The Hispanic Americans Baseline Alcohol Survey (HABLAS): the association between acculturation, birthplace and alcohol consumption across Hispanic national groups

Men of Mexican ethnicity, alcohol use, and help-seeking: "I can quit on my own."

INTRODUCTION

Hispanics report higher rates of problematic alcohol use compared to non-Hispanic Whites while also reporting lower rates of alcohol treatment utilization compared to non-Hispanics. The study employs Anderson's Behavioral Model of Healthcare Utilization Model to guide the exploration of alcohol use, help-seeking and healthcare utilization.

METHODS

The present qualitative study explored help-seeking and alcohol treatment utilization for Hispanic men of Mexican ethnicity. A total of 27 participants (Mage = 35.7, SD = 10.82) completed a semi-structured interview that explored the treatment experiences and underlying psychological mechanisms that shaped their help-seeking.

RESULTS

Through a thematic content analysis, the following themes emerged: 1) perceiving need with subthemes of familismo, role as protector and provider, and positive face; 2) predisposing beliefs on help-seeking; and 3) treatment experiences and elements of patient satisfaction with subthemes of monetized treatment, respect, and perceiving professional stigma.

CONCLUSIONS

The findings in this article may assist in improving strategies for increasing alcohol treatment utilization among men of Mexican ethnicity. By exploring beliefs, values, and experiences health researchers can develop culturally informed intervention strategies.

Ethnic Discrimination, Sexual Orientation Discrimination, and DSM-5 Alcohol Use Disorder Among U.S. Latino or Hispanic Adults

We aimed to assess the probability of past-year DSM-5 alcohol use disorder (AUD) and past-year moderate-to-severe DSM-5 AUD as a function of past-year ethnic discrimination among U.S. Latino/Hispanic adults and as a function of past-year discrimination types among Latino/Hispanic sexual minorities (SM). We used data from the 2012-2013 National Epidemiological Survey on Alcohol and Related Conditions-III (n = 36,309 U.S. adults aged ≥18 years). Our sample consisted of 6,954 Latino/Hispanic adults. Multivariable logistic regression analyses estimated the association of past-year ethnic discrimination with past-year AUD and past-year moderate-to-severe AUD among the overall Latino/Hispanic population. We tested the association between discrimination types (i.e. none, ethnic or sexual orientation discrimination, both) with AUD and moderate-to-severe AUD among Latino/Hispanic SM adults. Among Latino/Hispanic adults, 13.4% met criteria for past-year AUD and 6.4% met criteria for past-year moderate-to-severe AUD. Ethnic discrimination was significantly associated with AUD (AOR = 1.09, 95% CI = 1.07-1.12) and moderate-to-severe AUD (AOR = 1.10, 95% CI = 1.06-1.13). Latino/Hispanic SMs who experienced both ethnic and sexual orientation discrimination were more likely to meet criteria for AUD (AOR = 3.44, 95% CI = 1.97-6.03) and moderate-to-severe AUD (AOR = 2.69, 95% CI = 1.25-5.82) compared to those who did not experience discrimination. Discrimination is a risk factor for AUD and moderate-to-severe AUD among Latino/Hispanic overall and SM populations.

The relationship between discrimination, alcohol use severity, and PTSD symptoms among Latinx heavy drinkers

INTRODUCTION

Discrimination is linked to alcohol use severity among Latinx adults, who also show high prevalence rates of PTSD compared to non-Latinx adults. We know little about whether PTSD symptoms affects the relationship between discrimination and alcohol use severity. We hypothesized that the association between discrimination and alcohol use severity might differ by level of PTSD symptom severity.

METHODS

This is a secondary cross-sectional analysis of data collected at baseline from a completed randomized clinical trial testing the relative efficacy of a culturally adapted motivational interview designed to address discrimination and drinking behavior against an unadapted motivational interview for Latinx adults. Eligible participants screened positive for the NIAAA Single Alcohol Screening Question for heavy drinking days, identified as Latinx, and were 18-65 years old. We assessed the Everyday Discrimination Scale, Primary Care PC-PTSD screener, Alcohol Use Disorder Identification Test, and the Short Acculturation Scale for Hispanics. The study analyzed the main and interactive effects of discrimination and PTSD symptoms on alcohol use severity, while controlling for age, sex, household income, and acculturation.

RESULTS

After controlling for covariates in model 2, the interaction of discrimination and PTSD symptoms was significantly related to alcohol use severity. Simple slopes analysis indicated that discrimination was positively related to alcohol use severity among those with high (1 SD above the mean) but not low (1 SD below the mean) levels of PTSD symptoms.

CONCLUSIONS

Evidence suggests that the experiences of discrimination were associated with alcohol use severity among those who reported more PTSD symptoms. Specifically, discrimination may have a stronger effect on alcohol use severity among Latinx adults who report more PTSD symptoms. Screening Latinx adults for heavy drinking days, discrimination, and PTSD symptoms is clinically important. Culturally adapted alcohol interventions that target discrimination may be particularly effective for Latinx individuals with more PTSD symptoms.

Lifetime use of alcohol and cannabis among U.S. adolescents across age: Exploring differential patterns by sex and race/ethnicity using the 2019 NSDUH data

Background

Early use of alcohol and cannabis is associated with health and social problems. It is unclear how lifetime use changes for each additional year of age during adolescence, and whether this change varies by sex and race/ethnicity. This study characterized lifetime rates of alcohol and cannabis use by age among 12- to 17-year-old American youth and explored differential patterns by sex and race/ethnicity.

Methods

Data were obtained from the 2019 National Survey on Drug Use and Health. Analyses were restricted to 12-17-year-olds who were non-Hispanic White, non-Hispanic Black, or Hispanic/Latino (n = 11,830). We estimated the increase in lifetime use of alcohol and cannabis by age for the full sample and stratified by sex and race/ethnicity. Slopes of the regression lines were compared to assess differential patterns across groups.

Results

In these cross-sectional analyses, reported lifetime use increased substantially from age 12 to 17 for alcohol (6.4 % to 53.2 %) and cannabis (1.3 % to 35.9 %). The increase in lifetime alcohol use was slightly, but not significantly, steeper among girls than boys (F1,8 = 3.40, p = 0.09). White and Latino youth showed similar rates of increase in lifetime alcohol use, which was significantly flatter among Black youth (F2,12=21.26, p<0.0001). Latino youth had a slightly, but not significantly, steeper increase in lifetime cannabis use than White and Black youth (F2,12=3.17, p = 0.07).

Conclusions

Reports of lifetime alcohol and cannabis use substantially increase from age 12 to 17 and the rates are different according to sex and race/ethnicity, highlighting the need for early and tailored substance use prevention in adolescents.

Contexts of Drinking- and Alcohol-Related Problems Among Whites and Hispanics on and off the US/Mexico border in California

BACKGROUND

This paper examines the association between drinking context use by Whites and Hispanics on and off the US/Mexico border and alcohol problems.

METHODS

Data come from a household sample of 1209 adults 18 to 39 years of age resident in Imperial County on the California/Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Data were collected on the phone or online and analyzed with an ordinal generalized linear model.

RESULTS

The pattern of statistically significant associations between the frequency and the volume of drinking in different contexts varies across problem types. Furthermore, some contexts of drinking are associated with problems in more than one area. For instance, frequency of drinking at bars/pubs is associated with social problems, risky sex, and fights, but not with injuries. Injuries are associated with the frequency of drinking at home alone or with family and at restaurants. Volume of drinking at bars/pubs is also significantly associated with three different contexts: social problems, injury, and fights. But the volume of drinking at the home of friends or relatives is associated with fights only. Border location is an effect modifier, changing the effect of frequency of drinking at bars and pubs from protective to a factor of risk for social problems and fights.

CONCLUSION

These results provide support for the social ecology of drinking and micro environmental factors or risk. The effect of border location on frequency of drinking in bars/pubs underlines the importance of the macro environment in problem generation.

Development and Evaluation of a Measure of Drinking Behavior in Response to Acculturation Stressors for Latinx Adults Entering Alcohol Treatment

Introduction

The current study presents the development of a scale to assess drinking behavior in response to acculturation and immigration stress.

Methods

The 19-item Measure of Immigration and Acculturation Stressors (MIAS) and a parallel assessment, a Measure of Drinking in Response to Immigration and Acculturation Stressors (MDRIAS), were administered at baseline, 6 months, and 12 months in a completed randomized controlled trial testing culturally adapted motivational interviewing to reduce heavy drinking and related problems in Latinx individuals who met criteria for heavy drinking (n=149).

