Acculturation and alcohol among Latino adults in the United States: a comprehensive review

Contextualizing Bicultural Competence Across Youths' Adaptation From High School to College: Prospective Associations With Mental Health and Substance Use

Bicultural competence, the ability to navigate bicultural demands, is a salient developmental competency for youth of color linked with positive adjustment. This study investigated how discrimination experiences informed developmental trajectories of behavioral and affective bicultural competence across youth's adaptation from high school to college, and how these biculturalism trajectories predicted later adjustment (i.e., internalizing symptoms and binge drinking). Data were collected between 2016 through 2020 and included 206 U.S. Latino youth (Mage=17.59, 64% female, 85% Mexican origin, 11% first and 62% second generation immigrants). Linear latent growth analyses revealed that youth who experienced greater time-varying discrimination demonstrated lower concurrent behavioral and affective bicultural competence. Higher behavioral bicultural competence intercepts were associated with fewer internalizing symptoms in the third college year. No other significant associations emerged for internalizing symptoms or binge drinking. These findings have implications for mental health equity among Latino youth during a critical period of psychopathology onset.

Lifetime use of alcohol and cannabis among U.S. adolescents across age: Exploring differential patterns by sex and race/ethnicity using the 2019 NSDUH data

Background

Early use of alcohol and cannabis is associated with health and social problems. It is unclear how lifetime use changes for each additional year of age during adolescence, and whether this change varies by sex and race/ethnicity. This study characterized lifetime rates of alcohol and cannabis use by age among 12- to 17-year-old American youth and explored differential patterns by sex and race/ethnicity.

Methods

Data were obtained from the 2019 National Survey on Drug Use and Health. Analyses were restricted to 12-17-year-olds who were non-Hispanic White, non-Hispanic Black, or Hispanic/Latino (n = 11,830). We estimated the increase in lifetime use of alcohol and cannabis by age for the full sample and stratified by sex and race/ethnicity. Slopes of the regression lines were compared to assess differential patterns across groups.

Results

In these cross-sectional analyses, reported lifetime use increased substantially from age 12 to 17 for alcohol (6.4 % to 53.2 %) and cannabis (1.3 % to 35.9 %). The increase in lifetime alcohol use was slightly, but not significantly, steeper among girls than boys (F1,8 = 3.40, p = 0.09). White and Latino youth showed similar rates of increase in lifetime alcohol use, which was significantly flatter among Black youth (F2,12=21.26, p<0.0001). Latino youth had a slightly, but not significantly, steeper increase in lifetime cannabis use than White and Black youth (F2,12=3.17, p = 0.07).

Conclusions

Reports of lifetime alcohol and cannabis use substantially increase from age 12 to 17 and the rates are different according to sex and race/ethnicity, highlighting the need for early and tailored substance use prevention in adolescents.

Nativity and the risk of opioid use disorder among Hispanic/Latinx women in primary care in Los Angeles, CA

BACKGROUND

While rates of opioid use disorder (OUD) are lower among women compared to men, nativity may have disproportionate impacts on OUD risk among Hispanic/Latinx women but remain understudied.

OBJECTIVE

To assess the association between country of birth and reported OUD risk among low-income Hispanic/Latinx women in primary care in Los Angeles, CA.

METHODS

This was a cross-sectional study of 1189 non-pregnant, Hispanic/Latinx women attending two federally qualified health centers in Los Angeles between March and July 2013. OUD risk was assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and moderate-to-high risk was defined as ASSIST score ≥ 4.

RESULTS

Overall, 4.2% of women (n = 49) were at moderate-to-high risk for OUD. Risk for OUD was higher among US-born women compared to foreign-born women (6.7 vs. 1.7%; p < .01), those who reported 2+ chronic medical conditions (p < .01), and those who were at moderate-to-high risk for other substance use disorders (p < .01). In multivariable logistic regression analyses, being U.S.-born was independently associated with being at moderate-to-high risk for OUD among Hispanic/Latinx women as compared to those who were foreign-born (AOR = 2.8; 95% CI 1.2-6.8).

