Asians, Asian-Americans and alcohol

Neighborhood context and substance use disorders: a comparative analysis of racial and ethnic groups in the United States

BACKGROUND

There is evidence that ethnic/racial minorities are conferred differential risk for substance use problems based on where they live. Despite a burgeoning of research focusing on the role of neighborhood characteristics on health, limited findings are available on substance use. Our study uses nationally representative data (N=13,837) to examine: (1) what neighborhood characteristics are associated with risk of substance use disorders?; (2) do the associations between neighborhood characteristics and substance use disorders remain after adjusting for individual-level factors?; and (3) do neighborhood characteristics associated with substance use disorders differ by race/ethnicity after adjusting for individual-level factors?

METHODS

Data were drawn from the Collaborative Psychiatric Epidemiology Studies (CPES-Geocode file) with 836 census tracts. Analyses included African Americans, Asians, Caribbean Blacks, Latinos, and non-Latino whites. Separate logistic regression models were fitted for any past-year substance use disorder, alcohol use disorder, and drug use disorder.

RESULTS

Living in more affluent and residentially unstable census tracts was associated with decreased risk of past-year substance use disorder, even after adjusting for individual-level factors. However, when we investigated the interaction of race/ethnicity and census latent factors with past-year substance use disorders, we found different associations for the different racial/ethnic groups. We also found different associations between neighborhood affluence, residential instability and any past-year substance use and alcohol disorders by nativity.

CONCLUSIONS

Characteristics of the environment might represent differential risk for substance disorders depending on a person's ethnicity/race and nativity status.

Acculturation Style and Alcohol Use Among African American College Students

This study examined whether a relationship exists between acculturation and alcohol use among African American college students and if the relationship varies by religiosity and gender. Most researchers use unidimensional African American acculturation measures that cannot capture the construct’s complexity; this study is the first to use a bidimensional measure. Results revealed a relationship between acculturation and alcohol use. Less frequent drinking occurred among marginalists (those who reject both African and Eurocentric U.S. culture), while assimilationists (those who reject African culture in favor of Eurocentric U.S. culture) drank more frequently. Religiosity and gender also significantly influenced the nature of the relationship.

Social meaning of alcohol-related flushing among university students in China

This study explored drinking patterns, alcohol-related flushing, and ways students themselves and other people respond to flushing in drinking situations. Of 1080 Chinese undergraduate university students given the survey questionnaire, 725 (67.1%) returned the completed surveys. Eighty percent of the students were drinkers (93% of males and 69% of females); 68% of the drinkers were flushers. Most of the students (59.3%) said flushing had no special meaning, that is, would ignore flushing; 54% of the flushers said they could keep drinking "but less" when they flush; 27% of the students said that a flushing person should stop drinking; however, if the flushing person is a girl, 89% of the students said the girl should drink less or stop. If the flushing person was a boy, 61% of students said he should drink less or stop. The data do suggest gender differences in the understanding of and social reaction to alcohol-related flushing, and these differences raise interesting questions as to how flushing acts as a potential protective factor against alcohol misuse.

Empowering the disempowered: harm reduction with racial/ethnic minority clients

Harm-reduction principles, such as empowerment of clients and goals for moderation, align well with the cultural worldviews of many clients of color. Empirically supported harm-reduction strategies often work well with ethnic minority clients. However, clients of color require special clinical considerations. A case study illustrates the use of the community participatory model, which combines harm reduction, cultural sensitivity, and community support. Treatment services can be provided under one roof to eliminate barriers to seeking and receiving services. Harm-reduction therapists can carefully assess and diagnose clients of color to minimize the potential shortcomings and cultural biases in assessment tools. Therapy will include the family and incorporate traditional practices as desired by clients. Use of these methods will empower and support clients of color as they seek their treatment goals.

