Race and the Treatment of Alcoholism in a Southern State

Abstract

This study of the relationship between race and the delivery of services to patients in a state facility for alcoholic rehabilitation found some differences as hypothesized. However, the repeated under-representation of black alcoholics compelled changes in the research question from (1) how were black alcoholics treated within the state's most highly regarded program, to (2) where were they treated, and to (3) why were they not found in treatment programs. The explanation that the low admission rates were due to low rates of alcoholism or to treatment under other diagnoses seemed improbable. The explanation that local communities have alternatives with deviant drinkers and disproportionately channel whites toward treatment and blacks to prison was given support by a comparison of commitment and incarceration rates. The possibility that the black community reacts to this with mechanisms that inhibit the intervention of white (especially health and welfare) officials into the lives of black alcoholics is advanced. Labelling theory suggests that the absence of intervention by mandated labellers would be a “benign neglect.” The medical model predicts the opposite outcome. Differential rates of deaths related to alcohol were in line with the latter prediction.