CONCLUSION

Among low-income Hispanic/Latinx women presenting to primary care, one in twenty patients is at-risk for OUD. The odds of moderate-high risk of OUD were three times as high in US-born compared to foreign-born women, and higher among those with chronic medical conditions and those at risk of other substance use disorders. Gender-specific and culturally-tailored screening for OUD may inform overdose prevention interventions for US-born Hispanic/Latinx women.

Contexts of Drinking- and Alcohol-Related Problems Among Whites and Hispanics on and off the US/Mexico border in California

BACKGROUND

This paper examines the association between drinking context use by Whites and Hispanics on and off the US/Mexico border and alcohol problems.

METHODS

Data come from a household sample of 1209 adults 18 to 39 years of age resident in Imperial County on the California/Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Data were collected on the phone or online and analyzed with an ordinal generalized linear model.

RESULTS

The pattern of statistically significant associations between the frequency and the volume of drinking in different contexts varies across problem types. Furthermore, some contexts of drinking are associated with problems in more than one area. For instance, frequency of drinking at bars/pubs is associated with social problems, risky sex, and fights, but not with injuries. Injuries are associated with the frequency of drinking at home alone or with family and at restaurants. Volume of drinking at bars/pubs is also significantly associated with three different contexts: social problems, injury, and fights. But the volume of drinking at the home of friends or relatives is associated with fights only. Border location is an effect modifier, changing the effect of frequency of drinking at bars and pubs from protective to a factor of risk for social problems and fights.

CONCLUSION

These results provide support for the social ecology of drinking and micro environmental factors or risk. The effect of border location on frequency of drinking in bars/pubs underlines the importance of the macro environment in problem generation.

Hazardous alcohol consumption and problem drinking in Norwegian and Russian women and men: The Tromsø Study 2015-2016 and the Know Your Heart study 2015-2018

AIM

Harmful use of alcohol is a worldwide public health concern. Cultural differences may affect responses to questions on alcohol problems, making international comparisons difficult. We aimed to compare self-reported alcohol consumption and problem drinking between Norwegian and Russian populations.

METHODS

We used data from women and men aged 40-69 years participating in the Tromsø Study seventh survey (Tromsø7, N=17646, participation 65%), Tromsø (2015-2016), Norway, and the Know Your Heart study (KYH, N=4099, participation 51%), Arkhangelsk and Novosibirsk (2015-2018), Russia. Alcohol consumption and problem drinking were measured by the Alcohol Use Disorders Identification Test (AUDIT) via questionnaires (Tromsø7) and interviews (KYH). We compared AUDIT scores and components between populations, by sex.

RESULTS

Non-drinking was more commonly reported in KYH compared with Tromsø7 (men 15.5% versus 4.9%, women 13.3% versus 7.3%). In men, hazardous consumption (41.4% versus 31.5%) and problem drinking (24.8% versus 19.6%) was higher in KYH compared with Tromsø7, but opposite for women (6.5% versus 12.0%, and 2.3% versus 5.8%). KYH men were less likely to report problem drinking behaviours than Tromsø7 men, with the exception of needing a drink first thing in the morning (13.2% versus 2.4%). KYH women consistently reported less consumption and problem drinking than Tromsø7 women.

CONCLUSIONS

We found between-study differences in hazardous drinking, but in men these were lower than suggested by differences in country-level statistics on alcohol consumption and alcohol-related health-harms. Study sample selection, stronger social desirability bias effects in the Russian samples, and cultural differences in responding could have affected the results.