Rethinking Acculturation: A Study of Alcohol Use of Korean American Adolescents in Southern California

Given the considerable variability in drinking practices among Asian American groups, the generalizations that suggest an increase in their alcohol use associated with acculturation need to be questioned. Also, the experience of children of immigrants growing up in the United States may be much more complex than a focus on acculturation can capture. Informed by the theory of segmented assimilation, this study addresses two research questions: 1) Is acculturation associated with alcohol use of Korean American adolescents? and 2) What other social, economic, and cultural forces influence their alcohol use? Survey data collected from 202 adolescents of Korean descent in Southern California were used. Multivariate regression analyses revealed that acculturation was not a significant predictor of most measures of alcohol use, while peer influence, scholastic achievement/aspirations, and current smoking were predictive. Gender and social class were unrelated to drinking. Findings suggest focusing research on an integrative approach to understanding drinking in complex social, economic, and social contexts may be useful.

Ethnic identity, religiousness, and drinking among African Americans: what's the connection?

This study tested a theoretical model explaining how ethnic identity and religiousness might be related to alcohol use among African Americans. One hundred seventy-three African American undergraduates at a large, public, Southeastern historically black university completed the study. Findings indicate that although religiousness accounted for 31% of the relationship between ethnic identity and alcohol use, whether mediation existed depended on which dimensions of ethnic identity, religiousness, and alcohol use were examined. Daily spiritual experiences (but not forgiveness or private religious activities) mediated the link between ethnic belonging (but not ethnic identity search) and average number of alcoholic beverages consumed in a sitting (but not frequency of use or problems with use).

Alcohol use among two generations of Southeast Asians in the United States

This article assesses the drinking norms and practices of two generations of Southeast Asians in the East San Francisco Bay Area. Researchers included quantity and frequency measures of current alcohol use and binge drinking and open-ended questions on drinking norms and behaviors in a mixed-method study of tobacco use. The study generated data through in-person interviews with 164 respondents from two urban East Bay neighborhoods. The findings include normative drinking among women and underage youth, with binge drinking among underage youths particularly troubling. Preventive interventions for this population should consider community-level alcohol problems as well as individual alcohol use disorders.

Alcohol expectancies, drinking refusal self-efficacy and drinking behaviour in Asian and Australian students

The effects of alcohol expectancies (AE) and drinking refusal self-efficacy (DRSE) in predicting alcohol consumption in Caucasians has been well studied. However, the role of AE and DRSE in Asian students is still not well understood. This study reported on this using Caucasian (n=98) and Asian (n=92) student samples. Participants completed the Alcohol Use Disorder Identification Test (AUDIT) to measure their hazardous alcohol consumption, and the drinking expectancy profile (DEP) to assess their alcohol related expectancies and ability to resist drinking in certain situations. Results showed that Caucasians reported significantly higher confidence, higher sexual interest, and higher tension reduction expectancies than Asians. Conversely, Asians significantly expected cognitive enhancement and negative consequences more than Caucasians. Relative to Caucasians, the Asian sample also reported that they would be more able to refuse alcohol when under social pressure. Results from regression analyses showed that for the Caucasian sample, AE, DRSE and their interactions were significant predictors of alcohol consumption. For the Asian group, the only significant effect to emerge was that DRSE was negatively related to alcohol consumption. The clinical implications of the differential pattern of results between the samples are discussed in terms of self-efficacy and negative consequences of alcohol consumption, especially when dealing with university aged individuals.

Sexual activity and other risk-taking behaviors among Asian-American adolescents

STUDY OBJECTIVE

The purpose of this paper is to review the existing literature of sexual activity and risk-taking behaviors among Asian-American youth.

DESIGN

Literature review of sexual activity, alcohol, tobacco, and illicit drug use among Asian-American adolescents.

RESULTS

Asian-Americans are the fastest growing racial group in the United States. Asian-American adolescents report lower involvement with sexual activity than all other racial/ethnic peer groups. Once initiated, however, Asian-American adolescents have sexual behavior patterns comparable to other adolescent groups. In general, Asian-Americans have low rates of alcohol and tobacco usage and the males have higher use rates than the females. Degree of acculturation in the United States appears to be associated with risk-taking behavior. Asian-American adolescents also initiate smoking later than other groups. Although drug use among Asian-American adolescents is historically low, there appears to be variability on the level of illicit drug use among certain Asian-American adolescent subgroups.

