Alcohol use and misuse in urban Mexican men and women: an epidemiologic perspective

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.

Gender differences in drinking behavior among Latino/a heavy drinkers

BACKGROUND

In the United States (U.S.), higher levels of acculturation have been associated with higher rates of heavy alcohol use more consistently among Latino women than among Latino men. This paper explores mechanisms underlying the link between acculturation and alcohol use among Latino/as in the U.S. We examine alcohol use expectancies and motives from the perspectives of the social cognitive theory of gender development.

METHODS

Qualitative narratives data from six focus groups of individuals (total n = 37), who met criteria for heavy drinking (4/5 drinks/occasion for females/males), were examined separately by gender (18 females; 19 males). Coded narratives data were analyzed using a framework that compared lives in Latin America and in the U.S. Emergent themes were analyzed for their consistency across genders. Gender-specific themes were identified.

RESULTS

Changes in family structure and the loss of social networks prompted divergent patterns of drinking among men and women, such that relative to patterns in their countries of origin, drinking among Latino women increased while it decreased among Latino men. Men and women reported drinking to replace missing social bonds, a motive not frequently reported in the literature on drinking motives. Women who engaged in heavy-drinking nonetheless described traditional gender role expectations after U.S. arrival. Only men endorsed positive alcohol expectancies in Latin America. Women reported drinking to alleviate psychological distress in the U.S.

CONCLUSIONS

Pre and post-immigration comparisons revealed different drinking trajectories among men and women after immigration to the U.S. These patterns appeared to be influenced by new social contexts and changes in familial expectations regarding women's roles. Future inquiry that examines gender-specific themes in alcohol expectancies and motives unique to the experience of immigration, is warranted.

Cancer statistics for Hispanics/Latinos, 2015

Cancer is the leading cause of death among Hispanics/Latinos, who represent the largest racial/ethnic minority group in the United States, accounting for 17.4% (55.4 million/318 million) of the total US population in 2014. Every 3 years, the American Cancer Society reports on cancer statistics for Hispanics based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. Among Hispanics in 2015, there will be an estimated 125,900 new cancer cases diagnosed and 37,800 cancer deaths. For all cancers combined, Hispanics have 20% lower incidence rates and 30% lower death rates compared with non-Hispanic whites (NHWs); however, death rates are slightly higher among Hispanics during adolescence (aged 15-19 years). Hispanic cancer rates vary by country of origin and are generally lowest in Mexicans, with the exception of infection-associated cancers. Liver cancer incidence rates in Hispanic men, which are twice those in NHW men, doubled from 1992 to 2012; however, rates in men aged younger than 50 years declined by 43% since 2003, perhaps a bellwether of future trends for this highly fatal cancer. Variations in cancer risk between Hispanics and NHWs, as well as between subpopulations, are driven by differences in exposure to cancer-causing infectious agents, rates of screening, and lifestyle patterns. Strategies for reducing cancer risk in Hispanic populations include increasing the uptake of preventive services (e.g., screening and vaccination) and targeted interventions to reduce obesity, tobacco use, and alcohol consumption.

Beliefs of older Mexican American women about alcohol and alcohol use

This exploratory study assessed the belief system regarding alcohol use in a non-clinical population of Mexican American women age 55 and older drawn from a potential population of 1,000 older adults who attend nine senior centers. The overriding research question was: What are the normative attitudes, knowledge, and behavior regarding alcohol in this population of older Mexican American women? Findings from this study can serve as a baseline for comparison for future studies of older Mexican American who are more acculturated or who are second- and third-generation Mexican Americans.

Socioeconomic status, urbanicity and risk behaviors in Mexican youth: an analysis of three cross-sectional surveys

Background

The relationship between urbanicity and adolescent health is a critical issue for which little empirical evidence has been reported. Although an association has been suggested, a dichotomous rural versus urban comparison may not succeed in identifying differences between adolescent contexts. This study aims to assess the influence of locality size on risk behaviors in a national sample of young Mexicans living in low-income households, while considering the moderating effect of socioeconomic status (SES).

Methods

This is a secondary analysis of three national surveys of low-income households in Mexico in different settings: rural, semi-urban and urban areas. We analyzed risk behaviors in 15-21-year-olds and their potential relation to urbanicity. The risk behaviors explored were: tobacco and alcohol consumption, sexual initiation and condom use. The adolescents' localities of residence were classified according to the number of inhabitants in each locality. We used a logistical model to identify an association between locality size and risk behaviors, including an interaction term with SES.

Results

The final sample included 17,974 adolescents from 704 localities in Mexico. Locality size was associated with tobacco and alcohol consumption, showing a similar effect throughout all SES levels: the larger the size of the locality, the lower the risk of consuming tobacco or alcohol compared with rural settings. The effect of locality size on sexual behavior was more complex. The odds of adolescent condom use were higher in larger localities only among adolescents in the lowest SES levels. We found no statically significant association between locality size and sexual initiation.

Conclusions

The results suggest that in this sample of adolescents from low-income areas in Mexico, risk behaviors are related to locality size (number of inhabitants). Furthermore, for condom use, this relation is moderated by SES. Such heterogeneity suggests the need for more detailed analyses of both the effects of urbanicity on behavior, and the responses--which are also heterogeneous--required to address this situation.