Acculturation Style Is Associated with Stress and Tobacco Use among East African Immigrants

While tobacco use rates are relatively high among East African immigrants in the U.S., factors contributing to this high rate are largely unknown. Acculturation is associated with stress and substance use. Whether acculturation styles are related to stress and current tobacco use has not been tested among this population. We conducted a cross-sectional study that included 376 East African adults who provided information on demographic background, acculturation style, acculturative stress, depressive symptoms, and tobacco use. Multivariate analysis indicated that individuals who were distant to both the culture of the host country and the culture of origin (marginalization style) had greater levels of acculturative stress than those who adopted both cultures (integration style; p < .001). Marginalized people were four to eight times and assimilated people were three to four times more likely than integration people to be a current tobacco user (p < .04). This relationship did not change after controlling for demographic information and stress. In this study, acculturation style was associated with perceived stress and current tobacco use among East African immigrants. Research focused on characterizing integrated individuals may guide efforts to develop culturally-relevant strategies to reduce tobacco-related disparities among East African individuals.

Triangulation of evidence on immigration and rates of alcohol use disorder in Sweden: Evidence of acculturation effects

BACKGROUND

This study aimed to determine the robustness of the impact of immigration on risk for alcohol use disorder (AUD) using different measures, designs, and immigrant regional cohorts.

METHODS

The analytic sample included all individuals born between 1950 and 1990 and registered in Sweden from 1973 to 2017. Using Cox regression models, we examined the risk for AUD from Swedish nationwide registries in immigrants to Sweden from seven geographical regions: Africa, Asia and Oceania, Eastern Europe, Finland, Latin America and the Caribbean, Middle East/North Africa, and Western countries. We assessed greater exposure to Swedish culture, which we interpreted as increasing acculturation, by (i) comparing first-generation immigrants and their children with no and one native Swedish parent and (ii) examining age at immigration. The baseline comparison group was the native Swedish population. We also examined AUD risk in first-generation sibling pairs discordant for their age at immigration.

RESULTS

In nearly all immigrant cohorts in Sweden, increasing degrees of acculturation, as assessed by both our variables, were associated with rates of AUD that approached those of the Swedish population. These findings occurred in both men and women and both regional cohorts whose first-generation immigrants had lower and higher levels of AUD than native-born Swedes. For most cohorts, the rates of change with acculturation were greater in women than in men. In sibling pairs from most regions, the sibling who was younger at immigration had a higher rate of AUD.

CONCLUSIONS

An examination of both sexes and two different proxies for acculturation provides consistent support for socio-cultural influences on AUD risk. Our co-sibling analyses suggest that a meaningful proportion of this effect is likely to be causal in nature.

Genetic risk of AUDs and childhood impulsivity: Examining the role of parenting and family environment

This study examined the independent and interactive effects of genetic risk for alcohol use disorder (AUD), parenting behaviors, and family environment on childhood impulsivity. Data were drawn from White (n = 5,991), Black/African American (n = 1,693), and Hispanic/Latino (n = 2,118) youth who completed the baseline assessment (age 9-10) and had genotypic data available from the Adolescent Brain Cognitive Development Study. Participants completed questionnaires and provided saliva or blood samples for genotyping. Results indicated no significant main effects of AUD genome-wide polygenic scores (AUD-PRS) on childhood impulsivity as measured by the UPPS-P scale across racial/ethnic groups. In general, parental monitoring and parental acceptance were associated with lower impulsivity; family conflict was associated with higher impulsivity. There was an interaction effect between AUD-PRS and family conflict, such that family conflict exacerbated the association between AUD-PRS and positive urgency, only among Black/African American youth. This was the only significant interaction effect detected from a total of 45 tests (five impulsivity dimensions, three subsamples, and three family factors), and thus may be a false positive and needs to be replicated. These findings highlight the important role of parenting behaviors and family conflict in relation to impulsivity among children.

Thinking about drinking: Acculturation and alcohol-related cognitions among college-bound Latinas

Objective: This study examined acculturation with positive alcohol expectancies (PAE) and alcohol use intentions among college-bound Latinas using a bidimensional (ie U.S. acculturation/enculturation) and bidomain (ie behaviors/values) acculturation framework. Participants: A total of 298 Latina young adults between 18 and 20 years old were included in this analysis. Methods: Data were collected the summer before participants began college for the first time. We used an online survey to assess acculturation, PAE, and alcohol use expectancies. Results: Path analyses showed that U.S. acculturation values were related to more PAE and alcohol use intentions. U.S. acculturation behaviors were related to more alcohol use intentions, and the pathway was moderated by PAE. There was also an interaction between U.S. acculturation and enculturation behaviors predicting alcohol use intentions. Conclusion: This study sheds light on how acculturating Latina young women think about alcohol use prior to beginning college, which is an opportune window for targeted prevention programs.