CONCLUSION

Clinicians should focus prevention efforts and education on the Asian-American groups associated with higher risk-taking behaviors, particularly males and those who are more acculturated. Furthermore, to benefit Asian-American youth, anti-smoking education should continue through high school and early adulthood.

Asians in the United States: substance dependence and use of substance-dependence treatment

Clinicians have often observed that Asians are unlikely to utilize substance-dependence treatment services but few have reported empirical data examining this phenomenon. This study used data from the National Household Survey on Drug Abuse, 2000-2002, and tested whether Asians in the United States have relatively low rates of drug and alcohol dependence and whether substance-dependent Asians use treatment services less than Caucasians. Subsequent analyses were undertaken to identify factors that explained these racial differences. Of the 5,118 Asians, 159 met criteria for past-year drug or alcohol dependence. Asians with past-year substance dependence were significantly less likely than substance-dependent Caucasians to report past-year treatment (odds ratio 0.42, 95% confidence interval 0.19-0.96). Differences in past-year substance-dependence prevalence appear to be partially explained by between-group differences in ever using substances; differences in past-year treatment use appear to be in part related to differences in levels of acculturation and education.

Psychosocial, cultural and genetic influences on alcohol use in Asian American youth

OBJECTIVE

Environmental and cultural factors, as well as a genetic variant of the aldehyde dehydrogenase gene (the ALDH2*2 allele) have been identified as correlates of alcohol use among Asian Americans. However, concurrent examination of these variables has been rare. The present study assessed parental alcohol use, acculturation and ALDH2 gene status in relation to lifetime, current and heavy episodic drinking among Chinese and Korean American undergraduates.

METHOD

Participants (N = 428, 51% women; 52% Chinese American, age 18-19 years) were first-year college students in a longitudinal study of substance use initiation and progression. Data were collected via structured interview and self-report, and participants provided a blood sample for genotyping at the ALDH2 locus.

RESULTS

Gender, parental alcohol use and acculturation significantly predicted drinking behavior. However, none of the hypothesized moderating relationships were significant. In contrast with previous studies, ALDH2 gene status was not associated with alcohol use.

CONCLUSIONS

Results indicate that although the variables examined influence alcohol use, moderating effects were not observed in the present sample of Asian American college students. Findings further suggest that the established association of ALDH2 status and drinking behavior in Asians may not be evident in late adolescence. It is possible that ALDH2 status is associated with alcohol consumption only following initiation and increased drinking experience.

Epidemiologic trends in esophageal and gastric cancer in the United States

Use of tobacco, moderate to heavy alcohol ingestion, infrequent consumption of raw fruits and vegetables, and low income accounted for more [figure: see text] than 98% of the SCE rates among both African American and white men and for 99% of the excess incidence among African Americans compared to whites in a case-control study in three areas of the United States [14]. Thus, it is likely that declines in the prevalence of smoking and drinking, especially among men, and increased intake of fresh fruits and vegetables may have contributed to the downward incidence and mortality rate trends reported for SCE. In addition, it seems plausible that obesity, GERD, and possibly reductions in H. pylori prevalence have contributed to the upward trends in ACE rates. Reductions in smoking, improved diet, and reductions in H. pylori prevalence probably have contributed to the consistent reductions observed for NGA. Contributing factors are less clear for the rising incidence rates of GCA during the 1970s and 1980s. These incidence rates have not continued to rise in recent years.

Social influences as explanations for substance use differences among Asian-American and European-American adolescents

The present study examines the social influences in the Asian-American and European-American adolescent environment to provide a greater understanding of effect of ethnic differences on the prevalence of substance abuse. Participants were 957 Asian-American and 3705 European-American seventh grade adolescents. It was found that Asian-American students were less likely to use alcohol and cigarettes, and had a more abstinence-promoting environment than European-American adolescents. This difference in Asian-American adolescents appeared to be the result of less adult and peer influence to use alcohol or cigarettes, less offers of alcohol, and an increased likelihood of having an intact family when compared to European-American adolescents. Additionally, Asian-American adolescents reported having fewer friends and spending less time with their friends than European-American adolescents. It was concluded that social influences play an important role in explaining why Asian-American adolescents have lower rates of substance use.

