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Jones DM, Masyn KE, Spears CA. Discrimination, psychological functioning, and substance use among U.S. young adults aged 18-28, 2017. Exp Clin Psychopharmacol 2022; 30:884-896. [PMID: 34398638 PMCID: PMC9134875 DOI: 10.1037/pha0000502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to test whether (a) discrimination is associated with past 30-day/current alcohol, cigarette, e-cigarette, alcohol, marijuana, and other illicit drug use among Black and White U.S. adults aged 18-28, (b) psychological distress (PD) and positive well-being (PW) are mediators of the discrimination-substance use relationships, and (c) the associations are moderated by race and sex. Using data from a 2017 U.S. nationally representative survey we conducted multiple-group moderated mediation analyses among 2,192 young adults aged 18-28 (508 Black males, 594 Black females, 533 White males, 557 White females). Black males had higher discrimination, Whites had higher PW, and females had higher PD scores. Discrimination was positively associated with PD and negatively associated with PW. Among all groups, discrimination was positively associated with other illicit drug (direct and indirect), and marijuana use through PD. Indirect effects were stronger among White males for other illicit drugs and Black males for marijuana. The indirect effect of discrimination and alcohol use through PW was positive for Black females and negative for all other groups examined. Among Black males only, discrimination was positively associated with cigarette and alcohol use through PD (positive) and cigarette smoking through PW (negative). This study highlights the negative influence of perceived discrimination on current licit and illicit substance use among Black and White young adults. Our results suggest that this relationship may be partially mediated by PD and PW, especially among Black male young adults. Future discrimination and substance use studies should consider potential mediation effects of poor mental health and differences by race and sex. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Dina M. Jones
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
| | - Katherine E. Masyn
- Department of Population Health Sciences, School of Public Health, Georgia State University
| | - Claire Adams Spears
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University
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Busby DR, Hope MO, Lee DB, Heinze JE, Zimmerman MA. Racial Discrimination and Trajectories of Problematic Alcohol Use Among African American Emerging Adults: The Role of Organizational Religious Involvement. HEALTH EDUCATION & BEHAVIOR 2021; 49:242-255. [PMID: 34965768 DOI: 10.1177/10901981211051650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Racial discrimination jeopardizes a wide range of health behaviors for African Americans. Numerous studies demonstrate significant negative associations between racial discrimination and problematic alcohol use among African Americans. Culturally specific contexts (e.g., organized religious involvement) often function protectively against racial discrimination's adverse effects for many African Americans. Yet organized religious involvement may affect the degree to which racial discrimination increases problematic alcohol use resulting in various alcohol use trajectories. These links remain understudied in emerging adulthood marked by when individuals transition from adolescence to early adult roles and responsibilities. We use data from 496 African American emerging adults from the Flint Adolescent Study (FAS) to (a) identify multiple and distinct alcohol use trajectories and (b) examine organizational religious involvement's protective role. Three trajectory classes were identified: the high/stable, (20.76% of sample; n = 103); moderate/stable, (39.52% of sample; n = 196); and low/rising, (39.72% of the sample; n = 197). After controlling for sex, educational attainment, and general stress, the interaction between racial discrimination and organized religious involvement did not influence the likelihood of classifying into the moderate/stable class or the low/rising class, compared with the high/stable class. These results suggest organized religious involvement counteracts, but does not buffer racial discrimination's effects on problematic alcohol use. Findings emphasize the critical need for culturally sensitive prevention efforts incorporating organized religious involvement for African American emerging adults exposed to racial discrimination. These prevention efforts may lessen the role of racial discrimination on health disparities related to alcohol use.
