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Yan Y, Leong F, Song A, Goldman-Mellor S. Incidence and Correlates of Emergency Department Visits for Deliberate Self-Harm Among Asian American Youth. J Adolesc Health 2023; 72:510-518. [PMID: 36535866 PMCID: PMC10494551 DOI: 10.1016/j.jadohealth.2022.10.024] [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] [Received: 01/04/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE This study examined the epidemiology of self-harm emergency department (ED) visits among Asian American and Pacific Islander (AAPI) youth, and associated factors. METHODS We used California ED visit records in 2010 and 2011 to calculate incidence rates of self-harm ED visits for AAPI versus non-Hispanic White (NHW) patients aged 10-29 years. Demographic and clinical characteristics were compared for AAPI versus NHW patients presenting with self-harm. We used modified Poisson regression models to estimate the relative risk of recurrent ED self-harm visits for AAPI versus NHW patients and examined the association of insurance type and gender with recurrent self-harm among AAPIs. RESULTS Rates of self-harm ED visits for young AAPI patients were 38 and 26 per 100,000 among females and males, respectively. Although AAPI patients presenting with self-harm were equally or less likely than NHW patients to have comorbid psychological and substance use diagnoses at their index visit, they were 25% more likely to be admitted to hospital. However, they were 40% less likely to have a recurrent ED self-harm visit. Among AAPI patients, those who used Medicaid were significantly more likely than those with other insurance to be admitted as inpatients. DISCUSSION Young AAPI patients presenting to EDs with deliberate self-harm have different sociodemographic and clinical profiles compared to NHW patients. Our study also demonstrates significant heterogeneity in risk of recurrent self-harm by gender and insurance type among AAPI patients. This information may be useful for future intervention programs among self-harming AAPI youth.
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Affiliation(s)
- Yueqi Yan
- Health Sciences Research Institute, University of California, Merced, California
| | - Frederick Leong
- Department of Psychology, Michigan State University, East Lansing, Michigan
| | - Anna Song
- Department of Psychological Science, University of California, Merced, California
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D'Amico EJ, Rodriguez A, Tucker JS, Dunbar MS, Pedersen ER, Seelam R. Disparities in functioning from alcohol and cannabis use among a racially/ethnically diverse sample of emerging adults. Drug Alcohol Depend 2022; 234:109426. [PMID: 35364418 PMCID: PMC9175265 DOI: 10.1016/j.drugalcdep.2022.109426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Trajectory studies have consistently shown that alcohol and cannabis (AC) use during emerging adulthood (EA) affect functioning; however, few studies examine whether racial/ethnic disparities may occur at similar levels of use. METHODS We conducted web-based surveys across five waves from mean age 18.3 through 22.6. The sample (N = 2945) is 55% female, 46% Hispanic, 23% Asian, 23% White, 6% multi-racial (MR)/other, and 2% Black. MEASUREMENTS Past month substance use was defined as number of days used. Outcomes at age 22.6 included negative consequences, delinquency, physical ailments and health, depression and anxiety, peer relationship functioning, life satisfaction, employment, and education. RESULTS Compared to White EAs, Hispanic, Asian, and MR/other EAs reported less initial alcohol use; Hispanic and Asian EAs reported less initial cannabis use, whereas Black EAs reported more cannabis use. Greater initial frequency and increased frequency of AC use were associated with poorer outcomes (e.g., worse mental health). In terms of disparities, compared to White EAs, Hispanic EAs reported poorer physical health at the same levels of AC use; Hispanic, Asian, and MR/other EAs reported greater alcohol consequences and delinquency; Black, Hispanic, Asian and MR/other EAs reported lower life satisfaction; and Hispanic and MR/other EAs were less likely to pursue education beyond high school (although Asian EAs were more likely). CONCLUSIONS Findings emphasize that trajectories of AC use during EA are associated with a range of functional outcomes. Disparities in functioning at similar levels of AC use highlight the importance of reaching racially/ethnically diverse EAs with prevention and intervention programming.