Results

Exploratory factor analysis of the MIAS showed best fit for a four-factor solution (Relational Stress, Perceived Ethnic Discrimination, Attenuated Aspirations, and Sense of Alienation) with 15 items. The MIAS subscales and the four corresponding MDRIAS subscales were shown to have good reliability (i.e., internal consistency, intercorrelations, and test-retest) and criterion-related validity (i.e., concurrent, convergent, and predictive).

Conclusions

These findings suggest that the MIAS can be used to assess different types of immigration and acculturation stressors for Latinx adults and the MDRIAS can be used to assess drinking in response to those experiences. The MIAS and MDRIAS could be used in the future to adapt alcohol interventions to relevant stressors that contribute to Latinx adults' alcohol use.

Intimate Partner Violence and Mental Health Outcomes Among Hispanic Women in the United States: A Scoping Review

Hispanic women in the United States experience disproportionate mental health impacts of intimate partner violence (IPV). Following the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines, we synthesized the existing knowledge based on IPV and mental health outcomes among Hispanic women in the United States. In May 2020, we searched five electronic databases (i.e., MEDLINE, PILOTS, PSYCInfo, PSYCArticles, and EMBASE). From the initial 1,180 results, 13 articles met inclusion criteria for this review (written in English, empirical study, focus on the experiences of victimization from an intimate partner, focus on mental health outcomes occurring in the person experiencing IPV, included women who identify as Hispanic, and included participants residing in the United States), representing 4,060 women. Findings highlighted significant positive associations between IPV (n = 13; 4,060 women) and general mental health outcomes (n = 4; 759 women) as well as the specific outcomes of depression (n = 12; 2,661 women), anxiety (n = 1; 274 women), post-traumatic stress disorder (n = 3; 515 women), and substance misuse (n = 2; 1,673 women) among Hispanic women in the United States. Limitations included heterogeneity across Hispanic populations and methodological differences between studies. Key avenues for future research were identified, including the need to examine mental health outcomes understudied in relation to IPV among Hispanic women (e.g., personality, obsessive-compulsive, and eating disorders) and to identify cultural and demographic factors (e.g., nativity status, level of acculturation) that may influence relations between IPV and mental health outcomes among Hispanic women. Such research can inform prevention and intervention efforts aimed at improving mental health among Hispanic women in the Untied States experiencing IPV.

Reasons and obstacles for changing risky drinking behavior among Latinas at risk of an alcohol-exposed pregnancy

This study examined reasons and obstacles for changing risky alcohol use behavior among Latina adults at risk of an alcohol-exposed pregnancy. Using qualitative methods, data from CHOICES Plus intervention sessions of Latinas (N = 59) were analyzed. Reasons for wanting to change risky alcohol use centered on health, parenting, interpersonal conflict, control, and risk of harm. Obstacles included social obstacles, belief that drinking was not risky, and drinking to manage mood. Differences were found across level of acculturation. Knowledge about salient motives and obstacles is critical to addressing the needs and strengths of Latinas at risk of an alcohol-exposed pregnancy.

A characterization of pre- to post-immigration alcohol use among recent Latino immigrants to the United States before and during the COVID-19 pandemic

BACKGROUND

Although Latino immigrants to the United States tend to display a gradual increase in alcohol use after immigration, such escalation may not generalize to all Latino/a groups. This study examines patterns of alcohol use shown by recent Latino immigrants (RLIs) to Miami/Dade County (MDC), Florida covering a period from pre-immigration to the first two years after immigration. Differences in alcohol use prior to and during the COVID-19 pandemic were also assessed.

METHODS

Data came from an on-going longitudinal study of 540 young adult (50% female) RLIs. Inclusion criteria were age 18 to 34, residing in MDC and having immigrated from a Latin American country within the past year. Respondent-driven sampling was the primary recruitment strategy.

RESULTS

Recent Latino immigrants reported a decline in alcohol use from before immigration (18.3 drinks per month, d/m) to the first (13.9 d/m), and second years (10.4 d/m before and 12.9 d/m during the pandemic lockdown) in MDC. The decline, which was moderated by RLIs' sex and legal residency status, was halted by the pandemic lockdown. While "to celebrate" was the most often cited reason for drinking, "to forget" was often cited during the lockdown.

CONCLUSIONS

The noted decrease in alcohol use since immigration may reflect the unique array of support and resources available to RLIs in MDC. Nevertheless, some RLIs increased their alcohol use over time, particularly during the COVID-19 pandemic. This disparate impact of the pandemic on alcohol use calls attention to the need to identify the most vulnerable RLIs to MDC and develop targeted interventions for them.

The impact of cultural stress and gender norms on alcohol use severity among Latino immigrant men

Alcohol misuse affects 15 million people in the United States. Compared to White men, Latino men have disproportionately higher rates of both alcohol misuse and negative alcohol-related consequences (e.g. drunk driving, liver disease, alcohol dependence, HIV/AIDS). This cross sectional study examined how cultural stressors [immigration stress and negative context of reception (NCR)] coupled with traditional Latino male gender norms (machismo and caballerismo) influences alcohol use severity (AUS) among adult Latino immigrant men. Data for the present study was collected between 2017 and 2018 from 279 Cuban, Central American, and South American adult Latino men who immigrated to the US approximately 10 years prior. Results from hierarchical multiple regression analysis revealed higher levels of perceived NCR (β = 0.15, p  = .01), and machismo (β = 0.16, p = .02) were associated with greater AUS. Significant interaction effects were found between both cultural stressors and machismo [immigration stress x machismo (β = 0.22, p < .001); NCR x machismo (β = 0.22, p < .001)] whereby higher levels of machismo strengthened the association between cultural stress and AUS. Findings from the present study can inform culturally appropriate interventions aimed at mitigating alcohol use among Latino immigrant men.

Cancer Mortality Patterns by Birthplace and Generation Status of Mexican Latinos: The Multiethnic Cohort

BACKGROUND

Latinos are the largest minority group in the United States. We assessed cancer mortality by birthplace and generation status of Mexican Latinos in the Multiethnic Cohort.

METHODS

We included 26 751 Latinos of Mexican origin and 6093 non-Latino Whites aged 45-74 years at cohort entry (1993-1996) from the California Multiethnic Cohort component. The Mexican Latinos comprised 42% first-generation Mexico-born immigrants, 42% second-generation (28% US-born with both parents Mexico-born and 14% US-born with 1 parent US-born and 1 parent Mexico-born), and 16% third-generation or more who were US-born with both parents US-born. Multivariable Cox models were used to calculate covariate adjusted hazard ratios and 95% confidence intervals for overall and site-specific cancer mortality by birthplace and generation status. All statistical tests were 2-sided.

RESULTS

Cancer death rate was highest among the US-born with 1 parent US-born and 1 parent Mexico-born (age-adjusted rate = 471.0 per 100 000 person-years) and US-born with both parents US-born (age-adjusted rate = 469.0 per 100 000 person-years) groups. The US-born with both parents Mexico-born group had a 30% (hazard ratio = 1.30, 95% confidence interval = 1.18 to 1.44) higher risk of cancer death than the first-generation Mexico-born immigrants group, showing US birthplace was associated with an elevated cancer mortality. For cancer-specific mortality, US birthplace was positively associated with colorectal, liver and lung, and ovarian cancer (P values ranged from .04 to .005). Among US-born Mexican Latinos, generation status was not statistically significantly associated with overall cancer or site-specific cancer mortality.

CONCLUSIONS

Our findings suggest that US birthplace is a risk factor for cancer death in Mexican Americans. Identification of the contributing factors is important to curtail patterns of increasing cancer mortality in US-born Mexican Latinos.