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Affiliation(s)
- Danielle R Busby
- Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA.,University of Michigan, Ann Arbor, MI, USA
| | - Meredith O Hope
- University of Michigan, Ann Arbor, MI, USA.,The College of Wooster, Wooster, OH, USA
| | - Daniel B Lee
- Children's Minnesota Research Institute, Saint Paul, MN, USA
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Nalven T, Spillane NS, Rossi JS. Racial discrimination, racial identity affiliation, and heavy alcohol use among multiracial individuals. Alcohol Clin Exp Res 2021; 45:1653-1663. [PMID: 34388267 DOI: 10.1111/acer.14651] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/09/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alcohol use is disproportionately higher among multiracial than monoracial adults; yet, associated risk and protective factors are underexplored. The present study compared levels of experienced racial discrimination, racial identity affiliation, and heavy alcohol use among multiracial and monoracial adults and tested whether racial identity affiliation, experienced racial discrimination, and their interaction were significantly associated with heavy alcohol use among multiracial individuals. METHODS We conducted secondary analyses of data from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Participants are a nationally representative sample of all U.S. adults (N = 29,026; 56.4% female) and were interviewed for the study from 2012 to 2013. The sample includes 598multiracial individuals. RESULTS Linear regression analyses showed that multiracial individuals experienced significantly greater racial discrimination than White (b = -1.26, 95% CI [-1.47, -1.05], p < 0.001) or Asian individuals (b = -0.30, 95% CI [-0.53, -0.06], p = 0.013) but less than Black individuals (b = 0.29, 95% CI [0.08, 0.50], p = 0.007). Furthermore, multiracial individuals reported less affiliation with their racial identity than Black (b = 4.92, 95% CI [4.23, 5.62], p < 0.001) or Asian individuals (b = 3.86, 95% CI [3.09, 4.63], p < 0.001) but did not differ significantly from White individuals. Logistic regression analysis showed that multiracial individuals were significantly more likely to report heavy drinking than Asian individuals (OR = 0.53, 95% CI [0.36, 0.78], p = 0.001) but did not differ significantly from White or Black individuals. Finally, experienced racial discrimination was significantly related to heavy alcohol use in multiracial adults (b = 0.11, 95% CI [0.01, 0.20], p = 0.031), though neither racial identity affiliation nor the interaction of racial identity affiliation with experienced racial discrimination were significantly related to heavy alcohol use. CONCLUSIONS Our results suggest that multiracial individuals, as compared to other minoritized individuals who are monoracial, report high levels of experienced racial discrimination and heavy alcohol use and low levels of racial identity affiliation. Further understanding of the effects of racial identity affiliation and experienced racial discrimination on the risk for heavy alcohol use could help in the development of interventions aimed at reducing alcohol use disparities among multiracial individuals.
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Affiliation(s)
- Tessa Nalven
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Nichea S Spillane
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Joseph S Rossi
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Desalu JM, Goodhines PA, Park A. Vicarious racial discrimination, racial identity, and alcohol-related outcomes among Black young adults: An experimental approach. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:283-294. [PMID: 33705156 PMCID: PMC8084893 DOI: 10.1037/adb0000707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: Racial discrimination is a known risk factor for alcohol-related outcomes among young Black American adults. However, vicarious racial discrimination's associations with alcohol-related outcomes and the role of racial identity in these associations remain unknown. This within-subject experiment study tested whether associations of vicarious racial discrimination with alcohol craving and attentional bias differed by three components of racial identity (centrality, private regard, and public regard). Method: Black young adult, at-risk drinkers (N = 51; Mage = 21 [SD = 3.02]; 60% female) completed two vicarious racial discrimination conditions (manipulated by video) followed by alcohol craving and attentional bias tasks. Results: Associations of vicarious discrimination with alcohol craving were exacerbated by high centrality and buffered by high private regard, but did not differ by public regard. No associations of vicarious discrimination with alcohol attention bias were found. Conclusion: Findings highlight the important role of Black racial identity in within-group differences in the impact of vicarious racial discrimination on select implicit indicators of alcohol risk among Black young adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Kogan SM, Bae D. Racial Discrimination, Protective Parenting, and Binge Drinking Among Emerging Adult Black Men. Alcohol Clin Exp Res 2020; 44:2343-2349. [PMID: 32945530 DOI: 10.1111/acer.14459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Rural Black men experience escalating rates of binge drinking during emerging adulthood. We hypothesized that exposure to racial discrimination would predict growth in their binge-drinking trajectories and that protective parenting, including emotional and instrumental support and high expectations for success, would attenuate the influence of racial discrimination on growth in binge drinking. METHODS Hypotheses were tested with 3 waves of data from 505 men (ages 20.3, 21.9, and 23.1) participating in the African American Men's Project. Conditional and multigroup latent growth curve models (LGCMs) were implemented using Mplus. RESULTS LGCM indicated that binge-drinking frequency increased linearly across time; exposure to racial discrimination at baseline predicted growth in binge drinking (β = 0.19, p < 0.01). Multigroup comparison procedures indicated significant moderation by protective parenting. When protective parenting was high, racial discrimination had no significant influence on rates of young men's binge drinking (β = 0.01, p = 0.51). In contrast, when protective parenting was low, the influence of discrimination was heightened (β = 0.21, p < 0.01). CONCLUSIONS Racial discrimination is a pernicious stressor that contributes to increases in binge drinking among young Black men. When parents engaged in emotionally and instrumentally supportive parenting, however, racial discrimination had little influence on binge-drinking trajectories during emerging adulthood. Study findings underscore the importance of the emerging adult transition as a period of vulnerability and suggest directions for targeting alcohol preventive interventions. IMPLICATIONS AND CONTRIBUTION After high school, young Black men are exposed to racial discrimination that can increase rates of binge drinking. When young men's parents were emotionally and instrumentally supportive toward them, however, racial discrimination did not predict increases in binge drinking.
