Given major underreporting of alcohol-related diagnoses, minimum estimates from one survey of non-Federal, short-stay hospitals in 1991 found 54.5 patient discharges for alcohol- related diagnoses for every 10,000 people in the United States over age 15. The rate for whites was 48.2 per 10,000; however, the rate for African Americans was 102.9 per 10,000 population. Because it is not known whether the rates of underreporting are equal among ethnic groups, it is difficult to interpret the meaning of such reported differences. A study of alcohol-related mortality in California showed that African-Americans and Hispanics had higher rates of mortality from alcoholic cirrhosis than did whites or Asian-Americans. Nationwide, death rates attributed to alcohol dependence syndrome were also highest for African-Americans, although a higher percentage of African- Americans than whites abstain from using alcohol. The high rates of alcohol-related medical problems in African-Americans thus occur among a smaller percentage of the African-American population when compared with whites. The California study suggests that for many alcohol-related causes of death, such as alcohol dependence syndrome and alcoholic hepatitis, Hispanics had either similar or lower mortality rates compared with whites. Other findings suggest that alcohol abuse is highly variable among American Indian tribes, that minority groups may have genetic traits that influence alcoholism, and that acculturation can affect patterns of alcohol use in successive generations. Also, among minority patients who enter treatment programs, success rates are equal to those of whites; access to treatment is sometimes a problem for minorities. Prevention efforts that work among the general population have been shown to be effective among some minorities; however, it is not clear whether interventions designed for specific minorities also would be beneficial. 31 references