A Scoping Review of Health Inequities in Alcohol Use Disorder

Alcohol Use Disorder (AUD) poses a significant health burden, especially in medically underserved, as well as underrepresented racial and sexual minority populations. Ameliorating health inequities are vital to improving patient-centered care. Given the heightened focus on narrowing the health disparities gap, evaluating health inequities for patients with AUD has become of utmost importance. More research is needed to understand health inequities in AUD and the disproportionate impact on already marginalized populations. The objective of this scoping review is to chart the existing evidence on health inequities related to AUD and identify existing knowledge gaps to guide future equity-centered research. We performed a literature search using Ovid (Embase) and MEDLINE (PubMed) databases for articles on AUD that were published in the 5-year period spanning from 2017-2021 and written in English. This scoping review followed guidelines from the Joanna Briggs Institute as well as the PRISMA extension for scoping reviews. All studies were screened and extracted in a masked, duplicate manner. Frequencies of each health inequity examined were analyzed and main findings from each included study were summarized. Following screening, our sample consisted of 72 studies for data extraction and analysis. Alcohol Use Disorder was more likely in historically marginalized groups, among sexual minorities and more common in men, though there are rising rates in women. Our findings indicate that significant research gaps exist in education, rural under-resourced populations, and LGBTQ+ communities with Alcohol Use Disorder. Scoping review highlights the gaps in research on inequities in AUD, as well as the conflicting findings across studies. To bridge the current gaps, we recommend research on the following: 1) triage screening tools and the use of telemedicine for rural, under-resourced populations; 2) interventions to increase treatment engagement and retention for women; and 3) community-based participatory methodologies for the LGBTQ+ communities.