Health Risk Behaviours by Immigrants’ Duration of Residence: A Systematic Review and Meta-Analysis

Objectives: The aim was to systematically review and synthesise international evidence on changes in health risk behaviours by immigrants’ duration of residence.

Methods: We searched literature databases for peer-reviewed quantitative studies published from 2000 to 2019, examining alcohol, drug and tobacco use; physical inactivity; and dietary habits by duration of residence.

Results: Narrative synthesis indicated that immigrants tend to adopt health risk behaviours with longer residence in North America, with larger variation in effect sizes and directionality in other contexts. Random-effects meta-analyses examining the pooled effect across all receiving countries and immigrant groups showed lower odds of smoking (OR 0.54, 0.46–0.63, I² = 68.7%) and alcohol use (OR 0.61, 0.47–0.75, I² = 93.5%) and higher odds of physical inactivity (OR 1.71, 1.40–2.02, I² = 99.1%) among immigrants than natives, but did not provide support for a universal trend by duration of residence.

Conclusion: Findings suggest that duration of residence could serve as an effective instrument to monitor immigrants’ health changes. However, differences in receiving country contexts and immigrant populations’ composition seem to be important to predict the level and direction of behavioural change.

Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, PROSPERO CRD42018108881.

Cancer Mortality Patterns by Birthplace and Generation Status of Mexican Latinos: The Multiethnic Cohort

BACKGROUND

Latinos are the largest minority group in the United States. We assessed cancer mortality by birthplace and generation status of Mexican Latinos in the Multiethnic Cohort.

METHODS

We included 26 751 Latinos of Mexican origin and 6093 non-Latino Whites aged 45-74 years at cohort entry (1993-1996) from the California Multiethnic Cohort component. The Mexican Latinos comprised 42% first-generation Mexico-born immigrants, 42% second-generation (28% US-born with both parents Mexico-born and 14% US-born with 1 parent US-born and 1 parent Mexico-born), and 16% third-generation or more who were US-born with both parents US-born. Multivariable Cox models were used to calculate covariate adjusted hazard ratios and 95% confidence intervals for overall and site-specific cancer mortality by birthplace and generation status. All statistical tests were 2-sided.

RESULTS

Cancer death rate was highest among the US-born with 1 parent US-born and 1 parent Mexico-born (age-adjusted rate = 471.0 per 100 000 person-years) and US-born with both parents US-born (age-adjusted rate = 469.0 per 100 000 person-years) groups. The US-born with both parents Mexico-born group had a 30% (hazard ratio = 1.30, 95% confidence interval = 1.18 to 1.44) higher risk of cancer death than the first-generation Mexico-born immigrants group, showing US birthplace was associated with an elevated cancer mortality. For cancer-specific mortality, US birthplace was positively associated with colorectal, liver and lung, and ovarian cancer (P values ranged from .04 to .005). Among US-born Mexican Latinos, generation status was not statistically significantly associated with overall cancer or site-specific cancer mortality.

CONCLUSIONS

Our findings suggest that US birthplace is a risk factor for cancer death in Mexican Americans. Identification of the contributing factors is important to curtail patterns of increasing cancer mortality in US-born Mexican Latinos.

