment and, therefore, be more likely to participate as subjects. Finally, we need to consider the continuity and long-term future of URM research. Having URM investigators in key research roles allows them to identify and mentor promising URM students to join the next generation of investigators. For all these reasons, increasing URM representation in research projects is critical to building the necessary knowledge base about these issues.

3. Are there any notable trends in alcohol use among minority communities?

Yes, quite a few bear watching. First, let’s look at the big picture—overall drinking rates. Although there is considerable variability across surveys, it appears that AI/ANs have the highest overall rates of alcohol abuse and dependence, followed by non-Hispanic Whites, then Hispanics, African Americans, and Asian Americans. A separate, but very important measure is “new cases” or incidence of alcohol dependence, which can help predict future trends and identify new problem areas. By this measure, the rate is lowest among Asian Americans and non-Hispanic Whites.

Incidence rates are higher for Hispanics, African Americans, and AI/ANs; these groups may also have more persistent or recurrent alcohol problems than other URMs. Other interesting trends are grounded in gender differences. Historically, minorities have had large gender gaps in alcohol use, with women drinking much less than men or abstaining altogether. But this gender gap seems to be disappearing, at least among Hispanic young women. Recent Monitoring the Future data shows Hispanic high school girls are drinking as much, or in some instances more, than their male counterparts.

4. Where do you see the research heading?

In the coming years, URM research at NIAAA will focus on collaborations, technical assistance, and attention to the alcohol-related issues of specific minority groups. Sometime this year, we hope to undertake a review of minority health and health disparities addiction research, supported by NIAAA and the National Institute on Drug Abuse, to determine how to direct our resources more collaboratively. There’s also a lot of interest in developing cultural adaptations of existing evidence-based prevention and treatment interventions. By extension, we also will focus on capacity building in minority communities. For example, for the past 3 years, NIAAA has partnered with other Institutes and the NIH Office of Behavioral and Social Sciences Research on outreach and technical assistance workshops for AI/AN communities. Fortunately, we are beginning to see the fruits of these efforts, and expect to see many more innovative and high-quality grant proposals to study this population. And finally, we need to address some of our knowledge gaps. For example, although Asian Americans may have relatively lower rates of AUDs, problems (many of them unique to this group) still exist, so we hope to increase research focused on this community.

5. What would we be surprised to learn about you?

I was born and raised until age 6 in El Paso, Texas, where everyone I knew spoke Spanish. When people hear that English was not my first language, they often are surprised that I do not have a marked Spanish accent. I tell them that I did have an accent when I left Texas; that is, I spoke English with a Texas drawl, which I quickly made all efforts to lose!