Racial discrimination and alcohol use and negative drinking consequences among Black Americans: a meta-analytical review

Background and Aims Findings of the association between racial discrimination and alcohol use and related consequences are inconsistent, and the role of potential moderators in the association is largely unknown. This meta-analysis aimed to synthesize the discrimination-alcohol literature among Black Americans, estimate the magnitude of associations and explore differences as a function of sample characteristics. Methods Empirical studies reporting the association of racial discrimination with alcohol-related behaviors in an all-black sample were identified via systematic literature search. A random-effects meta-analysis was conducted using 33 effect sizes extracted from 27 studies, all of which used US samples (n = 26 894). Results Significant positive associations were found for racial discrimination with alcohol consumption [k = 9, confidence interval (CI) = 0.08, 0.17, I-2 = 49%, r = 0.12], heavy/binge drinking (k = 12, CI = 0.02, 0.10), I-2 = 27%, r = 0.06), at-risk drinking (k = 4, CI = 0.06, 0.23, I-2 = 0%, r = 0.14) and negative drinking consequences (k = 5, CI = 0.09, 0.25, I-2 = 94%, r = 0.25), but not with alcohol use disorder (k = 3, CI = -0.01, 0.20, I-2 = 90%, r = 0.10). Only alcohol consumption and negative drinking consequences showed significant between-study heterogeneity and had a sufficient quantity of studies for moderation analysis (i.e., 4 or more studies). The positive association of racial discrimination with negative drinking consequences was stronger among younger samples; the association with alcohol consumption did not differ by age or proportion of men. Conclusions Experiences of racial discrimination are associated with diverse alcohol-related behaviors among Black Americans, with a stronger association with problematic alcohol use, particularly among younger individuals.