Acculturation and drinking behavior among Latinxs: a narrative review

Research suggests that acculturation is associated with increased alcohol consumption among Latinxs. The purpose of this narrative review is to contribute to this literature by examining the association between acculturation and alcohol use within current theoretical and etiological frameworks on cultural norms, acculturative stress, and acculturative gaps. This review also compares the utility of these explanatory frameworks for guiding future research. Two databases (PubMed and PsycInfo) were used to identify peer-reviewed studies pertaining to the associations between acculturation and alcohol use among Latinxs. Studies that examined drinking norms, acculturative stress, acculturation gaps, and drinking behavior in Latinxs were included. The types of study approaches and designs included quantitative, qualitative, cross-sectional, cohort, and longitudinal studies published between January 2000 and December 2021. Quality assessment and data synthesis were conducted by two reviewers. A total of 65 articles reporting empirical studies were included in the final review. Eighteen studies did not utilize a specific framework, but generally supported that acculturation is associated with increased alcohol consumption and alcohol related consequences among Latinxs. Additionally, sixteen studies examined cultural norms, twenty-two examined acculturative stress, while only nine utilized a gap discrepancy framework. Studies examining drinking norms appeared to largely explain changes in drinking behavior among Latinas, while studies examining acculturative stress seemed to be better equipped to explain changes in drinking behavior among Latino men. Meanwhile, the Gap Discrepancy Model articulates the gap between old and new cultural influences and can be conceptualized as an additional dimension of acculturative stress.

Discrimination, acculturative stress, alcohol use and their associations with alcohol-related consequences among Latino immigrant men

Latino immigrant men are at increased risk for unhealthy alcohol use and related consequences due to social stressors associated with immigration. We assessed the associations of, and examined whether social stressors moderated associations between, alcohol use and alcohol-related consequences in a community-based sample of Latino immigrant men in Washington (N = 187). The mean Alcohol Use Disorders Identification Test Consumption (AUDIT-C) score was 6.3 (scores ≥ 4 indicate unhealthy alcohol use). More than half of the men (61.5%) reported experiencing discrimination in at least one setting and mean acculturative stress score was 18.3 indicating moderate levels of acculturative stress. Linear regression models were fit to assess main effects (associations between both alcohol use and social stressors and alcohol-related consequences) and moderation (whether the association between alcohol use and consequences varied based on experience of social stressors using multiplicative interaction) after adjustment for potential confounders. Alcohol use (β = 0.47, 95% CI = 0.20-0.73; p = .001), discrimination (β = 0.85, 95% CI = 0.27-1.43; p = .004), and acculturative stress (β = 0.13, 95% CI = 0.02-0.24; p = .025) were all associated with increased experience of alcohol-related consequences. The association between alcohol use and alcohol-related consequences was stronger for those with high levels of acculturative stress (p = .025) but not experience of discrimination (p = .587). Findings underscore the importance of social and cultural context in alcohol use and related consequences. Efforts to reduce negative consequences of drinking may include focus on reducing exposure to discrimination and acculturative stress.

Associations of clustered health risk behaviors with diabetes and hypertension in White, Black, Hispanic, and Asian American adults

Background

The clustering of Big Four contributors to morbidity and mortality—alcohol misuse, smoking, poor diet, and physical inactivity—may further elevate chronic health risk, but there is limited information about their specific combinations and associated health risks for racial/ethnic minority groups. We aimed to examine patterns of clustering in risk behaviors for White, Black, Hispanic, and Asian American adults and their associations with diabetes and hypertension. As these behaviors may be socioeconomically-patterned, we also examined associations between clustering and socioeconomic status (SES).

Methods

Latent class analyses and multinomial and logistic regressions were conducted using a nationally-representative sample of United States (US) adults ages 40–70 (N = 35,322) from Waves 2 (2004–2005) and 3 (2012–2013) of the National Epidemiologic Survey on Alcohol and Related Conditions. Obesity was used as a proxy for unhealthy diet. The outcomes were diabetes and hypertension.

Results

A relatively-healthy-lifestyle class was found only among White adults. Common patterns of unhealthy clustering were found across groups with some variations: the obese-inactive class among White, Black, and Hispanic adults (and the inactive class among Asian adults); the obese-inactive-smoking class among White, Black, and Hispanic adults; the smoking-risky-drinking class among White and Hispanic adults; and the smoking-risky-drinking-inactive class among Black and Asian adults. Positive associations of unhealthier clustering (having a greater number of risk behaviors) with lower SES (i.e., family income and education) and with health conditions were more consistent for Whites than for other groups. For racial minority groups, lower education than income was more consistently associated with unhealthy clusters. The associations between unhealthier clustering and diabetes and hypertension were less clear for Blacks and Asians than for Whites, with no significant association observed for Hispanics.

