Alcohol use among Native Americans compared to whites: Examining the veracity of the ‘Native American elevated alcohol consumption’ belief

• We tested the belief that Native Americans (NA) have elevated alcohol consumption.
• Using national samples, we compared NA to whites on a range of drinking measures.
• NA use rates were similar to or less than those of whites across all of the measures.
• These findings can be used to help correct misinformation on NA alcohol consumption.

BackgroundThis study uses national survey data to examine the veracity of the longstanding belief that, compared to whites, Native Americans (NA) have elevated alcohol consumption.MethodsThe primary data source was the National Survey on Drug Use and Health (NSDUH) from 2009 to 2013: whites (n = 171,858) and NA (n = 4,201). Analyses using logistic regression with demographic covariate adjustment were conducted to assess differences in the odds of NA and whites being alcohol abstinent, light/moderate drinkers (no binge/heavy consumption), binge drinkers (5+ drinks on an occasion 1–4 days), or heavy drinkers (5+ drinks on an occasion 5+ days) in the past month. Complementary alcohol abstinence, light/moderate drinking and excessive drinking analyses were conducted using Behavioral Risk Factor Surveillance System (BRFSS) data from 2011 to 2013: whites (n = 1,130,658) and NA (n = 21,589).ResultsIn the NSDUH analyses, the majority of NA, 59.9% (95% CI: 56.7–63.1), abstained, whereas a minority of whites, 43.1% (CI: 42.6–43.6), abstained—adjusted odds ratio (AOR): 0.64 (CI: 0.56–0.73). Approximately 14.5% (CI: 12.0–17.4) of NA were light/moderate-only drinkers, versus 32.7% (CI: 32.2–33.2) of whites (AOR: 1.90; CI: 1.51–2.39). NA and white binge drinking estimates were similar—17.3% (CI: 15.0-19.8) and 16.7% (CI: 16.4–17.0), respectively (AOR: 1.00; CI: 0.83–1.20). The two populations' heavy drinking estimates were also similar—8.3% (CI: 6.7–10.2) and 7.5% (CI: 7.3–7.7), respectively (AOR: 1.06; CI: 0.85–1.32). Results from the BRFSS analyses generally corroborated those from NSDUH.ConclusionsIn contrast to the ‘Native American elevated alcohol consumption’ belief, Native Americans compared to whites had lower or comparable rates across the range of alcohol measures examined.