How African-American Drinking Patterns Are More Deadly

In alcohol research circles, it's known as the J-shaped curve. It demonstrates the relationship difference in mortality rates for non-drinkers, moderate drinkers, and heavy drinkers.

In several studies over the years, moderate drinkers have shown a lower mortality risk than lifetime abstainers, while heavy drinkers show a higher mortality rate the both of the other two groups.

If you chart the mortality rates of the groups along a scale from non-drinkers on the left, to moderate drinkers to heavy drinkers, the resulting chart would look much like the letter "J."

What the chart is reported to show is the protective health effects of moderate alcohol consumption, particularly when the alcohol is red wine. This had led some researchers to speculate that it may be other ingredients in the red wine—specifically resveratrol—that holds the health benefits, rather than the alcohol itself.

Regardless, here at the Verywell.com Alcoholism site, we have not reported on any studies that show any beneficial aspects of drinking alcohol. After all, it's the alcoholism site, not the alcohol site. We wouldn't want to encourage anyone who currently is not drinking to take up the habit.

Besides, there are some studies that dispute the findings of protective health effects of moderate alcohol consumption. One such study found clearly that those beneficial effects do not extend to everyone, particularly African-American drinkers.

University of Buffalo researchers, examining the drinking patterns and mortality rates of more than 2,000 African-Americans over a 20-year period, found that blacks experience no protective health effects from moderate alcohol consumption.

"One of the most discussed findings in alcohol epidemiology is the J-shaped curve," said Christopher T. Sempos, professor and director of graduate studies in the department of social and preventive medicine at the University of Buffalo. "Essentially, what it tells us is that some kind of drinking is beneficial to health."

"In our study, however, this beneficial effect could not be found in African-Americans, even when using the same study where the beneficial effect had been found for whites," Sempos said.

The Buffalo researchers believe that the pattern of drinking and preferences of the types of alcohol consumed that contribute to the lack of moderate drinking benefits for blacks.

"We believe that patterns of drinking - that is, the style of how alcohol is consumed - explain the differences between African-Americans and whites. For example, somebody can have an average moderate volume by drinking heavily once or twice a week."

The researchers returned to results from the National Health and Nutrition Examination Survey which collected data from 14,407 adults age 25 to 75 during the years from 1971 to 1975, with follow-up surveys conducted in four waves extending to 1992.

The NHANES Epidemiologic Follow-up Study (NHEFS) comprised 20 years of follow-up data. The Buffalo researchers examined the data from 2,054 African-Americans - 768 men and 1,286 women.

"This study clearly demonstrates an absence of a protective effect at lower volumes of consumption in a large sample of African-Americans followed over a long period of longitudinal follow-up," said Tom Greenfield, center director at the Alcohol Research Group. "Given that the protective effect of the J-shaped mortality curve is seen in the same large NHANES/NHEFS study for white respondents, the absence of this effect in the African-Americans is striking."

The study found that many African-Americans drank less often than whites, but often drank in large amounts when they did drink, compared to the white participants in the same study.

The researchers noted that all alcohol carries the same risks regardless of what type of alcohol it is because the content of ethanol is the same. But, they said, there are cultural differences in how some types of alcohol are consumed.

"For example," Sempos said, "Grape wine is most often consumed moderately and regularly with meals. If consumed in irregular binges outside meals, however, the same amount of alcohol may be much more detrimental."

"In fact, such a drinking style has no beneficial health outcomes. We know that African-Americans have more binge drinking than whites or Hispanics. In addition, in some subgroups, such as those that are socioeconomically disadvantaged, special kinds of drinks like Malt Liquor that come in large serving sizes prevail."

During the late 1980s and early 1990s, the United States experienced what the researchers called a "drying" trend during which frequent, heavy drinking declined among both white men and women. The same declining trend was not seen among blacks and Hispanics.

Other studies have found that blacks and Hispanics suffer the consequences of larger containers and higher alcohol-content products that are marketed specifically to their ethnic groups, which has been linked to higher rates of cirrhosis among those groups, compared with whites.

The Alcohol Research Group researchers suggest that prevention efforts focused on reducing the average consumption of alcohol focus instead on drinking patterns.

"For African-Americans in particular," said Greenfield, "we need to develop evidence-based interventions, health messages and other prevention programs that will reinforce the acceptability of drinking in smaller amounts while emphasizing the health and social harms of drinking larger amounts."