Abstract
OBJECTIVE: We examined sociodemographic factors associated with barriers to healthcare utilization (HCU) among a national sample of adults engaging in heavy drinking behavior (HDB). METHODS: A sample of 3257 participants from the All of Us program (2018-2022 Controlled Tier Dataset-v7) who reported HDB (i.e., six or more drinks on one occasion, at least weekly) was selected to examine the associations between socio-demographic factors and barriers to HCU (i.e., structural, competing social roles, attitudinal, and financial barriers). Multiple logistic regressions estimated adjusted Odds Ratios (aOR) for the associations of interest. RESULTS: Financial barriers (23.64 %) were the most common of the four barriers, followed by attitudinal (18.27 %), competing social roles (15.66 %), and structural (13.36 %) barriers. Females were more likely than males to report competing social roles (or = 1.56, 95 %CI = 1.28,1.90), attitudinal (aOR = 1.41, 95 %CI = 1.17,1.70), and financial (or = 1.41, 95 %CI = 1.19,1.68) barriers. Lower income (aOR = 6.71, 95 %CI = 4.77,9.56), and Non-Hispanic Black/African Americans (aOR = 1.39, 95 %CI = 1.04,1.85) showed higher odds of reporting structural barriers. CONCLUSIONS: As many as one in four individuals who engage in HDB experience at least one HCU barrier, particularly women, those with low-incomes, and Non-Hispanic Black/African Americans. The findings highlight the need for implementation of evidence-based strategies among the identified populations to reduce HCU barriers, and ultimately, alcohol-related disparities.