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Affiliation(s)
| | | | - Joan S Tucker
- RAND Corporation, 1776 Main St., Santa Monica, CA 90401, USA
| | - Michael S Dunbar
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
| | - Eric R Pedersen
- University of Southern California, Los Angeles, CA 90089, USA
| | - Rachana Seelam
- RAND Corporation, 1776 Main St., Santa Monica, CA 90401, USA
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Dunbar MS, Siconolfi D, Rodriguez A, Seelam R, Davis JP, Tucker JS, D’Amico EJ. Alcohol and Cannabis Use Trajectories and Outcomes in a Sample of Hispanic, White, and Asian Sexual and Gender Minority Emerging Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042059. [PMID: 35206249 PMCID: PMC8871829 DOI: 10.3390/ijerph19042059] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 02/05/2023]
Abstract
Substance use disproportionately affects health and psychosocial outcomes for some racial/ethnic groups, but few longitudinal studies examine the extent to which sexual and gender minority (SGM) emerging adults of different racial/ethnic groups may experience disparities in outcomes at similar levels of alcohol or cannabis use. This study used five waves of annual survey data (spanning 2015 (average age 18) to 2020 (average age 23)) from an ongoing longitudinal cohort study of emerging adults. In the subset of 359 SGM emerging adults, separate sequelae of change models assessed differences in trajectories of alcohol or cannabis use (past 30-day frequency) and multiple health and psychosocial outcomes across Hispanic, Asian, and White individuals. White SGM emerging adults showed higher baseline levels of alcohol and cannabis frequency compared to Hispanic and Asian peers, but all groups showed similar rates of change (slope) over time. We observed few racial/ethnic differences in SGM emerging adult outcomes at the same levels of alcohol or cannabis use; that is, racial/ethnic groups showed similar patterns on most health and psychosocial outcomes; however, some differences emerged. For example, Asian respondents reported less engagement in sex with casual partners after using alcohol, marijuana, or other drugs compared to their White peers, at the same levels of alcohol use (β = −0.579, p = 0.03) or cannabis use (β = −0.737, p = 0.007). Findings underscore a need to consider multiple outcome domains and factors beyond additive stress in examining the effects of substance use across different groups of SGM individuals. More longitudinal studies with large, contemporary, and diverse samples of SGM emerging adults are needed to better characterize similarities and differences in patterns of substance use and use-related consequences in relation to intersecting SGM, racial/ethnic, and other identities.
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Affiliation(s)
- Michael S. Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA;
- Correspondence:
| | - Daniel Siconolfi
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA;
| | | | - Rachana Seelam
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; (R.S.); (J.S.T.); (E.J.D.)
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34th Street, Los Angeles, CA 90089, USA;
| | - Joan S. Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; (R.S.); (J.S.T.); (E.J.D.)
| | - Elizabeth J. D’Amico
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; (R.S.); (J.S.T.); (E.J.D.)
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Phillips KT, Okamoto SK, Johnson DL, Rosario MH, Manglallan KS, Pokhrel P. Correlates of tobacco use among Asian and Pacific Islander youth and young adults in the U.S.: A systematic review of the literature. Exp Clin Psychopharmacol 2021; 29:440-455. [PMID: 34636585 PMCID: PMC8516062 DOI: 10.1037/pha0000511] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Rates of tobacco product use, including the use of combustible and electronic cigarettes, remain high in youth and young adults within the U.S. Though a substantial body of work has examined risk factors associated with initiation and ongoing use of tobacco products, research on tobacco use and associated correlates among Asian and Pacific Islanders (APIs) has been more limited despite high rates in select API subgroups. This systematic review outlines recent research (2010-2020) on the correlates of tobacco use in APIs aged 9-29. To better understand determinants of tobacco use and identify gaps in the literature, we framed correlates based on the National Institute on Minority Health and Health Disparities (NIMHD) multidimensional research framework. Database and author-focused searches were conducted, followed by article abstract and full-text reviews, much of which were guided by a discrete set of inclusionary and exclusionary criteria related to tobacco use and youth/young adults. A total of 24 articles were included in this review. The majority of articles focused on individual-level correlates, with a high number of studies demonstrating association between behavioral and sociocultural factors and tobacco product use behavior. Interpersonal factors also made up a substantial portion of the literature, commonly focusing on peer, family, and social norms. Gaps related to the NIMHD model are addressed. Future research should examine biological and community/societal factors associated with API smoking to better understand unique correlates in this population and to inform tobacco prevention and intervention approaches. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Scott K. Okamoto
- School of Social Work, Hawai’i Pacific University,Cancer Prevention in the Pacific Program, University of Hawai’i Cancer Center
| | | | | | | | - Pallav Pokhrel