Acculturation and drinking behavior among Latinxs: a narrative review

Research suggests that acculturation is associated with increased alcohol consumption among Latinxs. The purpose of this narrative review is to contribute to this literature by examining the association between acculturation and alcohol use within current theoretical and etiological frameworks on cultural norms, acculturative stress, and acculturative gaps. This review also compares the utility of these explanatory frameworks for guiding future research. Two databases (PubMed and PsycInfo) were used to identify peer-reviewed studies pertaining to the associations between acculturation and alcohol use among Latinxs. Studies that examined drinking norms, acculturative stress, acculturation gaps, and drinking behavior in Latinxs were included. The types of study approaches and designs included quantitative, qualitative, cross-sectional, cohort, and longitudinal studies published between January 2000 and December 2021. Quality assessment and data synthesis were conducted by two reviewers. A total of 65 articles reporting empirical studies were included in the final review. Eighteen studies did not utilize a specific framework, but generally supported that acculturation is associated with increased alcohol consumption and alcohol related consequences among Latinxs. Additionally, sixteen studies examined cultural norms, twenty-two examined acculturative stress, while only nine utilized a gap discrepancy framework. Studies examining drinking norms appeared to largely explain changes in drinking behavior among Latinas, while studies examining acculturative stress seemed to be better equipped to explain changes in drinking behavior among Latino men. Meanwhile, the Gap Discrepancy Model articulates the gap between old and new cultural influences and can be conceptualized as an additional dimension of acculturative stress.

The Role of Acculturation in the Relation Between Intimate Partner Violence and Substance Misuse Among IPV-victimized Hispanic Women in the Community

Hispanic women in the United States are disproportionately affected by intimate partner violence (IPV). One correlate of IPV among Hispanic women with important public health implications is substance misuse. However, limited research has identified culturally relevant factors that may impact the strength of the IPV-substance misuse association in this population. The present study examined the moderating role of acculturation in the relation between IPV types (i.e., physical, psychological, and sexual) and substance (i.e., alcohol and drug) misuse. Participants were 150 IPV-exposed Hispanic women in the community (M age = 35.13). IPV types, substance misuse outcomes, and acculturation were significantly and positively correlated with each other at zero-order. Moderation analyses indicated that the relations between IPV and substance misuse were stronger among Hispanic women with higher (vs. lower) levels of acculturation. These findings suggest the potential utility of considering acculturation when assessing and treating substance misuse among IPV-exposed Hispanic women.

Characteristic physical traits of first-grade children in the United States with fetal alcohol spectrum disorders (FASD) and associated alcohol and drug exposures

We compared growth, physical features, and minor anomalies in 131 first-grade children with fetal alcohol spectrum disorders (FASD) to those of a representative comparison group of typically developing children from the same populations (n = 1212). The data were collected from three regional sites in the NIAAA-funded Collaboration on FASD Prevalence (CoFASP). Dysmorphology examinations were performed by a team of expert clinical geneticists, and FASD diagnoses were assigned according to the Revised Institute of Medicine Guidelines, which include assessments of growth, dysmorphology, neurobehavior, and maternal risk interviews. We present detailed data on 32 physical traits, minor anomalies, and a summary dysmorphology score for children within each of the four diagnostic categories in the continuum of FASD. There were few differences in the frequency of FASD diagnoses by race or Hispanic ethnicity. Children with FASD were born to mothers who reported using alcohol, tobacco (28.3%), and other drugs (14.2%) during pregnancy. Controlling for tobacco and other drug use, risk analysis indicated that women with a drinking pattern of 3 drinks per drinking day prior to pregnancy were 10 times more likely (p < 0.001, OR = 9.92, 95% CI: 4.6-21.5) to bear a child with FASD than those who reported abstinence prior to pregnancy.

Ethnic density effect on alcohol-related hospitalizations among Chinese enclaves and ethnoburbs in California, 2007-2011

INTRODUCTION

Research suggests there is an 'ethnic density effect' whereby racial/ethnic minority populations appear healthier when they reside in neighborhoods with greater numbers of people from the same ethnic group. The purpose of this study is to test whether this effect is observed for residents in Chinese enclaves (immigrant neighborhoods in urban areas) and ethnoburbs (immigrant neighborhoods in suburban areas) for measures on alcohol abuse and dependence.

METHODS

ZIP code areas of California that represented Chinese enclaves and ethnoburbs were identified and mapped. Spatial regression models were used to compare neighborhood-level effects, including the ethnic density of Chinese enclaves and ethnoburbs on observed rates of alcohol-related hospitalizations compared to the rest of California. Analyses used Bayesian Space-Time Misalignment Poisson models on the annual number of alcohol-related hospitalizations per ZIP code for the years 2007-2011 (n = 8488 space-by-time units).

RESULTS

Ethnic density effect appeared for residents of ZIP code areas with greater proportions of Chinese Americans (RR=0.986, 95% CI: 0.982, 0.990). After controlling for sociodemographic characteristics, residents of ZIP code areas representing Chinese enclaves had lower risks for alcohol-related hospitalizations (RR=0.766, 95% CI: 0.630, 0.927); hospitalizations among residents of Chinese ethnoburbs no longer differed from the rest of the state. Compared to Chinese enclaves, Chinese ethnoburbs had a lower poverty rate (p < .001), a greater English fluency rate (p = .002), and similar proportions of residents who were Chinese and foreign-born.

CONCLUSION

Despite the socioeconomic advantages of living in Chinese ethnoburbs, populations living in these neighborhoods experience more problems related to alcohol abuse and dependence.

Multidimensional Acculturation, Acculturative Stress and Alcohol or Drug Use of Adult Latinx Immigrants

Few studies have used a multidimensional acculturation framework, i.e., cultural practices, identity, and values, to investigate links with alcohol or drug use of Latinx immigrants to the U.S. This cross-sectional study tested links between measures of acculturation (language-based Hispanicism and Americanism, cultural identity, familism), acculturative stress, and alcohol or drug use, controlling for age and gender. 391 adult (18-44 years old) Latinx immigrants (69% women) completed measures on past 6-month behavior in Spanish or English. Results showed that Americanism was related to alcohol use severity, heavy episodic drinking, drug use severity, and any drug use. Acculturative stress was related to alcohol use severity, drug use severity, and any drug use, but not heavy episodic drinking. Familism was inversely related to drug use severity and any drug use, but not alcohol use severity or heavy episodic drinking. Cultural identity and Hispanicism were not related to alcohol or drug use. Consistent with previous research, a language-based measure of acculturation to the U.S. (Americanism) and acculturative stress were related to alcohol and drug use. Incremental validity of a multidimensional acculturation approach was limited. Intervention adaptations for Latinx immigrants should address stress reduction and mitigating adoption of receiving cultural practices.

Alcohol use severity among recent Latino immigrants: Associations of acculturation, family history of alcohol use and alcohol outcome expectancies

Having a family history of alcohol (FH+) use is a well-documented risk factor for alcohol use and alcohol related problems. However, there are limited studies examining the impact of FH + on current alcohol use among Latino immigrants. This study aimed to determine the influence of having a FH + on current alcohol use among Latino immigrants and the influence of alcohol outcome expectancies (AOEs) and acculturation on this relationship. This is a longitudinal secondary data analysis of data from the Recent Latino Immigrant Study (RLIS), the first community-based cohort study to examine pre- to post-immigration alcohol use trajectories of young adult Latino immigrants. Linear mixed models were performed to assess the association between various pre- and post-immigration factors and alcohol use among Latino immigrants. There were 518 young adult Latino immigrants with 18.7% reporting a FH + with those with a FH + having higher mean AUDIT score compared to those without (4.74 vs. 3.81; p = 0.028). Positive AOEs were associated with increase AUDIT scores. FH + individuals with greater positive AOEs experienced higher AUDIT scores compared to FH- individuals. Family cohesion was protective against alcohol use while endorsement of Americansism was associated with increased alcohol use. Theses results provide the framework for more in-depth exploration regarding the influences of FH+, AOEs, and acculturation have on the alcohol use among Latino immigrants. Future longitudinal research studies should account for whether traditional cultural values mediate or moderate the relationship between a FH+, AOE, and alcohol use of Latino immigrants.

Association between acculturation surrogates and alcohol consumption in rural-to-urban migrants: The PERU MIGRANT study

Introduction

There is a paucity of information about the association between acculturation and alcohol consumption in rural-to-urban migrants who move to urban environments usually characterized by a higher prevalence of alcohol consumption than their rural places of origin.

Objectives

To evaluate the cross-sectional association between surrogates of acculturation and alcohol consumption in Peruvian rural-to-urban migrants; to explore the effects of sex and age at migration on these associations; and to explore this association longitudinally.

Methods

Data from the PERU MIGRANT Study, which evaluated a cohort of Peruvian rural-to-urban migrants from 2007 to 2012, were analyzed. Four acculturation surrogates were evaluated: language preference on the radio, language spoken at home, Spanish proficiency, and length of residence in urban area. Alcohol consumption was defined as having consumed alcohol in the last year at the time of the baseline survey, while onset of alcohol consumption was defined as having consumed alcohol in the last year at the follow-up survey. Poisson regressions with robust variance were performed to estimate crude and adjusted prevalence ratios (PR) and relative risks (RR) with a 95% confidence interval (95% CI) to cross-sectional and longitudinal analyses respectively.

