Does Ethnic Identity Moderate the Relationship between Racial Discrimination and Cannabis Use among US- and non-US Born Black Emerging Adults?

Health Impact of Racism-Based Experiences Among Black African Immigrant Adults in the United States: An Integrative Review

Racism-based experiences among Black African immigrants in the United States are a growing concern due to the prevalence of these events and risk for negative health (mental, behavioral, and physical) outcomes. This integrative review appraised published studies (2012-2023) addressing the relationship between racism-based experiences and adverse health for Black African immigrants. Articles were identified using structured search terms in several databases (APA PsycINFO, CINAHL, PubMed, Web of Science), Google Scholar, and citation mining. A total of fourteen studies met the inclusion criteria. Studies found a significant positive association between racism-based experiences and adverse mental (n = 9), behavioral (n = 3), and physical (n = 2) health outcomes. Racism-based experiences appear to have mental, behavioral, and physical health consequences for Black African immigrant adults. Given the growing population of Black African immigrants in the United States, more work is needed to elucidate the relationship between racism-based experiences and negative health outcomes.

Associations among discrimination, psychological functioning, and substance use among US Black adults aged 18-28: Moderation by racial attribution and sex

INTRODUCTION

Discrimination is associated with poor mental health and substance use among Black Americans, but research is needed on mediators and moderators of these relationships. This study tested whether: 1) discrimination is associated with current alcohol, tobacco (cigarette or e-cigarette), and cannabis use among US Black emerging adults; 2) psychological distress (PD) and positive well-being (PW) are mediators of discrimination-substance use relationships; and 3) these relationships are moderated by sex and attributions to discrimination (racial vs. nonracial).

METHODS

Using data from a 2017 US nationally representative survey, we conducted bivariate and multiple-group moderated mediation analyses among 1118 Black American adults aged 18-28. The study assessed discrimination and attribution to discrimination using the Everyday Discrimination scale, past 30-day PD with the Kessler-6 scale, and past 30-day PW with the Mental Health Continuum Short Form. We utilized probit regression for all structural equation models and adjusted final models for age.

RESULTS

Discrimination was positively associated with past 30-day cannabis and tobacco use directly and indirectly through PD in the overall model. Among males who reported race as the sole/main attribution to discrimination, discrimination was positively associated with alcohol, cannabis, and tobacco use through PD. Among females who reported race as the sole/main attribution to discrimination, discrimination was positively associated with cannabis use through PD. Discrimination was positively associated with tobacco use among those who reported nonracial attributions to discrimination and with alcohol use among those whose attribution was not assessed. Discrimination was positively associated with PD among those who reported race as a secondary attribution to discrimination.

CONCLUSIONS

Discrimination specifically attributed to race may contribute to greater PD and in turn alcohol, cannabis, and tobacco use among Black emerging adults, especially males. Future substance use prevention and treatment efforts targeted to Black American emerging adults may benefit from addressing racial discrimination and PD.

Examining promotive and protective effects of ethnic identity on alcohol and cannabis use among Black young adults

INTRODUCTION

Experiences of racial discrimination among Black Americans are associated with numerous adverse behavioral health outcomes, including risk for substance use. Research has shown ethnic identity to be directly related to reduced substance use risk among Black Americans, as well as mitigate substance use risk as a consequence of exposure to racial discrimination. However, whether the specific facet of ethnic identity (affirmation and exploration), is related to the relationship between racial discrimination and problem substance use based on substance type is unclear. Thus, the current study examined 1) the association between ethnic identity (affirmation and exploration) and problem alcohol and cannabis use, and 2) whether ethnic identity affirmation or exploration moderates the association between racial discrimination and problem substance use among a sample of Black young adults.

METHODS

Three-hundred and ninety Black young adults ages 18-24 (M = 20.6, 62 % female, 85 % monoracial) completed an online survey that included measures on past-year experiences of racial discrimination, ethnic identity affirmation and exploration, and problem alcohol and cannabis use. Utilizing multiple linear regression and the PROCESS macro, the study examined the promotive (direct) association between ethnic identity and problem substance use, and the protective (moderating) effect of ethnic identity on the relationship between racial discrimination and problem substance use.

RESULTS

After accounting for the demographic covariates of age, gender (male, female, and other), and race (monoracial and bi/multiracial), higher ethnic identity affirmation was significantly associated with lower problem alcohol, and higher ethnic identity exploration was significantly associated with lower problem alcohol and cannabis use. The study also observed a moderating effect of ethnic identity affirmation and exploration on the relationship between racial discrimination and problem alcohol use. Specifically, the association between racial discrimination and problem alcohol use weakened at higher levels of ethnic identity affirmation and exploration. Neither ethnic identity affirmation nor exploration significantly moderated the relationship between racial discrimination and problem cannabis use.

CONCLUSION

Findings suggest that ethnic identity is associated with problem alcohol use and may also reduce the strength of the association between racial discrimination and problem alcohol use, although these findings need to be confirmed with longitudinal study designs. If supported, interventions focused on strengthening one's ethnic identity affirmation and exploration may offer a potential target for interventions addressing alcohol misuse among Black young adults. However, more research should seek to understand promotive and protective factors for problem cannabis use among Black young adults.

Disparities in functioning from alcohol and cannabis use among a racially/ethnically diverse sample of emerging adults

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.

Advancing Health Equity through Substance Use Research

Several health inequities exist among racial/ethnic minoritized populations (REMPs) who use substances including disparities in use patterns, inequities in health and legal consequences of use, as well as in treatment access and effectiveness. To address these inequities, more research is needed to examine the associated factors and identify areas for improving treatment. Divided into three categories, this special issue includes papers that examine the social and contextual factors that are associated with substance use among REMPs, papers that consider the role of racism and discrimination on substance use, and papers that explore racial/ethnic differences in treatment access and outcomes. Recommendations for advancing health equity in substance use research are also included.