Alcohol Use, Problems, and the Course of Posttraumatic Stress Disorder: A Prospective Study of Female Crime Victims

OBJECTIVE

This study examines whether alcohol use disorder status and consequences of drinking moderate the course of PTSD over the first 6 months following trauma exposure in a sample of female victims of interpersonal violence.

METHODS

Female sexual and physical assault victims (n = 64) were recruited through police, hospital, and victim service agencies. Women completed structured clinical interviews and self-report measures within the first five weeks, three months, and six months post-trauma with 73% retention across all three time points (n = 47). Analyses were conducted using Hierarchical Linear Modeling using alcohol abuse/dependence, peak alcohol use, and consequences during the 30 days prior to assault as moderators of the course of PTSD over time.

RESULTS

Women with alcohol use disorder at baseline had lower initial PTSD symptoms but also less symptom recovery over time than women without alcohol use disorder. This pattern of results was also found for those with high negative drinking consequences during the month prior to the assault. Baseline alcohol use was not found to significantly moderate PTSD course over the 6 months.

CONCLUSIONS

Findings suggest that negative consequences associated with alcohol use may be a risk factor for PTSD. Incorporating assessment of drinking problems for women presenting early post-trauma may be useful for identifying PTSD risk.

The Influence of Linguistic Acculturation and Gender on the Initiation of Substance Use Among Mexican Heritage Preadolescents in the Borderlands

This article examined the impact of linguistic acculturation and gender on the substance use initiation of a sample of 1,473 Mexican heritage preadolescents attending 30 public schools in Phoenix, Arizona. It was hypothesized that linguistic acculturation operates differently as a risk or protective factor for young children than for older youth. The study used discrete-time event history methods to model the rate at which nonusing children initiate substance use. Alcohol, cigarettes, marijuana, and inhalants were studied separately while inhalant use was examined more closely. Results suggested that while linguistic acculturation is a risk factor for Mexican heritage preadolescents, this association depended on gender, the linguistic acculturation context (family, friends, or media), and the type of substance. For inhalants, higher linguistic acculturation with friends was inversely associated with drug initiation both for boys and girls. Implications for preventive science and future intervention research are discussed.

Gender and anxiety in Nepal: the role of social support, stressful life events, and structural violence

INTRODUCTION

Throughout the world, anxiety disorders are 1.5-2 times more prevalent among women than men but the reasons for this gender disparity remain elusive. Despite frequent attribution to cultural roles of men and women, data regarding gendered risk factors in non-Western settings are scant.

AIMS

This study evaluated the role of gender as a moderator (effect modifier) of stressful life events (SLEs) and social support on the risk of anxiety in Nepal. A cross-sectional random sampling design was employed to recruit 316 persons in a rural community. The participants completed the Beck Anxiety Inventory (BAI), Stressful Life Events Rating Scale (SLERS), and a measure of social support.

RESULTS

The prevalence of anxiety differed by gender: 36.9% of women versus 20.4% of men endorsed anxiety symptoms above the validated cutoff for intervention (odds ratio [OR]= 2.3, 95% confidence interval [CI]= 1.4-3.8). The number of SLEs and levels of social support did not differ by gender, nor did gender moderate the relationship between SLEs and anxiety. Gender did moderate the relationship of social support with anxiety. Men who reported low social support had 3.5 times greater odds (95% CI = 1.4-10.7) of endorsing anxiety relative to men reporting high social support. Women exhibited no association of anxiety with social support.

CONCLUSION

Women are at a greater risk of anxiety in Nepal. Social support moderates the risk of anxiety among men but not among women. Ethnography and mixed-methods research are needed to identify other forms of support that may be protective for women and such factors should be promoted in gender-focused mental health interventions.

Gender and alcohol consumption: patterns from the multinational GENACIS project

AIMS

To evaluate multinational patterns of gender- and age-specific alcohol consumption.

DESIGN AND PARTICIPANTS

Large general-population surveys of men's and women's drinking behavior (n's > 900) in 35 countries in 1997-2007 used a standardized questionnaire (25 countries) or measures comparable to those in the standardized questionnaire.

MEASUREMENTS

Data from men and women in three age groups (18-34, 35-49, 50-65) showed the prevalence of drinkers, former drinkers, and lifetime abstainers; and the prevalence of high-frequency, high-volume, and heavy episodic drinking among current drinkers. Analyses examined gender ratios for prevalence rates and the direction of changes in prevalence rates across age groups.

FINDINGS

Drinking per se and high-volume drinking were consistently more prevalent among men than among women, but lifetime abstention from alcohol was consistently more prevalent among women. Among respondents who had ever been drinkers, women in all age groups were consistently more likely to have stopped drinking than men were. Among drinkers, the prevalence of high-frequency drinking was consistently greatest in the oldest age group, particularly among men. Unexpectedly, the prevalence of drinking per se did not decline consistently with increasing age, and declines in high-volume and heavy episodic drinking with increasing age were more typical in Europe and English-speaking countries.

CONCLUSIONS

As expected, men still exceed women in drinking and high-volume drinking, although gender ratios vary. Better explanations are needed for why more women than men quit drinking, and why aging does not consistently reduce drinking and heavy drinking outside Europe and English-speaking countries.