Racial/ethnic disparities in the risk of alcohol-related injury from volume of consumption and heavy drinking in the U.S. general population: Data from four National Alcohol Surveys

National population data on racial/ethnic disparities in risk of alcohol-related injury are scarce. The association of alcohol-related injury with volume and heavy drinking is examined in a merged sample of respondents from four (1995-2010) U.S. National Alcohol Surveys using risk function analysis. Self-reported consumption on 15,476 respondents who consumed at least one drink in the last 12 months was assessed as the average number of drinks consumed monthly, and separately, frequency of consuming 5 or more drinks in a day (5+ days) in the last year. Alcohol-related injury was defined as drinking within six hours prior to the event. Risk curves were defined, separately for whites, blacks and Hispanics using fractional polynomial regression. Risk of alcohol-related injury was greater for Hispanics to 110 drinks per month, and for blacks to 40 drinks per month compared to whites.  Controlling for demographic and SES characteristics, risk curves remained similar for both Hispanics and whites as uncontrolled curves, but blacks were found to be at lower risk at all monthly volume levels. Hispanics were at higher risk than whites to 28 5+ drinking days, while blacks were at lower risk at all 5+ frequencies. When demographic and SES characteristics were controlled, risk was similar for Hispanics and whites to 13 5+ drinking days, at which point risk for whites was higher, while blacks continued to be at lower risk than whites and Hispanics at all 5+ frequencies. A disparity was found in alcohol-related injury for Hispanics compared to whites at the same average monthly volume up to 3-4 drinks per day, but a reverse disparity was found for 5+ drinking days, while a reverse disparity was found for blacks for both average monthly volume and 5+ drinking days. These mixed findings suggest this is an important area deserving future research attention.