- Cancer Prevention in the Pacific Program, University of Hawai’i Cancer Center
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Lee MH, Kim-Godwin YS, Hur H. Race/ethnicity differences in risk and protective factors for marijuana use among U.S. adolescents. BMC Public Health 2021; 21:1167. [PMID: 34193108 PMCID: PMC8247234 DOI: 10.1186/s12889-021-11159-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about how race and ethnicity influence marijuana-specific risk and protective factors in U.S. adolescents. We examined differences in risk and protective factors of marijuana use (MU) and their associations with MU by race/ethnicity. METHODS The present study used data from the 2015-2019 National Survey on Drug Use and Health. A total of 68,263 adolescents (aged 12 to 17 years) were divided into seven subgroups by race/ethnicity (White, Hispanic, Black, Asian, Native American, Native Hawaiian/Pacific Islander (NH/PI), and mixed race). Marijuana-specific risk and protective factors (RPFs) were examined, including perceived availability of marijuana, adolescents' perceived risk of MU and perceived disapproval of parents, peers, and close friends. Past-month, past-year, and lifetime MU were used as MU outcomes to examine the associations with RPFs as well as with race/ethnicity. RESULTS Overall, 6.85, 12.67, and 15.52% of the sample reported past-month, past-year, and lifetime MU respectively. Weighted adjusted logistic regression analyses revealed that mixed race adolescents reported the greatest perceived availability of marijuana, whereas Black and Asian adolescents had less access compared to White adolescents. The adolescents' perception of parental disapproval of MU was the lowest for Native American adolescents and highest for Asian adolescents. Mixed race adolescents experienced lower peer and close friend disapproval of MU while Black and Asian adolescents had higher. The MU risk perception was lower in most groups including Black, Hispanic, Native American, and mixed race adolescents, but not in Asian adolescents. Native American adolescents scored the highest on all MU outcomes, whereas Asian adolescents scored the lowest. Perceived availability of marijuana was associated with higher MU in all MU outcomes. Lower disapproval MU perceptions and lower MU risk perceptions were also associated with greater MU. CONCLUSION These findings suggest there is considerable heterogeneity of marijuana risk and protective factors and MU across race/ethnicity among U.S. adolescents.
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Affiliation(s)
- Meen Hye Lee
- School of Nursing, University of North Carolina Wilmington, 601 S College Rd, Wilmington, NC, 28403, USA
| | - Yeoun Soo Kim-Godwin
- School of Nursing, University of North Carolina Wilmington, 601 S College Rd, Wilmington, NC, 28403, USA
| | - Hyungjo Hur
- Department of Public Administration, Dankook University, 152 Jukjeon-ro, Suji-gu, Yongin-si, Gyeonggi-do, South Korea.
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Aguocha CM, Duru CB, Ndukuba AC, Nwefoh EC. Gender differences in psychoactive substance use among undergraduates in a developing country. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1779363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Chukwuma B. Duru
- Department of Community Medicine, Imo State University, Owerri, Imo State, Nigeria
| | - Appolos C. Ndukuba
- Department of Psychological Medicine, University of Nigeria Nsukka, Enugu State, Nigeria
| | - Emeka C. Nwefoh
- Department of Medicine, Imo State University, Owerri, Imo State, Nigeria
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Greene KM, Maggs JL. Immigrant paradox? Generational status, alcohol use, and negative consequences across college. Addict Behav 2018; 87:138-143. [PMID: 30029161 DOI: 10.1016/j.addbeh.2018.06.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 06/27/2018] [Accepted: 06/27/2018] [Indexed: 12/16/2022]
Abstract
The current study examined linkages between generational status, alcohol use, wanting to get drunk, and negative alcohol-related consequences during college. We tested whether immigrant students' longitudinal alcohol use trajectories converged to dominant unhealthy patterns or whether immigrant students maintained healthier patterns across college. We also examined if the weekend exerted equal risk for students of different generations. Furthermore, we explored whether patterns were consistent among Latinx and Asian American students. Stratified random sampling identified first-year students attending a US college. A longitudinal daily diary design was used; students completed web-based surveys for up to 14 days within each of 7 semesters. Each day, participants (N = 689; n1st generation = 114; n2nd generation = 244; 51% female) reported their alcohol use and consequences (N = 55,829 days). Multi-level models demonstrated that compared to 3rd generation students, 1st generation students were more likely to abstain from alcohol and less likely to binge drink and want to get drunk. First generation students also experienced fewer negative alcohol-related consequences. The protective effect of being 1st generation was maintained across college semesters, with subgroup analyses focusing on Latinx and Asian American students largely supporting the main findings. However, for abstaining and negative consequences, the weekend effect was less pronounced for immigrants than later generation students. For example, the difference in negative consequences between 1st (vs. 3rd) generation students was largest on the weekend. Additional work is needed to understand how 1st generation students leverage protective factors to abstain from alcohol use even when exposed repeatedly to "wet" drinking environments.