Results

Data from 567 rural-to-urban migrants, mean age 47.6 years (SD ±11.5), 52% females, was included in the study. Crude cross-sectional analyses showed an association between acculturation surrogates and alcohol consumption, but these were not observed in adjusted regressions. In the sex-stratified analyses, only women showed an association between Spanish proficiency and alcohol consumption, where those with higher language proficiency had a 22% higher prevalence of alcohol consumption (PR: 1.22, 95% CI: 1.04-1.43). Analyses stratified by age at migration showed no association between acculturation surrogates and alcohol consumption. On the longitudinal analyses, acculturation surrogates were not associated with the onset of alcohol consumption.

Conclusions

No association between acculturation surrogates and alcohol consumption in cross-sectional and longitudinal analyses were found. The only exception was observed in female migrants according to their Spanish proficiency and alcohol consumption .

Trends in Premature Deaths From Alcoholic Liver Disease in the U.S., 1999-2018

INTRODUCTION

So-called deaths of despair-those involving drug overdoses, alcohol-related liver disease, and suicide-have been rising in the U.S. among middle-aged white, non-Hispanic adults without a college degree. Premature deaths (ages 25-69) from alcoholic liver disease were examined specifically in this study from 1999 to 2018, by sex, race/Hispanic origin, and age group.

METHODS

Data were drawn from the 1999-2018 Multiple Cause of Death database and bridged-race estimates of the U.S. resident population, including 281,243 alcoholic liver disease deaths or an average of 8 deaths per 100,000 population. Analyses examined alcoholic liver disease death rates for sex differences among 3 age groups (25-49, 50-59, and 60-69 years), by race and Hispanic origin, from 1999 to 2018; age-adjusted and age-specific annual percentage changes (accounted for cohorts); years of potential life lost; and age of death for sociodemographic backgrounds, alcoholic liver disease clinical courses, and comortalities.

RESULTS

White non-Hispanics increasingly experienced greater alcoholic liver disease mortality than black non-Hispanics and Hispanics, confirming the racial and ethnic crossover observed in previous studies. Although men consistently had higher rates of mortality, male-to-female ratios decreased in the past 2 decades and were the lowest among ages 25-49 years and especially among ages 25-34 years. Although women generally had longer life expectancies, women died of alcoholic liver disease on average about 2-3 years earlier than men.

CONCLUSIONS

Prevention and intervention efforts are imperative to address the narrowing sex gap and widening racial disparities in alcoholic liver disease premature deaths.

Alcohol use severity among Hispanic emerging adults: Examining the roles of bicultural self-efficacy and acculturation

OBJECTIVE

This study aimed to (1) examine respective associations of acculturation orientations (e.g., U.S. orientation and Hispanic orientation) and domains (e.g., social groundedness and role repertoire) of bicultural self-efficacy, the perceived confidence to function effectively within the receiving culture and the heritage culture, with alcohol use severity among Hispanic emerging adults. This study also aimed to (2) examine potential moderating factors of respective associations among acculturation orientations and bicultural self-efficacy with alcohol use severity.

METHOD

200 Hispanic emerging adults from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey. Inclusion criteria were being ages 18-25, self-identify as Hispanic or Latina/o, and currently living in Maricopa County or Miami-Dade County. Data were analyzed using hierarchical multiple regression and moderation analyses.

RESULTS

Findings indicate that neither of the acculturation orientations nor role repertoire had main effects with alcohol use severity. However, higher social groundedness was associated with lower alcohol use severity. Moderation analyses indicate that the interaction between the U.S. orientation and study site and the interaction between the Hispanic orientation and social groundedness were statistically significant in relation to alcohol use severity.

CONCLUSIONS

Considering that the U.S. orientation was associated with alcohol use severity only in Arizona highlights the need for multisite studies on acculturation. Our findings demonstrate that other sociocultural processes such as acculturation can impact bicultural self-efficacy; and that the association between bicultural self-efficacy and alcohol merits further investigation. However, more thorough assessments of bicultural self-efficacy are needed to better understand its effects on alcohol.

Alcohol use trajectories of adult Latinx immigrants during their first decade in the United States

BACKGROUND

Despite important research advances on the alcohol use behaviors of Latinx immigrants, the bulk of existing evidence has focused on alcohol use patterns after immigrant's arrival to the US. The present study examines pre- to post immigration alcohol use trajectories among Latinx immigrants of diverse national origins throughout their first decade in the United States.

METHODS

Data for this longitudinal study was collected between 2007 and 2017. At baseline, retrospective pre-immigration alcohol use data was collected on 527 Cuban, South American and Central American participants ages 18-34 who immigrated to the US less than one year prior. Three subsequent follow-up assessments over the past 10 years have collected data on post-immigration alcohol use.

RESULTS

Overall decreases in pre- to post-immigration alcohol use were found. Gender, income, and national origin were associated with distinct drinking patterns after immigration.

CONCLUSION

Findings underscore the importance of examining pre-immigration experiences among Latinx immigrants, in addition to longitudinal alcohol use patterns after immigration. This knowledge is important not only from an epidemiological perspective, but for the development of effective culturally relevant alcohol interventions targeting Latinx immigrants early in the immigration process.

Covariates of hazardous alcohol use among sexual and gender minorities in Texas: Identifying the most vulnerable

BACKGROUND

Information is limited on the prevalence of hazardous drinking and associated covariates among sexual and gender minority (SGM) persons. These analyses estimated the prevalence of hazardous drinking and identified associated covariates.

METHODS

A total of 1273 SGM adolescents and adults living in Texas completed an online survey between March 2016 and January 2017. Variables associated with hazardous drinking at the bivariate-level (p < 0.10) were entered into multiple logistic regression models to estimate the strength of their association.

RESULTS

More than a third (39.1%) of participants meet criteria for hazardous drinking. Compared to non-hazardous drinkers, hazardous drinkers were younger (x- = 20.7 [SD = 8.9] vs. x- = 26.5 [SD = 13.8]) and more likely to be Hispanic (41.5% vs. 26.2%). Hazardous drinkers were more likely to report using substances in past 12 months, including opioids (15.3% vs. 6.7%), stimulants (26.3% vs. 12.7%), and marijuana (37.6% vs. 21.2%). More hazardous drinkers reported injecting drugs (12.3% vs. 5.8%) and having a history of incarceration (14.1% vs. 7.3%). They were less likely to be diagnosed with depression (50.2% vs. 56.5%). When entered into a multivariate logistic regression model, hazardous drinkers were more likely to be younger (aOR = 0.97 [0.95, 0.98]), Hispanic (aOR = 1.5 [1.2, 2.0]), have a history of incarceration (aOR = 2.4 [1.5, 3.6]), and use a substance, not including marijuana (aOR = 1.7 [1.3, 2.3]). They were less likely to be diagnosed with depression (aOR = 0.73 [0.6, 0.9]).

CONCLUSIONS

Our findings highlight the intersection of race and ethnicity, mental health, criminal justice involvement, and substance use and the need for tailored interventions that address underlying determinants.

Subjective Social Status and Financial Hardship: Associations of Alternative Indicators of Socioeconomic Status with Problem Drinking in Asian Americans and Latinos

Background: Prior research shows inconsistent associations between socioeconomic status (SES) and alcohol outcomes, particularly for immigrant populations. Conventional markers of SES may not fully capture how social position affects health in these groups. Objective: We examine: (1) the associations of two alternative indicators, subjective social status (SSS) and financial hardship, with problem drinking outcomes, heavy episodic drinking (HED) and alcohol use disorder (AUD), for Asian Americans and Latinos; and (2) moderation of these relationships by educational level and nativity status. Methods: Multiple logistic regression modeling was performed using nationally-representative Asian American (n = 2,095) and Latino samples (n = 2,554) from the National Latino and Asian American Study. Age, gender, nativity, individual-level SES (income and education), unfair treatment, racial discrimination, and social support were adjusted. Results: Financial hardship was independently associated with AUD in both Asians and Latinos. Lower SSS was associated with increased AUD risk among individuals with college degrees or with US nativity in both populations. The association between financial hardship and HED was positive for US-born Latinos and foreign-born Asians, and negative for foreign-born Latinos. Conclusions: SSS and financial hardship are indicators of SES that may have particular relevance for immigrant health, independently of education and income, with SSS particularly meaningful for AUD in the more conventionally advantaged subgroups. There may be underlying processes affecting Asian and other Latino subgroups with similar socioeconomic and nativity profiles and exposing them to common risk/protective factors of AUD.