Ethnicity, alcohol, and acculturation

In the social and behavioral sciences there is a strong correlation alleged between alcohol abuse and ethnonational origins. Changes in drinking patterns and problem drinking among immigrants to the United States are often mistakenly attributed to acculturation, just as the etiology of alcohol abuse and alcoholism is often erroneously traced to the 'ethnic origins' of these men and women. In addition, and for the same reasons, researchers and practitioners may have thus unwittingly influenced the perceptions and understandings of this population with respect to the relationship between particular ethnic groups and alcohol consumption. This paper summarizes how the term acculturation has been employed recently in alcohol studies. Preliminary findings are reported from ethnographic fieldwork with Latin America-born men in the San Francisco Bay Area.

Alcohol norms, expectancies, and reasons for drinking and alcohol use in a U.S. versus a Japanese college sample

Two hundred eighty-two students at Arizona State University in the U.S. and 339 students at Okayama University in Japan completed a questionnaire on their alcohol use, expectancies of the effects of alcohol on their own and others' moods and behaviors, the desirability of these effects, norms of significant others for levels of alcohol use and the subject's desire to comply with these norms, and reasons for drinking and not drinking alcohol. Although frequencies of current drinkers versus abstainers did not differ between the two samples, the U.S. students began regular alcohol use at a significantly earlier age, currently drank more alcohol, had higher alcohol expectancies for emotional responses, and endorsed more celebratory reasons for drinking than their Japanese counterparts. U.S. students, however, had lower expectancies for flushing and lower perceived norms for drinking. Hierarchical multiple regressions performed using data from the current drinkers indicated that expectancies of disinhibition and especially aggressiveness after alcohol use, alcohol norms, celebratory (but not pathological) reasons for drinking, and reasons for not drinking were more predictive of reported levels of alcohol use among the U.S. students as compared with the Japanese students.

Toward a culturally anchored ecological framework of research in ethnic-cultural communities

Proposed a research framework (the "cube" model) in which community psychologists working in ethnic-cultural communities can make appropriate decisions on conceptual and methodological issues from a culturally anchored, ecological-contextualist perspective. The intent of the model is to articulate ethnic-cultural heterogeneity in community research by elucidating three metamethodological issues: (a) definition of an ethnic-cultural community, (b) applicability of cross-cultural theories and methods to ethnic-cultural community research, and (c) geographical or ecological stability of an ethnic-cultural community. The model posits that ethnic-cultural community research can be conceptualized as a three-dimensional structure that represents an interaction among research questions, methods, and cultural complexity (referring to the extent to which an ethnic-cultural group is defined in a larger ecological context or community both at the individual and collective levels). Future directions for research were discussed in terms of the utility and the limitations of the proposed research model.

Substance abuse treatment: cultural barriers in the Asian-American community

Asians constitute the largest growing minority in the United States. However, inaccurate perceptions and stereotypes continue to mask a full understanding of the state of knowledge regarding their alcohol and other drug abuse. Much of the existing research has continued this trend by categorizing Asians as "others" or persisting in its attempts to explain low incidence rates by investigating metabolic phenomena. More recent community-based studies have shown alarming incidence rates of specific substance abuse among different Asian ethnic groups. Asian heterogeneity and cultural barriers have also contributed to the lack of knowledge regarding substance abuse prevalence rates. Issues related to taboo, denial, and loss of face further mask understanding of the extent of the problem. Institutional barriers and the lack of community infrastructure make treatment efforts difficult in serving a myriad of Asian groups. For most Asians undergoing treatment, cultural factors need to be considered, including the involvement of the family as well as the risk related to its transition under immigration and the following acculturation patterns. An example of a specific treatment program and activity is discussed in relationship to the cultural factors indicated above. Finally, recommendations are specified for future treatment policy, research, and services.