ArticleThe American journal of psychiatry2023
Racial and Ethnic Bias in the Diagnosis of Alcohol Use Disorder in Veterans.
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Article in The American journal of psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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21citing papers in PubMed
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21 citing papers in PubMed, 37 citations in OpenAlex.
- Rates of Diagnosis and Treatment for Alcohol Use Disorder Among All of Us Participants with Unhealthy Alcohol Use.Journal of general internal medicine · 2026Article
- Article
- Ethnoracial inequities in social stressors and patterns of alcohol use in a population of United States transgender Veterans.Social science & medicine (1982) · 2025Article
- Denial of Personal Racial Discrimination and Its Impact Among People of Color Who Use Substances: Implications for Measuring Racial Discrimination in Substance Use Research.Journal of racial and ethnic health disparities · 2025Article
- Variations in documentation of alcohol use disorder (AUD) diagnoses across race, ethnicity, and sex in a health system that assesses AUD symptoms as part of routine primary care.Journal of substance use and addiction treatment · 2025Article
- Screening high-risk Veterans for cirrhosis: taking a stepwise population health approach.BMC health services research · 2025Article
- Modeling diagnostic code dropout of schizophrenia in electronic health records improves phenotypic data quality and cross-ancestry transferability of polygenic scores.medRxiv : the preprint server for health sciences · 2025Article
- Utility of Candidate Genes From an Algorithm Designed to Predict Genetic Risk for Opioid Use Disorder.JAMA network open · 2025Article
- Perspective on Using Artificial Intelligence in Alcohol Research and Treatment: Opportunities and Ethical Considerations.Alcohol research : current reviews · 2025Review
- Risk factors for harmful alcohol consumption: a multilevel analysis.Revista latino-americana de enfermagem · 2025Article
- Disparities in Treatment for Alcohol Use Disorder Among All of Us Participants.The American journal of psychiatry · 2024Article
- Incidence of Hospitalizations Involving Alcohol Withdrawal Syndrome in a Primary Care Population.JAMA network open · 2024Article
- Prevalence of alcohol use disorders documented in electronic health records in primary care across intersections of race or ethnicity, sex, and socioeconomic status.Addiction science & clinical practice · 2024Article
- Candidate Genes from an FDA-Approved Algorithm Fail to Predict Opioid Use Disorder Risk in Over 450,000 Veterans.medRxiv : the preprint server for health sciences · 2024Article
- Alcohol Use Disorder and Dementia: A Review.Alcohol research : current reviews · 2024Review
- Demographic differences in the cascade of care for unhealthy alcohol use: A cross-sectional analysis of data from the 2015-2019 National Survey on Drug Use and Health.Alcohol, clinical & experimental research · 2023Article
- Alcohol Consumption and Alcohol Use Disorder: Exposing an Increasingly Shared Genetic Architecture.The American journal of psychiatry · 2023Article
- Residence in a Medicaid-expansion state and receipt of alcohol screening and brief counseling by adults with lower incomes: Is increased access to primary care enough?Alcohol, clinical & experimental research · 2023Article
- Retrospective study of disparities in regional anesthesia and discharge opioid prescriptions at a veterans affairs medical center.F1000Research · 2023Article
- Cannabis Use Disorder Among People With and Without HIV.Journal of addiction medicineArticle
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Authors and funding
11 authors at 4 institutions in 2 countries.
Rachel Vickers-SmithMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
Amy C JusticeMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
William C BeckerMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
Christopher T RentschMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
Brenda CurtisMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
Anita FernanderMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
Emily E HartwellMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
Eseosa T IghodaroMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
Rachel L KemberMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
Janet TateMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
Henry R KranzlerMental Illness Research, Education, and Clinical Center, Veterans Integrated Service Network 4, Philadelphia (Vickers-Smith, Hartwell, Kember, Kranzler); Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington (Vickers-Smith); Department of Internal Medicine, Yale School of Medicine, New Haven (Justice, Becker, Tate); Department of Health Policy and Management, Yale School of Public Health, New Haven (Justice); Veterans Affairs Connecticut Healthcare System, West Haven (Justice, Becker, Rentsch, Tate); Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (Rentsch); National Institute on Drug Abuse Intramural Research Program, Baltimore (Curtis); Department of Integrated Medical Science, Florida Atlantic University, Boca Raton (Fernander); Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia (Hartwell, Kember, Kranzler); Department of Neurology, Mayo Clinic, Rochester, Minn. (Ighodaro).
University of Pennsylvania · USVA Connecticut Healthcare System · USLondon School of Hygiene & Tropical Medicine · GBUniversity of Kentucky · US
Funding
Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9MNIDA IRP Clinical Core support of the NIDA IRP HIV Clinical ProgramZIDDA000623 · NIDA · NATIONAL INSTITUTE ON DRUG ABUSE · PI LEGGIO, LORENZO · 2018 to 2025
$17.6MDigital Markers in Relapse and RecoveryZIADA000628 · NIDA · NATIONAL INSTITUTE ON DRUG ABUSE · PI CURTIS, BRENDA · 2019 to 2025
$10.0MCharacterizing the phenotypic spectrum associated with genetic liability for alcohol use disorderK01AA028292 · NIAAA · UNIVERSITY OF PENNSYLVANIA · PI KEMBER, RACHEL LORRAINE · 2021 to 2024
$505kGenetic Vulnerability for Sustained Multi-Substance Use in MVPI01BX003341 · VA · VA CONNECTICUT HEALTHCARE SYSTEM · PI FEDERMAN, DANIEL, JUSTICE, AMY CAROLINE · 2017 to 2017
–BLRD VA I01 BX003341NCATS NIH HHS UL1 TR001863NIAAA NIH HHS K01 AA028292
Abstract
objectiveStudies show that racially and ethnically minoritized veterans have a higher prevalence of alcohol use disorder (AUD) than White veterans. The investigators examined whether the relationship between self-reported race and ethnicity and AUD diagnosis remains after adjusting for alcohol consumption, and if so, whether it varies by self-reported alcohol consumption.
methodsThe sample included 700,012 Black, White, and Hispanic veterans enrolled in the Million Veteran Program. Alcohol consumption was defined as an individual's maximum score on the consumption subscale of the Alcohol Use Disorders Identification Test (AUDIT-C), a screen for unhealthy alcohol use. A diagnosis of AUD, the primary outcome, was defined by the presence of relevant ICD-9 or ICD-10 codes in electronic health records. Logistic regression with interactions was used to assess the association between race and ethnicity and AUD as a function of maximum AUDIT-C score.
resultsBlack and Hispanic veterans were more likely than White veterans to have an AUD diagnosis despite similar levels of alcohol consumption. The difference was greatest between Black and White men; at all but the lowest and highest levels of alcohol consumption, Black men had 23%-109% greater odds of an AUD diagnosis. The findings were unchanged after adjustment for alcohol consumption, alcohol-related disorders, and other potential confounders.
conclusionsThe large discrepancy in the prevalence of AUD across groups despite a similar distribution of alcohol consumption levels suggests that there is racial and ethnic bias, with Black and Hispanic veterans more likely than White veterans to receive an AUD diagnosis. Efforts are needed to reduce bias in the diagnostic process to address racialized differences in AUD diagnosis.
Indexed as
AlcoholismVeteransAlcohol DrinkingEthnicityHumansMaleUnited StatesUnited States Department of Veterans AffairsAlcohol Use DisorderDiagnosis and ClassificationDrug Use DisordersRacismStigma/Discrimination
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