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Affiliation(s)
- Steven M Kogan
- From the, Department of Human Development and Family Science, (SMK), University of Georgia, Athens, Georgia
| | - Dayoung Bae
- Department of Child and Family Studies, (DB), Korea University, Seoul, Korea
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Desalu JM, Goodhines PA, Park A. Racial discrimination and alcohol use and negative drinking consequences among Black Americans: a meta-analytical review. Addiction 2019; 114:957-967. [PMID: 30714661 PMCID: PMC6510626 DOI: 10.1111/add.14578] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/31/2018] [Accepted: 01/28/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Findings of the association between racial discrimination and alcohol use and related consequences are inconsistent, and the role of potential moderators in the association is largely unknown. This meta-analysis aimed to synthesize the discrimination-alcohol literature among Black Americans, estimate the magnitude of associations and explore differences as a function of sample characteristics. METHODS Empirical studies reporting the association of racial discrimination with alcohol-related behaviors in an all-black sample were identified via systematic literature search. A random-effects meta-analysis was conducted using 33 effect sizes extracted from 27 studies, all of which used US samples (n = 26 894). RESULTS Significant positive associations were found for racial discrimination with alcohol consumption [k = 9, confidence interval (CI) = 0.08, 0.17, I2 = 49%, r = 0.12], heavy/binge drinking (k = 12, CI = 0.02, 0.10), I2 = 27%, r = 0.06), at-risk drinking (k = 4, CI = 0.06, 0.23, I2 = 0%, r = 0.14) and negative drinking consequences (k = 5, CI = 0.09, 0.25, I2 = 94%, r = 0.25), but not with alcohol use disorder (k = 3, CI = -0.01, 0.20, I2 = 90%, r = 0.10). Only alcohol consumption and negative drinking consequences showed significant between-study heterogeneity and had a sufficient quantity of studies for moderation analysis (i.e., 4 or more studies). The positive association of racial discrimination with negative drinking consequences was stronger among younger samples; the association with alcohol consumption did not differ by age or proportion of men. CONCLUSIONS Experiences of racial discrimination are associated with diverse alcohol-related behaviors among Black Americans, with a stronger association with problematic alcohol use, particularly among younger individuals.
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Affiliation(s)
| | | | - Aesoon Park
- Department of PsychologySyracuse University Syracuse NY USA
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Zapolski TCB, Rowe AT, Banks DE, Faidley M. Perceived Discrimination and Substance Use among Adolescents: Examining the Moderating Effect of Distress Tolerance and Negative Urgency. Subst Use Misuse 2018; 54:156-165. [PMID: 30395759 PMCID: PMC6379120 DOI: 10.1080/10826084.2018.1512625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 06/25/2018] [Accepted: 08/12/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Perceived discrimination has been found to increase substance use vulnerability among adolescent populations. However, less is known about individual level factors which may moderate this risk. OBJECTIVES The aim of the current study is to examine whether two emotion-based personality traits (i.e., distress tolerance and negative urgency) moderates the effect of perceived discrimination on substance use. We hypothesized that high distress tolerance would decrease risk, while high negative urgency would increase risk for substance use as a consequence of discrimination. METHODS 108 youth ages 12-18 (68.6% male; 56.2% African-American) provided data on perceived discrimination, distress tolerance, negative urgency, and substance use (i.e., alcohol and marijuana use). RESULTS Contrary to our hypothesis, no moderating effect was observed for negative urgency. Distress tolerance was found to moderate the relationship, but in the opposite direction than expected. CONCLUSIONS It is speculated that this counterintuitive finding may be due to the racial/ethnic composition of the sample, suggesting that distress tolerance may operate differently among minority youth. Further research examining these relationships among minority youth is warranted.