Conclusion

Concerted efforts to address clustered risk behaviors in most US adults, particularly in racial/ethnic minority groups given the high prevalence of unhealthy clustering, are warranted.

Alcohol abstinence and binge drinking: the intersections of language and gender among Hispanic adults in a national sample, 2002-2018

PURPOSE

Prior research examining alcohol use using national data has often overlooked vital heterogeneity among Hispanics, especially that related to language dominance and gender. We examine the prevalence of alcohol abstinence and-given prior research suggesting that many Spanish dominant Hispanics do not drink-examine rates of binge drinking among past-year alcohol users with a focus on the intersections of language and gender among Hispanics, while drawing comparisons with non-Hispanic (NH) White and NH Black adults.

METHODS

Drawing from the National Survey on Drug Use and Health-a nationally representative survey between 2002 and 2018-we examine the year-by-year prevalence of alcohol abstinence and binge drinking among adults ages 18 and older in the United States.

RESULTS

A disproportionate number of Spanish-dominant Hispanics abstain from alcohol use (54%), with particularly high levels of alcohol abstinence observed among Spanish dominant women (men: 39%, women: 67%). The prevalence of alcohol abstinence among English-dominant Hispanic men (24%) and women (32%) is far lower, approximating that of NH Whites (men: 23%, women: 32%). Importantly, however, among Spanish-dominant drinkers, the prevalence of binge drinking (men: 52%, women: 33%) is comparable to or greater than NH Whites (men: 42%, women: 32%). Binge drinking levels among English-dominant Hispanic men (50%) and women (37%) are greater than among their NH White counterparts.

CONCLUSION

Findings paint a complex picture; consistent with prior research, we see that many Hispanics abstain from alcohol, but we also see new evidence underscoring that-among Hispanic drinkers-the prevalence of binge drinking is disconcertingly elevated.

Interrelationships of Economic Stressors, Mental Health Problems, Substance Use, and Intimate Partner Violence among Hispanic Emergency Department Patients: The Role of Language-Based Acculturation

We analyzed the interrelationships of economic stressors, mental health problems, substance use, and intimate partner violence (IPV) among a sample of Hispanic emergency department patients and probed if Spanish language preference, which may represent low acculturation and/or immigrant status, had a protective effect, in accordance with the Hispanic health paradox. Study participants (n = 520; 50% female; 71% Spanish speakers) provided cross-sectional survey data. Gender-stratified logistic regression models were estimated for mental health problems (PTSD, anxiety, depression), substance use (risky drinking, cannabis, illicit drug use), and IPV. Results showed that economic stressors were linked with mental health problems among men and women. Among men, PTSD was associated with greater odds of cannabis and illicit drug use. Men who used cannabis and illicit drugs were more likely to report IPV. Male Spanish speakers had lower odds of anxiety and cannabis use than English speakers. Female Spanish speakers had lower odds of substance use and IPV than English speakers. The protective effect of Spanish language preference on some mental health, substance use, and IPV outcomes was more pronounced among women. Future research should identify the mechanisms that underlie the protective effect of Spanish language preference and explore factors that contribute to the observed gender differences.

Drinking cultures and socioeconomic risk factors for alcohol and drug use disorders among first- and second-generation immigrants: A longitudinal analysis of Swedish population data

BACKGROUND

Few longitudinal studies investigate predictors of substance use incidence among immigrants. The current study describes substance use disorders in immigrants to Sweden, focusing on drinking culture in the country of origin and socioeconomic status (SES), and how these intersect with generational status to influence risk.

