Abstract P155: The Impact of Drinking Patterns on Differences in the Alcohol-Mortality Relationship between Blacks and Whites in the United States

Background: Moderate alcohol consumption appears to confer survival benefits, but previous studies suggest that blacks may not experience such benefits due to, for example, differences in genetic polymorphisms in ethanol metabolizing genes or societal/behavioral factors related to type and pattern of consumption. Investigating potential Black-White differences in the alcohol-mortality relationship may also help illuminate if apparent benefits of moderate alcohol consumption are confounded by lifestyle and socioeconomic characteristics. Few studies, however, have included a sufficient number of blacks. Objective: To investigate Black-White differences in the relationship between alcohol consumption and all-cause mortality. Methods: We pooled cross-sectional surveys of nationally representative samples of 145,143 adults in the National Health Interview Survey from 1997-2002 with mortality follow-up through 2006. Usual drinking days/week and level of alcohol consumed/day were based on self-report. Race-sex specific Cox regression analyses were used to adjust for marital status, education, physical activity, smoking status, and other potential confounders. Results: Over 9 years of follow-up, there were 13,366 deaths: 11,221 in whites and 2,145 in blacks. Participants who consumed 1 drink/day on 3-7 days/week had the lowest age-adjusted mortality rates (MR)/1,000 person years among white men (MR: 66.5 [95%CI: 57.7-75.3]) and women (MR: 34.3 [95%CI: 27.1-41.5]). Two drinks/day on ≤2 days/week in black men (MR: 101.9 [95%CI: 69.3-134.5]) and 1 drink/day ≤2 days/week in black women (MR: 60.0 [95%CI: 41.8-78.1]) was associated with the lowest MR. Compared to never drinkers after accounting for important covariates, the lowest relative risk of mortality for white men (HR=0.55 [95%CI: 0.42-0.74]) was found among those who consumed 2 drinks between 3 to 7 days/week, and white women (HR=0.39 [95%CI: 0.26-0.59]) consuming 1 drink/day on 3 to 7 days/week had the lowest mortality risk. Black women (HR=0.44 [95%CI: 0.27-0.72]) consuming 1 drink on ≤2 days/week had the lowest mortality risk, and black men (HR=0.52 [95%CI: 0.26-1.01]) who consumed 2 drinks ≤2 days/week had the lowest risk of total mortality. Conclusions: Light-to-moderate drinking patterns of alcohol consumption were associated with lowest all-cause mortality among white and black men and women although the apparent nadir varied by race and sex. Further research investigating racial differences in drinking patterns and health outcomes is warranted.