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Affiliation(s)
- Tamika C B Zapolski
- a Department of Psychology , Indiana University Purdue University , Indianapolis , IN , USA
| | - Alia T Rowe
- a Department of Psychology , Indiana University Purdue University , Indianapolis , IN , USA
| | - Devin E Banks
- a Department of Psychology , Indiana University Purdue University , Indianapolis , IN , USA
| | - Micah Faidley
- a Department of Psychology , Indiana University Purdue University , Indianapolis , IN , USA
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Zapolski TCB, Faidley MT, Beutlich M. The Experience of Racism on Behavioral Health Outcomes: The Moderating Impact of Mindfulness. Mindfulness (N Y) 2018; 10:168-178. [PMID: 30854146 DOI: 10.1007/s12671-018-0963-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Research shows that racial discrimination results in adverse behavioral health outcomes for African American young adults, including risk for depression, anxiety, and substance use. Although high levels of mindfulness have been shown to reduce risk for such health outcomes, it is unknown whether mindfulness can reduce risk as a consequence of racial discrimination, particularly among African Americans. Three-hundred and eighty-eight African American young adults between the ages of 18-24 (M=20.6, 62% female) completed measures assessing past year experiences of racial discrimination, depressive symptoms, anxiety symptoms, alcohol use, and trait mindfulness. A positive correlation was found between racial discrimination and the behavioral health outcomes, as well as a negative correlation between mindfulness and the behavioral health outcomes. Moreover, mindfulness was found to significantly moderate the effect of racial discrimination on mood symptoms. Although mindfulness was found to lessen the effect of racial discrimination on alcohol use, this difference was not statistically significant. In line with previous literature, racial discrimination was shown to have a negative impact on behavioral health outcomes among African Americans. Moreover, our findings provide support for the buffering effect of mindfulness on mood symptoms as a consequence discrimination. This suggests that increasing mindfulness may be an effective strategy to include in interventions targeting improvement in mood symptoms for African American young adults. However, alternative strategies may be more appropriate to address outcomes, such as alcohol use, as a consequence of racial discrimination.
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Gerrard M, Gibbons FX, Fleischli ME, Cutrona CE, Stock ML. Moderation of the effects of discrimination-induced affective responses on health outcomes. Psychol Health 2018; 33:193-212. [PMID: 28436272 PMCID: PMC6145071 DOI: 10.1080/08870446.2017.1314479] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The goal of the study was to examine differential mediation of long-term effects of discrimination on health behaviour and health status by internalising (anxiety and depression) and externalising (hostility and anger), and to explore moderation of these effects, specifically, by the presence of support networks and coping tendencies. DESIGN The current analyses employed structural equation modelling of five waves of data from Black female participants of the Family and Community Health Study over 11 years (M age 37-48). MAIN OUTCOMES MEASURES The main outcome variables were health status and alcohol use (frequency and problematic consumption). RESULTS Perceived racial discrimination was associated with increases in internalising and externalising. In addition, internalising reactions to discrimination were associated with deterioration in health status and increases in problematic drinking; externalising reactions were associated with increases in frequency of drinking. These relations were attenuated by availability of support networks, and exacerbated by use of avoidance coping. CONCLUSION The current study (a) replicated previous research suggesting that two different types of affective reactions mediate the relations between perceived racial discrimination and physical health status vs. health-impairing behaviours: internalising and externalising, and (b) revealed moderation of these effects by coping mechanisms.