The combined relations of gender, enculturation, and depressive symptoms with health risk behaviors in Mexican-Americans: a moderated mediation analysis

Objectives: The present study investigated the relationships of enculturation and depressive symptoms with health risk behavior engagement in Mexican-American college students and examined how these relationships differed by gender. Previous research has noted consistent gender differences in health risk behavior (e.g. alcohol use, substance use, and risky sexual behavior) among Latina/os, and emphasized the role of U.S. acculturation in this difference. Research examining the role of heritage cultural retention (i.e. enculturation), and including the added influence of mental health variables, such as depressive symptoms, is currently lacking. This study sought to address this gap.Design: A large sample (N = 677) of Mexican-American college students from four universities (located in New York, California, Florida, and Texas) completed an online questionnaire assessing health risk behaviors and corresponding variables.Results: We found that males who endorsed more behavioral enculturation and depressive symptoms were more likely to engage in health risk behavior than all others in the sample. Contrary to previous literature, no relationship was found between behavioral enculturation and health risk behavior in females.Conclusion: The current study found behavioral enculturation to be associated with depressive symptoms, and in turn with health risk behaviors among the males in our sample. Additional research will be needed to identify the mechanism underlying the relationship between enculturation and depressive symptoms as well as between depressive symptoms and risky behavior.

At risk alcohol consumption with smoking by national background: Results from the Hispanic community health study/study of Latinos

INTRODUCTION

Tobacco smoking and binge or excess drinking are unhealthy behaviors that frequently co-occur. Studies of Hispanics/Latinos have mostly been of Mexican Americans although there are substantial differences in smoking and drinking by heritage background. Associated with co-use by 5 subpopulations.

METHODS

Cross-sectional data of 16,412 Hispanics/Latinos from Miami, the Bronx, Chicago and San Diego collected between 2008 and 2011 as part of the HCHS/SOL were analyzed. Smoking and alcohol consumption and demographic data were measured by self-report. Prevalence of smoking and alcohol consumption and co-use were reported. Logistic regression models examined the odds of co-use of smoking and binge or excess alcohol use by Hispanic/Latino background group.

RESULTS

Men of Cuban (10.3%), Puerto Rican (8.9%), and Mexican (8.9%) background had the highest prevalence of co-use of smoking and binge drinking compared to men of Central American (6.1%) and Dominican (6.6%) background. Women of Dominican (16.4%) and Puerto Rican (19.7%) background had the highest prevalence of binge drinking compared to women of Central American (10%) and Cuban (8%) background and Puerto Rican (34.1%) and Cuban (21.8%) women were the most likely to report current smoking compared to women of Central American (8.3%) and Mexican (10.4%) background. Acculturation was not associated with co-use among men and women. Elevated depressive symptoms were positively associated with smoking and binge drinking among men, OR = 1.5 [1.2-2.0], and women, OR = 1.5 [1.1-2.2]. Puerto Rican women had increased odds of co-use of smoking and binge or excess drinking compared to Mexican American women, OR = 3.2 [1.5-6.6].

CONCLUSIONS

Puerto Rican and Dominican Latinas and Central American and South American men have a higher prevalence of co-use.

Pre- and Post-Immigration Correlates of Alcohol Misuse among Young Adult Recent Latino Immigrants: An Ecodevelopmental Approach

Latinos in the United States experience numerous alcohol-related health disparities. There is accumulating evidence that pre-immigration factors are associated with post-immigration alcohol use, but the explanation for health disparities remains unclear. The present study is a secondary analysis of data from the Recent Latino Immigrant Study (RLIS), the first community-based cohort study to examine the pre- to post-immigration alcohol use trajectories of young adult Latino immigrants during their initial years in the United States. Exploratory analysis and hierarchical multiple logistic regression were performed to assess associations between various pre- and post-immigration factors and alcohol misuse among young adult Latino immigrants early in the immigration process. Using an ecodevelopmental approach, we examined potential social and environmental determinants across multiple levels of influence associated with post-immigration alcohol misuse in this population. The study sample consisted of 474 young adult Latino immigrants between the ages of 18–34. The sample was comprised of the following national/regional origins: Cuban (43%), South American (28.7%), and Central American (28.3%). Approximately half of the sample (49.6%) reported a family history of substance use problems (FHSUP+). Participants who reported FHSUP+ and who engaged in alcohol misuse prior to immigrating to the US were more likely to engage in post-immigration alcohol misuse. Results revealed various social and environmental factors associated with pre-immigration alcohol misuse in this population. Study findings can inform culturally tailored prevention interventions aimed at mitigating problem drinking behaviors among young adult recent Latino immigrants.

Perceived Discrimination and Cardiometabolic Risk Among US Hispanics/Latinos in the HCHS/SOL Sociocultural Ancillary Study

BACKGROUND

Metabolic syndrome (MetS) is a group of cardiovascular risk factors including elevated blood pressure, elevated triglycerides, decreased high-density lipoprotein cholesterol, impaired fasting glucose, and abdominal obesity, which disproportionately affects Hispanics/Latinos. The present study examined associations between perceived discrimination and MetS in Hispanic/Latino adults from various background groups (i.e., Dominican, Central American, Cuban, Mexican, Puerto Rican, South American).

METHODS

Data were obtained from 5174 Hispanics/Latinos who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. MetS components and covariates were measured at a baseline examination, and perceived discrimination was assessed within 9 months of baseline. Path analysis modeled associations of perceived discrimination with MetS prevalence and each of the six components of MetS, controlling for age, sex, income, acculturation, physical activity, diet, smoking, and alcohol use.

RESULTS

Among the full cohort, perceived discrimination was not associated with MetS prevalence in any of the models evaluated. Higher perceived discrimination at work/school was associated with larger waist circumference. When examining background groups separately, higher perceived ethnicity-associated threat was related to increased MetS prevalence only among individuals of Central American background. Differential patterns of association between perceived discrimination and MetS components were found for different background groups.

CONCLUSIONS

Overall results suggested that perceived discrimination was not strongly or consistently associated with MetS among Hispanics/Latinos.

Process for developing a culturally informed brief motivational intervention

The present study culturally enhances a standard brief intervention for alcohol use. Through an iterative process engaging key stakeholders; including patients, and expert consultants, this research sought to enhance current evidence based interventions. Five culturally informed enhancements consistent with Motivational Interviewing were introduced into standard brief interventions. These culturally informed enhancements can be refined to address the cultural risk and protective factors of other priority populations. The distinctions and advantages of this approach over prior cultural adapted interventions is discussed. Importantly, the present study outlines a process for refining the culturally informed brief intervention to other target populations.

Disaggregating Hispanic American Cancer Mortality Burden by Detailed Ethnicity

BACKGROUND

Hispanics are the largest minority population in the United States (18%). They represent a heterogeneous and growing population. Cancer is the leading cause of death among Hispanics, yet few studies have described cancer mortality burden by specific Hispanic group nationwide.

METHODS

Cancer-related deaths from U.S. death certificates for the years 2003-2012 were analyzed for decedents identifying as Mexican, Puerto Rican, Cuban, and Central or South American. We calculated descriptive statistics, including potential years of lives lost (PYLL), age-adjusted rates, standardized mortality ratios, and fitted JoinPoint regression models, to evaluate annual trends by Hispanic group, using non-Hispanic Whites (NHW) as the reference population.

RESULTS

We identified 287,218 cancer-related deaths among Hispanics and 4,570,559 among NHWs. Mortality trends were heterogeneous across Hispanic groups. Female NHWs and male Puerto Ricans had the greatest rates of adjusted PYLL per 1,000 (NHWs, 19.6; Puerto Ricans, 16.5). Liver cancer was ranked among the top 5 cancer-related deaths for every Hispanic group, but not for NHWs. Stomach cancer mortality was twice as high for most Hispanic groups when compared with NHWs and especially high for Mexicans [male standardized mortality ratio (SMR), 2.07; 95% confidence interval (CI), 2.01-2.13; female SMR, 2.62; 95% CI, 2.53-2.71].

