Several investigators have questioned the validity of the DSM-IV Alcohol Use Disorders criteria for diagnosing alcohol use problems among teenagers, with specific concerns about their utility across different subgroups. In the current study, we examined whether particular racial/ethnic or gender subgroups varied in the incidence and onset age of Alcohol Use Disorder symptoms. Members of a sample composed of 1,045 community-dwelling "drinkers" (59.4% male; 13.8% black, 21.2% foreign-born Hispanic, 30.7% U.S.-born Hispanic and 33.6% non-Hispanic white) were interviewed retrospectively using the Composite International Diagnostic Interview. The first occurrence of each DSM-IV symptom in a participant was examined by race/ethnicity and gender. Discrete-time event history analysis compared onset patterns from ages 14 through 20 years. The cumulative incidence of Alcohol Abuse and Alcohol Dependence diagnoses, as well as one alcohol abuse symptom and four dependence symptoms, varied by race/ethnicity. The incidence of both diagnoses, as well as two alcohol abuse symptoms, varied by gender. Event history analysis revealed no significant subgroup variation in first onset patterns for only three of the eleven symptoms. Racial/ethnic variation, but not gender variation, was significant for three symptoms, and both racial/ethnic variation and gender variation was significant for the remaining five symptoms. Our findings indicate that most of the DSM-IV Alcohol Use Disorder symptoms, when applied to adolescents, demonstrate significant subgroup variation in incidence and onset age patterns. These results speak to the urgent need for additional research concerning the nosology and diagnosis of alcohol use problems among younger drinkers, especially among specific racial/ethnic and gender subgroups.

Importance The novel Coronavirus Disease 2019 (COVID-19), declared a pandemic in March 2020, may present with disproportionately higher rates in underrepresented racial/ethnic minority populations in the United States, including African American communities who have traditionally been over-represented in negative health outcomes. Study Objective To understand the impact of the density of African American communities (defined as the percentage of African Americans in a county) on COVID-19 prevalence and death rate within the three most populous counties in each U.S. state and territory (n=152). Design An ecological study using linear regression was employed for the study. Setting The top three most populous counties of each U.S. state and territory were included in analyses for a final sample size of n=152 counties. Participants Confirmed COVID-19 cases and deaths that were accumulated between January 22, 2020 and April 12, 2020 in each of the three most populous counties in each U.S. state and territory were included. Main outcome measures Linear regression was used to determine the association between African American density and COVID-19 prevalence (defined as the percentage of cases for the county population), and death rate (defined as number of deaths per 100,000 population). The models were adjusted for median age and poverty. Results There was a direct association between African American density and COVID-19 prevalence; COVID-19 prevalence increased 5% for every 1% increase in county AA density (p<.01). There was also an association between county AA density and COVID-19 deaths, such; the death rate increased 2 per 100,000 for every percentage increase in county AA density (p=.02). Conclusion These study findings indicate that communities with a high African American density have been disproportionately burdened with COVID-19. Further study is needed to indicate if this burden is related to environmental factors or individual factors such as types of employment or comorbidities that members of these community have. Question What is the impact of the density of African American communities (defined as the percentage of African Americans in a county) on COVID-19 prevalence and death rate by U.S. counties. Findings This ecological study including the three most populous counties in each U.S. state and territory, found that COVID-19 prevalence increased 5% for every percentage increase in county African American density, and that the death rate increased 2 per hundred thousand for every percentage increase in county African American density. Both were statistically significant increases. Meaning These study findings indicate that communities with a high African American density have been disproportionately burdened with COVID-19.

We examined whether discrimination experienced by Hispanic/Latino adolescents is associated (a) directly with adolescent alcohol use or (b) indirectly with adolescent alcohol use via mediation by ethnic identity and/or peer associations. Data were drawn from an NIAAA-funded randomized controlled trial evaluating the efficacy of a Guided-Self Change intervention for Hispanic/Latino youth with alcohol and interpersonal violence problems (R01 AA12180; see Wagner et al., 2014). The current sample included 371 Hispanic/Latino teenagers (mean age = 16.3 years [SD = 1.37]; 38% female). Using structural equation modeling (SEM), results revealed that perceived discrimination was indirectly related to alcohol consumption through positive (non-drinking) peer affiliations. Additionally, ethnic identity was found to moderate the relationship between discrimination and positive peer affiliation. These findings further our understanding about how discrimination and ethnic identity interact, as well as provide directions for how the effectiveness of prevention models may be enhanced for reducing underage drinking among Hispanic/Latino adolescents.