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Affiliation(s)
- Meg Gerrard
- a Department of Psychological Sciences and Institute for Collaboration on Health, Intervention and Policy (InChip) , University of Connecticut , Storrs , CT , USA
| | - Frederick X Gibbons
- a Department of Psychological Sciences and Institute for Collaboration on Health, Intervention and Policy (InChip) , University of Connecticut , Storrs , CT , USA
| | - Mary E Fleischli
- b Institute for Collaboration on Health, Intervention and Policy (InChip) , University of Connecticut , Storrs , CT , USA
| | - Carolyn E Cutrona
- c Department of Psychology , Iowa State University , Ames , IA , USA
| | - Michelle L Stock
- d Department of Psychology , The George Washington University , Washington , DC , USA
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Glass JE, Rathouz PJ, Gattis M, Joo YS, Nelson JC, Williams EC. Intersections of poverty, race/ethnicity, and sex: alcohol consumption and adverse outcomes in the United States. Soc Psychiatry Psychiatr Epidemiol 2017; 52:515-524. [PMID: 28349171 PMCID: PMC5862428 DOI: 10.1007/s00127-017-1362-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 02/16/2017] [Indexed: 10/19/2022]
Abstract
We examine whether intersectionality theory-which formalizes the notion that adverse health outcomes owing to having a marginalized social status, identity, or characteristic, may be magnified for individuals with an additional marginalized social status, identity, or characteristic-can be applied using quantitative methods to describe the differential effects of poverty on alcohol consumption across sex and race/ethnicity. Using the National Epidemiologic Survey on Alcohol and Related Conditions, we analyze longitudinal data from Black, Hispanic, and White drinkers (n = 21,140) to assess multiplicative interactions between poverty, as defined by the US Census Bureau, sex, and race/ethnicity, on adverse alcohol outcomes. Findings indicated that the effect of poverty on the past-year incidence of heavy episodic drinking was stronger among Black men and Black women in comparison to men and women of other racial/ethnic groups. Poverty reduction programs that are culturally informed may help reduce racial/ethnic disparities in the adverse outcomes of alcohol consumption.
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Affiliation(s)
- Joseph E Glass
- Group Health Research Institute, Group Health Cooperative, 1730 Minor Avenue Ste. 1500, Seattle, WA, 98101, USA.
- Institute for Research on Poverty, University of Wisconsin-Madison, Madison, WI, USA.
| | - Paul J Rathouz
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Maurice Gattis
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Young Sun Joo
- School of Social Work, University of Wisconsin-Madison, Madison, WI, USA
| | - Jennifer C Nelson
- Group Health Research Institute, Group Health Cooperative, 1730 Minor Avenue Ste. 1500, Seattle, WA, 98101, USA
| | - Emily C Williams
- Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
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Gilbert PA, Zemore SE. Discrimination and drinking: A systematic review of the evidence. Soc Sci Med 2016; 161:178-94. [PMID: 27315370 PMCID: PMC4921286 DOI: 10.1016/j.socscimed.2016.06.009] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 11/17/2022]
Abstract
Although it is widely accepted that discrimination is associated with heavy and hazardous drinking, particularly within stress and coping frameworks, there has been no comprehensive review of the evidence. In response, we conducted a systematic review of the English language peer-reviewed literature to summarize studies of discrimination and alcohol-related outcomes, broadly defined. Searching six online data bases, we identified 938 non-duplicative titles published between 1980 and 2015, of which 97 met all inclusion criteria for our review and reported quantitative tests of associations between discrimination and alcohol use. We extracted key study characteristics and assessed quality based on reported methodological details. Papers generally supported a positive association; however, the quantity and quality of evidence varied considerably. The largest number of studies was of racial/ethnic discrimination among African Americans in the United States, followed by sexual orientation and gender discrimination. Studies of racial/ethnic discrimination were notable for their frequent use of complex modeling (i.e., mediation, moderation) but focused nearly exclusively on interpersonal discrimination. In contrast, studies of sexual orientation discrimination (i.e., heterosexism, homophobia) examined both internalized and interpersonal aspects; however, the literature largely relied on global tests of association using cross-sectional data. Some populations (e.g., Native Americans, Asian and Pacific Islanders) and types of discrimination (e.g., systemic/structural racism; ageism) received scant attention. This review extends our knowledge of a key social determinant of health through alcohol use. We identified gaps in the evidence base and suggest directions for future research related to discrimination and alcohol misuse.
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Affiliation(s)
- Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145N. Riverside Drive, N414 CPHB, Iowa City, IA 52242, USA; Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA.
| | - Sarah E Zemore
- Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA
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