CONCLUSIONS

We observed marked heterogeneity in cancer mortality across Hispanic groups. Several cancers affect Hispanics disproportionately compared with NHWs. Screening programs in Hispanics should be considered for stomach and liver cancer.

IMPACT

Disaggregated analysis of Hispanics is needed to fully understand cancer burden among the diverse Hispanic population and is critical for cancer prevention and control efforts.

Liver cancer: A leading cause of cancer death in the United States and the role of the 1945-1965 birth cohort by ethnicity

Liver cancer is highly fatal and the most rapidly increasing cancer in the US, where chronic hepatitis C (HCV) infection is the leading etiology. HCV is particularly prevalent among the 1945-1965 birth cohort, the so-called “baby boomers”. Focusing on this cohort-etiology link, we aim to characterize liver cancer patterns for 15 unique US populations: White, African American, Mexican Immigrant, Mexican American, Cuban and Chinese, among others.

Methods

Individual-level mortality data from 2012–2016 from the health departments of 3 large states – California, Florida, New York – were pooled to compute liver cancer mortality rates for each racial/ethnic group and for 2 birth cohorts of interest: “1945–1965 cohort” and “older cohort”.

Results

Liver cancer is a major cause of cancer death among all US male groups and the leading cause in Mexican American men. Over 50% of the age-adjusted liver cancer mortality of White, African American, Mexican American, and Puerto Rican males came from the 1945-1965 birth cohort. In contrast, foreign-born male and all female populations had higher liver cancer mortality originating from the older cohort. Internationally, US White male baby boomers had a 49% higher liver cancer mortality rate than their counterparts in Europe (mortality rate ratio 1.49; 95% CI 1.43–1.56).

Conclusions

Populations burdened disproportionately by liver cancer in the 1945–1965 cohort include US-born males who were all present in the US during the 1960s–1990s when significant HCV transmission took place; these individuals will benefit most from HCV screening and treatment. For the others, including all women, Asian subgroups, and especially burgeoning Hispanic immigrant populations, comprehensive liver cancer prevention efforts will require detailed study of the distribution of etiologies.

Lay summary

Liver cancer, a major cause of cancer death among US males, is increasing. The causes of liver cancer are varied, including hepatitis C, hepatitis B, alcohol-related liver disease, and non-alcoholic fatty liver disease. Racial/ethnic groups are impacted differently, but the highest rates are seen among US-born men born between 1945–1965, the so-called “baby boomers”, whether White, Black, or Hispanic, likely linked to the known high prevalence of hepatitis C infection among this cohort.

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Liver cancer is now the leading cause of cancer death among Mexican American males.

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Rates vary intra-racially: e.g. Vietnamese have high rates; South Asians have low.

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US-born male “baby boomers” of any race/ethnicity have the highest liver cancer mortality.

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Foreign-born men and all women have higher mortality at older ages, 70 or more.

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In the “baby boomer” cohort, US Whites have higher liver cancer mortality than Europeans.

Patterns of Alcohol Abstinence in Mexican Women Residing in the United States: Effects of Nativity and Duration in the United States

OBJECTIVES

Explore changes in abstinence rates in Mexican women (MW) residing in the United States based on nativity and time in the United States as an indicator risks for future alcohol-related disorders.

DESIGN

A secondary analysis of data from the National Health Interview Survey evaluated rates of abstinence between 2000 and 2017. A logistic regression was completed to address the impact of age, years in the United States, sample years.

SAMPLE

A total of 29,860 MW surveyed over an 18-year period that included those born in and outside the United States.

PRIMARY RESEARCH VARIABLES

Dependent variable was abstinence status; independent variables included nativity, year of survey, age, years in the United States (if immigrant).

RESULTS

Immigrant MW showed higher rates of alcohol abstinence than U.S.-born MW across all years, but regardless of place of birth, fewer MW are abstaining over time. Among immigrant MW, those only in the United States greater than 15 years had a greater risk of becoming a drinker than those in the United States less than 5 years.

CONCLUSION

There are declining rates of alcohol abstinence among MW regardless of immigration status. The lower rate of abstinent MW increases their risk for alcohol-related disorders. Assessing MW's use of alcohol and providing targeted education is essential.

Reconsidering the Relationship between Age at Migration and Health Behaviors among US Immigrants: The Modifying Role of Continued Cross-border Ties

Age-at-migration is commonly utilized as a proxy measure for assimilation. We re-consider this approach by examining the role of continued connection with places of origin on alcohol use. Cross-border connections may diminish the association between earlier age-at-migration and alcohol use by providing an alternative channel of influence for behavioral norms. Alternatively, a stress and coping perspective on cross border ties suggests potentially countervailing impacts of these connections on alcohol use. We use data from the 2002/2003 National Latino and Asian American Study (NLAAS) (n=1641/1630 Asian and Latino origin respondents, respectively). We first estimate the association between age-at-migration (child/adolescent versus adult migrant) and any past-year alcohol use. We subsequently test the interaction between age-at-migration and two measures of cross-border contact. All models are stratified by region of origin and gender. For Latin American-origin women, cross-border ties are associated with increased risk for alcohol use among those who migrated early in life. In contrast, Asian-origin men and women who migrated as adults and have contact with family and friends abroad have the lowest predicted probabilities of past-year alcohol use. The results among Asians support the idea that cross-border ties can be alternative influences on health behavior outcomes, particularly for adult migrants. Overall, we find qualified support for both transnational and assimilationist perspectives on alcohol use behaviors among US immigrants -- as well as the interaction between these two frameworks. The joint influences of cross-border ties and age-at-migration were observed primarily for immigrant women, and not always in expected directions. We nevertheless urge future research to consider both US and country-of-origin influences on a wider range of health and health behavior outcomes for immigrants, as well as the potential intersection between US and cross-border connections.

The Role of Acculturation and Alcohol Problems on Frequency of Cannabis Use Among Latinas at Risk of an Alcohol-Exposed Pregnancy

Background: Along with alcohol, cannabis is one of the most commonly used substances among women of childbearing age. Recent studies indicate detrimental effects of prenatal cannabis use. Because many women use these substances before realizing they are pregnant, these serious health consequences for women and their offspring are of great concern. Despite the recent upsurge in cannabis use, little is known about individual and sociocultural factors that may contribute to risk of a cannabis-exposed pregnancy, particularly among Latinas of child-bearing age also at risk of an alcohol-exposed pregnancy (AEP). Objectives: Examine the relationships of acculturation, alcohol use, alcohol problems, and psychological distress with frequency of cannabis use among adult Latinas at risk of an AEP. Methods: The hypothesized model included 76 Latinas and was analyzed using path analysis. The study used baseline data from a randomized controlled trial of an intervention targeting risky drinking and tobacco use among women at risk of an AEP in primary care clinics. Results: Greater acculturation was associated with more frequent cannabis use and greater psychological distress. There was a positive indirect relationship between acculturation and alcohol use and alcohol problems through psychological distress. Greater alcohol problems were associated with more frequent cannabis use. Greater psychological distress and alcohol use were indirectly related to more frequent cannabis use through alcohol problems. Conclusions: Findings underscore the critical role of acculturation and alcohol-related problems in cannabis use frequency and have relevant implications for preventive efforts addressing cannabis use among Latinas at risk of an AEP.

A Critical Review and Meta-Analysis of the Associations Between Acculturation and Alcohol Use Outcomes Among Hispanic Americans

Acculturation has been studied as one key sociocultural determinant that helps explain ethnic disparities in alcohol use outcomes among Hispanic Americans. Primary studies and other systematic reviews have found between-study inconsistencies regarding the extent to which acculturation is associated with alcohol use outcomes among Hispanic Americans. To better examine whether acculturation is distinctly linked to drinker status, drinking frequency, volume, intensity, binge drinking, and hazardous alcohol use/drinking problems, and to identify individual and methodological factors that moderate these associations, we conducted a comprehensive research synthesis. A systematic review was conducted on research pertaining to the associations between acculturation and alcohol use among Hispanics. We included 88 independent study samples (N = 68,282) coded from 68 manuscripts published in 1987 to 2017. Standard and robust variance estimation (RVE) meta-analyses were conducted to calculate the correlations between acculturation and overall alcohol use. We also conducted a series of analyses to examine the weighted mean correlations between acculturation and 6 specific drinking outcomes. We found a statistically significant correlation between acculturation and overall alcohol use (r = 0.09, p < 0.001). Acculturation was associated with drinker status (r = 0.10, p < 0.001), drinking intensity (r = 0.09, p = 0.001), binge drinking (r = 0.05, p = 0.006), and hazardous alcohol use/drinking problems (r = 0.06, p = 0.006), but not drinking frequency (r = 0.02, p = 0.56) or volume (r = 0.01, p = 0.73). Gender, acculturation dimension, acculturation domain, age group, and sampling settings were found to explain between-study variability in some of these associations. Findings show small relations between acculturation and various alcohol use outcomes, but the effects are relatively more robust among Hispanic women, adults, and when studies measured U.S. cultural orientation, linguistic acculturation, and behavioral practices.