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El Kazdouh H, El-Ammari A, Bouftini S, El Fakir S, El Achhab Y. Potential risk and protective factors of substance use among school adolescents in Morocco: A cross-sectional study. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1535003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Hicham El Kazdouh
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
| | - Abdelghaffar El-Ammari
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
| | - Siham Bouftini
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
| | - Samira El Fakir
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
| | - Youness El Achhab
- Faculty of Medicine and Pharmacy of Fez, Laboratory of Epidemiology, Clinical Research and Community Health, Fez, Morocco
- Regional Centre for Careers Education and Training of Fez-Meknes, Fez, Morocco
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Luczak SE, Liang T, Wall TL. Age of Drinking Initiation as a Risk Factor for Alcohol Use Disorder Symptoms is Moderated by ALDH2*2 and Ethnicity. Alcohol Clin Exp Res 2017; 41:1738-1744. [PMID: 28847041 PMCID: PMC5626619 DOI: 10.1111/acer.13469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/01/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND An early age of drinking initiation (ADI) has been associated with increased risk for alcohol use disorders (AUDs), but the consistency of this risk across diverse samples has not been well studied. The purpose of this study was to examine whether the pathway from ADI to AUD symptoms by early adulthood is moderated by ethnicity and possessing an alcohol-metabolizing gene ALDH2*2 variant allele. METHODS We used multigroup structural equation modeling, including 5 groups split by ethnicity and ALDH2*2, to examine the consistency of the path from ADI to AUD symptoms in 604 Chinese-, Korean-, and White-American college students. We further examined the effects of ALDH2*2, ethnicity, and their interaction in Asians to better understand their unique contributions to the moderation. RESULTS The association between ADI and AUD symptoms was moderated, with ADI negatively associated with AUD symptoms among Koreans without ALDH2*2 and Whites, but not among Koreans with ALDH2*2 or Chinese regardless of ALDH2*2. Both ALDH2*2 and ethnicity within Asians contributed unique variability in the effect. CONCLUSIONS Ethnicity and ALDH2*2 altered the relationship of ADI as a risk factor for AUD symptoms. Being Chinese and possessing an ALDH2*2 allele within Koreans both buffered against the risk for AUD symptoms associated with earlier ADI, indicating that this relationship can be attenuated by protective factors.
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Affiliation(s)
- Susan E Luczak
- Department of Psychology, University of Southern California, Los Angeles, California
| | - Tiebing Liang
- Departments of Medicine and Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Tamara L Wall
- Department of Psychiatry, University of California, San Diego, San Diego, California
- Veterans Affairs San Diego Healthcare System, San Diego, California
- Veterans Medical Research Foundation, San Diego, California
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Kane JC, Damian AJ, Fairman B, Bass JK, Iwamoto DK, Johnson RM. Differences in alcohol use patterns between adolescent Asian American ethnic groups: Representative estimates from the National Survey on Drug Use and Health 2002-2013. Addict Behav 2017; 64:154-158. [PMID: 27614054 PMCID: PMC5143158 DOI: 10.1016/j.addbeh.2016.08.045] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 08/28/2016] [Accepted: 08/31/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Studies have suggested that alcohol use prevalence is increasing among Asian American adolescents and there may be significant differences between specific adolescent Asian American ethnicities. METHOD Data from the National Survey on Drug Use and Health (2002-2013) were used to estimate prevalence of alcohol use (lifetime, past-month, past-year) and problem (binge drinking, alcohol use disorder [AUD], and early initiation of use) outcomes among adolescent Asian American ethnicities. RESULTS Filipino Americans had the highest prevalence of lifetime (29.3%) and past-month (10.3%) use; Korean Americans had the highest prevalence of past-year use (22.7%). Asian Indian Americans had the lowest prevalence of all three use indicators: 14.6%, 11.9%, and 4.9% for lifetime, past-year, and past-month, respectively. Korean Americans had the highest prevalence of binge drinking (5.4%), Filipino Americans had the highest prevalence of AUD (3.5%), and Vietnamese Americans had the highest prevalence of early initiation of use (13.5%). Asian Indian Americans had the lowest prevalence for all three alcohol problem indicators: 2.6%, 1.0%, and 4.9% for binge drinking, AUD, and early initiation of use, respectively. CONCLUSIONS Prevalence estimates of alcohol outcomes among Korean, Japanese, and Filipino American adolescents were high and similar to other racial groups that are often considered higher risk racial groups. Estimates among large subgroups with low alcohol use prevalence, Chinese and Asian Indian Americans, may mask high rates among other Asian ethnicities when alcohol use estimates are presented among Asians overall. When feasible, researchers should present alcohol use estimates disaggregated by specific Asian American ethnicities and investigate differences in risk factors across groups.
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Affiliation(s)
- Jeremy C Kane
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States.
| | - April Joy Damian
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States
| | - Brian Fairman
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States
| | - Judith K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States
| | - Derek K Iwamoto
- Department of Psychology, University of Maryland, 4094 Campus Drive, College Park, MD 20742, United States
| | - Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North, Broadway, Baltimore, MD 21205, United States
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