Assessment of culture and environment in the Adolescent Brain and Cognitive Development Study: Rationale, description of measures, and early data

Neurodevelopmental maturation takes place in a social environment in addition to a neurobiological one. Characterization of social environmental factors that influence this process is therefore an essential component in developing an accurate model of adolescent brain and neurocognitive development, as well as susceptibility to change with the use of marijuana and other drugs. The creation of the Culture and Environment (CE) measurement component of the ABCD protocol was guided by this understanding. Three areas were identified by the CE Work Group as central to this process: influences relating to CE Group membership, influences created by the proximal social environment, influences stemming from social interactions. Eleven measures assess these influences, and by time of publication, will have been administered to well over 7,000 9-10 year-old children and one of their parents. Our report presents baseline data on psychometric characteristics (mean, standard deviation, range, skewness, coefficient alpha) of all measures within the battery. Effectiveness of the battery in differentiating 9-10 year olds who were classified as at higher and lower risk for marijuana use in adolescence was also evaluated. Psychometric characteristics on all measures were good to excellent; higher vs. lower risk contrasts were significant in areas where risk differentiation would be anticipated.

High cancer mortality for US-born Latinos: evidence from California and Texas

Background

Latinos born in the US, 36 million, comprise 65% of all US Latinos. Yet their cancer experience is nearly always analyzed together with their foreign-born counterparts, 19 million, who constitute a steady influx of truly lower-risk populations from abroad. To highlight specific cancer vulnerabilities for US-born Latinos, we compare their cancer mortality to the majority non-Latino white (NLW) population, foreign-born Latinos, and non-Latino blacks.

Methods

We analyzed 465,751 cancer deaths from 2008 to 2012 occurring among residents of California and Texas, the two most populous states, accounting for 47% of US Latinos. This cross-sectional analysis, based on granular data obtained from death certificates on cause of death, age, race, ethnicity and birthplace, makes use of normal standardization techniques and negative binomial regression models.

Results

While Latinos overall have lower all-cancers-combined mortality rates than NLWs, these numbers were largely driven by low rates among the foreign born while mortality rates for US-born Latinos approach those of NLWs. Among Texas males, rates were 210 per 100,000 for NLWs and 166 for Latinos combined, but 201 per 100,000 for US-born Latinos and 125 for foreign-born Latinos. Compared to NLWs, US-born Latino males in California had mortality rate ratios of 2.83 (95% CI: 2.52–3.18) for liver cancer, 1.44 (95% CI: 1.30–1.61) for kidney cancer, and 1.25 (95% CI: 1.17–1.34) for colorectal cancer (CRC). Texas results showed a similar site-specific pattern.

Conclusions

Specific cancer patterns for US-born Latinos, who have relatively high cancer mortality, similar overall to NLWs, are masked by aggregation of all Latinos, US-born and foreign-born. While NLWs had high mortality for lung cancer, US-born Latinos had high mortality for liver, kidney and male colorectal cancers. HCV testing and reinforcement of the need for CRC screening should be a priority in this specific and understudied population. The unprecedented proximity of overall rates between NLWs and US-born Latino populations runs counter to the prevailing narrative of Latinos having significantly lower cancer risk and mortality. Birthplace data are critical in detecting meaningful differences among Latinos; these findings merit not only clinical but also public health attention.

Racial/ethnic differences in 30-year trajectories of heavy drinking in a nationally representative U.S. sample

BACKGROUND

Racial/ethnic minorities bear a disproportionate burden of alcohol-related problems in the U.S. It is unknown whether this reflects harmful patterns of lifecourse heavy drinking. Prior research shows little support for the latter but has been limited to young samples. We examine racial/ethnic differences in heavy drinking trajectories from ages 21 to 51.

METHODS

Data on heavy drinking (6+ drinks/occasion) are from the 1979 National Longitudinal Survey of Youth (N=9468), collected between 1982 and 2012. Sex-stratified, generalized estimating equations (GEE) were used to model heavy drinking frequency trajectories as a function of age with a cubic curve, and interactions of race with age terms were tested to assess racial/ethnic differences. Models adjusted for time-varying socioeconomic status and marital and parenting status; predictors of trajectories were examined in race- and sex-specific models.

RESULTS

White men and women had similarly steep declines in heavy drinking frequency throughout the 20s, contrasting with slower declines (and lower peaks) in Black and Hispanic men and women. During the 30s there was a Hispanic-White crossover in men's heavy drinking curves, and a Black-White female crossover among lifetime heavy drinkers; by age 51, racial/ethnic group trajectories converged in both sexes. Greater education was protective for all groups.

CONCLUSION

Observed racial/ethnic crossovers in heavy drinking frequency following young adulthood might contribute to disparities in alcohol-related problems in middle adulthood, and suggest a need for targeted interventions during this period. Additionally, interventions that increase educational attainment may constitute an important strategy for reducing heavy drinking in all groups.

Drinking, Alcohol Use Disorder, and Treatment Access and Utilization Among U.S. Racial/Ethnic Groups

Data from approximately 140 articles and reports published since 2000 on drinking, alcohol use disorder (AUD), correlates of drinking and AUD, and treatment needs, access, and utilization were critically examined and summarized. Epidemiological evidence demonstrates alcohol-related disparities across U.S. racial/ethnic groups. American Indians/Alaska Natives generally drink more and are disproportionately affected by alcohol problems, having some of the highest rates for AUD. In contrast, Asian Americans are less affected. Differences across Whites, Blacks, and Hispanics are more nuanced. The diversity in drinking and problem rates that is observed across groups also exists within groups, particularly among Hispanics, Asian Americans, and American Indians/Alaska Natives. Research findings also suggest that acculturation to the United States and nativity affect drinking. Recent studies on ethnic drinking cultures uncover the possible influence that native countries' cultural norms around consumption still have on immigrants' alcohol use. The reasons for racial/ethnic disparities in drinking and AUD are complex and are associated with historically rooted patterns of racial discrimination and persistent socioeconomic disadvantage. This disadvantage is present at both individual and environmental levels. Finally, these data indicate that admission to alcohol treatment is also complex and is dependent on the presence and severity of alcohol problems but also on a variety of other factors. These include individuals' sociodemographic characteristics, the availability of appropriate services, factors that may trigger coercion into treatment by family, friends, employers, and the legal system, and the overall organization of the treatment system. More research is needed to understand facilitators and barriers to treatment to improve access to services and support. Additional directions for future research are discussed.

Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians

Limited English proficient (LEP) individuals face disparities in accessing substance abuse treatment, but little is known on how to reach this population. This study aimed to test online recruitment methods for tobacco and alcohol screening among LEP Portuguese speakers. The study was advertised in Portuguese using Facebook, Google, online newsletters and E-mail. Participants clicked ads to consent and access a screening for tobacco and alcohol dependence. Ads yielded 690 screening responses in 90 days. Respondents had a mean age of 42.7 (SD 12), with a higher proportion of women than men, 95% born in Brazil with high levels of LEP and low levels of acculturation. Facebook ads yielded 41.4% of responses, and were the lowest cost recruitment channel ($8.9, $31.10 and $20.40 per respondent, hazardous drinker and smoker, respectively). Online recruitment of LEP populations is feasible. Future studies should test similar strategies in other LEP groups.

Substance use, age at migration, and length of residence among adult immigrants in the United States

In this study we scrutinize prevalence of current smoking and binge drinking among adult US immigrants, and examine whether age at migration predicts these two behaviors and moderates the effect of length of residence. Immigrant groups include those from Latin America/Caribbean, East and South Asia, Sub-Saharan Africa, Europe/Central Asia, and Middle East/North Africa. Multivariate logistic regressions are estimated using cross-sectional data from the New Immigrant Survey (N = 7,397). Results show that patterns of smoking and binge drinking vary by gender and by region of origins. In addition, arriving at age 0-9 are directly associated with higher odds of binge drinking among adult women. Among adult men, age at migration moderates the association between length of residence and substance use. Specifically, length of residence has more detrimental effects for adolescent immigrants (arriving at age 10-18) on smoking, while its detrimental effects are more pronounced for childhood immigrants (arriving at age 0-9) on binge drinking. We interpret our findings within the critical period model in epidemiological research, concluding that adolescence and childhood are critical life stages that are associated with differential effects of length of residence when looking at smoking and binge drinking among immigrant men.

Saliendo Adelante: Stressors and Coping Strategies Among Immigrant Latino Men Who Have Sex With Men in a Nontraditional Settlement State

Immigrant Latino men who have sex with men (MSM) are marginalized along multiple dimensions (e.g., ethnicity, sexual orientation, language use), which can negatively affect their health and well-being. As little is known about how this subgroup experiences the stress of marginalization and how, in turn, they cope with such stress, this study investigated stressors and coping strategies to better understand the factors shaping Latino MSM health. Assisted by a community advisory committee, we conducted in-depth interviews with 15 foreign-born Latino MSM in a nontraditional settlement state. Drawing on grounded theory methods, we analyzed transcripts iteratively to identify processes and characterize themes. Results were confirmed in member check interviews (n = 4) and findings were further contextualized through key informant interviews (n = 3). Participants reported ubiquitous, concurrent stressors due to being an immigrant, being a sexual minority, and being working poor. In particular, homophobia within families and local Latino communities was seen as pervasive. Some participants faced additional stressors due to being undocumented and not being Mexican. Participants drew on four types of coping strategies, with no dominant coping response: passive coping (i.e., not reacting to stressors); attempting to change stressors; seeking social support; and seeking distractions. Family ties, especially with mothers, provided key emotional support but could also generate stress related to participants' sexuality. This study lays a foundation for future work and is particularly relevant for Latino MSM in nontraditional settlement states. Findings may inform future interventions to reduce stressors and increase resiliency, which can positively affect multiple health outcomes.

The contribution of stress, cultural factors, and sexual identity on the substance abuse, violence, HIV, and depression syndemic among Hispanic men

OBJECTIVES

The purpose of this study was to confirm the substance abuse, violence, HIV, and depression syndemic among Hispanic men, and to test whether stress and sociocultural factors, including acculturation, family support, and sexual orientation, predict this syndemic.

METHOD

A cross-sectional survey was administered to 164 Hispanic men using standardized measures for Hispanic Stress (Cervantes, Padilla, & Salgado de Snyder, 1991), substance abuse (Kelly et al., 1994), violence (Peragallo et al., 2005), risk for HIV (González-Guarda, Peragallo, Urrutia, Vasquez, & Mitrani, 2008), and depression (Center for Epidemiologic Studies Scale, CES-D; Radloff, 1977).

RESULTS

Results from Structural Equation Modeling (SEM) supported the syndemic factor among Hispanic men. While family/cultural stress and homosexual identity were risk factors for the syndemic factor, family support was protective.

CONCLUSIONS

More longitudinal research is needed to identify influences on the syndemic factor among diverse Hispanic communities. Interventions that address stress and enhance family supports may show promise in addressing and preventing syndemics among Hispanic men. (PsycINFO Database Record

Trajectories of Drug Abuse and Addiction Development Among FSU Immigrant Drug Users in Israel

This qualitative study explores the trajectories of drug abuse and addiction development among former Soviet Union (FSU) immigrant users. It is based on in-depth interviews with 19 Russian-speaking recovering addict counselors employed in Israeli addiction treatment centers. The interview analysis yielded two main trajectories: one of abuse deterioration and the other of abuse initiation in the context of coping with immigration. The core issue that characterizes both trajectories is the immigrant users’ sense of loneliness. Participation in treatment appears as a path for regaining their sense of belonging. Implications for prevention and treatment based on the interviewees’ reflections, as well as on extant literature, are discussed.

Patterns of Unhealthy Alcohol Use among Latino Day Laborers

OBJECTIVE

We sought to describe patterns of unhealthy alcohol use among Latino immigrant day laborers and identify correlates of these behaviors.

METHODS

Participants (N = 104) completed surveys on substance use, alcohol-related problems, mental health, and demographics. We assessed differences in unhealthy alcohol use by subject characteristic using chi-square tests of independence and 2-sample tests of proportions.

RESULTS

Unhealthy alcohol use was common with 65% having an AUDIT score of 8 or higher. Living situation and income were significantly associated with unhealthy alcohol use and high levels of depression and anxiety were associated with increased alcohol-related problems.

CONCLUSIONS

Interventions to reduce unhealthy alcohol use should consider the role of stable housing, income and mental health.

Negative Affectivity and Problematic Alcohol Use Among Latinos in Primary Care: The Role of Emotion Dysregulation

OBJECTIVE

Latinos are the largest and most rapidly growing racial/ethnic group in the United States. In Latino communities, alcohol is the most widely abused substance, yet there is little empirical understanding of the factors underlying problematic alcohol use among Latinos. The current study explored whether negative affectivity exerted an indirect effect via emotion dysregulation in relation to two alcohol-related outcomes.

METHODS

Participants were 316 Latinos attending a community-based primary care facility (Mage = 39.3, SD = 11.3; 85.4% female; 95.3% first language Spanish), who completed a variety of self-report and interview measures. Mediation analyses evaluated the indirect effect of negative affectivity via emotion dysregulation on problematic drinking and symptoms of alcohol dependence.

RESULTS

While there was no direct or total effect of negative affectivity on either alcohol-related outcome, negative affectivity was significantly associated with both problematic alcohol use and symptoms of dependence via emotion dysregulation. Effect sizes were in the medium range, K(2) = .09 and .10, respectively. Post-hoc multiple mediation analyses evaluated subfactors of emotion dysregulation as mediators of the negative affectivity-alcohol associations. These results suggested that difficulties engaging in goal-directed behavior might be particularly important in explaining the association between negative affectivity and problematic alcohol use/symptoms of dependence. Last, independent mediation analyses evaluated emotion dysregulation subfactors and found that limited access to effective emotion regulation strategies and difficulties engaging in goal-directed behavior were, independently, significant mediators for both outcomes. Nonacceptance of emotional responses may also mediate negative affectivity and problematic drinking. Surprisingly, impulse control difficulties was not a significant mediator in any model.

CONCLUSIONS

These data provide novel insight that among Latinos in primary care, emotion dysregulation is a possible mechanism underlying the indirect relationship between negative affectivity and problematic alcohol use and symptoms of dependence. Results also highlight specific facets of emotion dysregulation as potential targets of intervention. Future research should be longitudinal in nature, be conducted among more representative samples, and utilize measures that will better assess the potential variability in these associations. Results of such work may inform the development of alcohol treatment interventions incorporating the use of adaptive emotion regulation among Latinos in primary care.

Characteristics of Mexican and Mexican American adolescents in treatment for "cheese" heroin use

Clinical and cultural characteristics of Hispanic adolescent heroin users are not well described. The current exploratory study was conducted to describe a sample of in-treatment Hispanic adolescents with opioid dependence, specifically, cheese heroin. Mexican and Mexican American adolescents with heroin dependence (N = 72) in three treatment programs were interviewed and completed self-report measures. Participants reported, on average, first using cheese heroin at age 13.5 years and daily use at age 14.2 years. The majority (74%) reported a previous overdose. Adolescents being raised by caregivers other than both biological parents, who used drugs with relatives, and whose immediate family members have documentation to be in the United States fared worse on several indicators of drug use severity and other risky behaviors. The self-reported brief time period from first use to daily use strongly suggests the need for early prevention efforts. Additional research is needed to add to these preliminary results and inform prevention efforts.

Social and Cultural Contexts of Alcohol Use: Influences in a Social-Ecological Framework

Alcohol use and misuse account for 3.3 million deaths every year, or 6 percent of all deaths worldwide. The harmful effects of alcohol misuse are far reaching and range from individual health risks, morbidity, and mortality to consequences for family, friends, and the larger society. This article reviews a few of the cultural and social influences on alcohol use and places individual alcohol use within the contexts and environments where people live and interact. It includes a discussion of macrolevel factors, such as advertising and marketing, immigration and discrimination factors, and how neighborhoods, families, and peers influence alcohol use. Specifically, the article describes how social and cultural contexts influence alcohol use/misuse and then explores future directions for alcohol research.