METHODS

Using pseudonymized Swedish population registry data, we track onset of alcohol use disorder and drug use disorder in a longitudinal study of 815,778 first-generation immigrants and 674,757 second-generation immigrants from 64 countries over a 6-year period. Cox regression analysis estimated risks of alcohol and drug use disorders in second-generation immigrants compared to first-generation, and moderation analyses assessed interactions of generational status with country-of-origin per capita alcohol consumption and SES.

RESULTS

Immigrants and second-generation immigrants originating from countries with high levels of alcohol consumption had higher risks for alcohol and drug use disorders. Immigrants with high SES had lower risks for alcohol and drug use disorders. The interaction between generational status and country-of-origin alcohol consumption was significant for drug use disorder (not for alcohol use disorder), with drug use disorder risk for second-generation immigrants being highest for those from countries with the lowest level of country-of-origin per capita alcohol consumption. The interaction between generational status and SES was significant for alcohol use disorder, with low-SES second-generation immigrants showing markedly higher risk than first-generation immigrants with comparable SES.

CONCLUSIONS

Among immigrants in Sweden, second-generation immigrants are at increased risk of developing alcohol and drug use disorders, particularly if they have lower SES. Policy and community attention to these high-risk subgroups in immigrant communities is warranted.

Alcohol use severity among recent Latino immigrants: Associations of acculturation, family history of alcohol use and alcohol outcome expectancies

Having a family history of alcohol (FH+) use is a well-documented risk factor for alcohol use and alcohol related problems. However, there are limited studies examining the impact of FH + on current alcohol use among Latino immigrants. This study aimed to determine the influence of having a FH + on current alcohol use among Latino immigrants and the influence of alcohol outcome expectancies (AOEs) and acculturation on this relationship. This is a longitudinal secondary data analysis of data from the Recent Latino Immigrant Study (RLIS), the first community-based cohort study to examine pre- to post-immigration alcohol use trajectories of young adult Latino immigrants. Linear mixed models were performed to assess the association between various pre- and post-immigration factors and alcohol use among Latino immigrants. There were 518 young adult Latino immigrants with 18.7% reporting a FH + with those with a FH + having higher mean AUDIT score compared to those without (4.74 vs. 3.81; p = 0.028). Positive AOEs were associated with increase AUDIT scores. FH + individuals with greater positive AOEs experienced higher AUDIT scores compared to FH- individuals. Family cohesion was protective against alcohol use while endorsement of Americansism was associated with increased alcohol use. Theses results provide the framework for more in-depth exploration regarding the influences of FH+, AOEs, and acculturation have on the alcohol use among Latino immigrants. Future longitudinal research studies should account for whether traditional cultural values mediate or moderate the relationship between a FH+, AOE, and alcohol use of Latino immigrants.

Racial/Ethnic Disparities in Mutual Help Group Participation for Substance Use Problems

Mutual help groups are a ubiquitous component of the substance abuse treatment system in the United States, showing demonstrated effectiveness as a treatment adjunct; so, it is paramount to understand whether they are as appealing to, and as effective for, racial or ethnic minority groups as they are for Whites. Nonetheless, no known comprehensive reviews have examined whether there are racial/ethnic disparities in mutual help group participation. Accordingly, this study comprehensively reviewed the U.S. literature on racial/ethnic disparities in mutual help participation among adults and adolescents with substance use disorder treatment need. The study identified 19 articles comparing mutual help participation across specific racial/ethnic minority groups and Whites, including eight national epidemiological studies and 11 treatment/community studies. Most compared Latinx and/or Black adults to White adults, and all but two analyzed 12-step participation, with others examining "self-help" attendance. Across studies, racial/ethnic comparisons yielded mostly null (N = 17) and mixed (N = 9) effects, though some findings were consistent with a racial/ethnic disparity (N = 6) or minority advantage (N = 3). Findings were weakly suggestive of disparities for Latinx populations (especially immigrants, women, and adolescents) as well as for Black women and adolescents. Overall, data were sparse, inconsistent, and dated, highlighting the need for additional studies in this area.

Association between acculturation surrogates and alcohol consumption in rural-to-urban migrants: The PERU MIGRANT study

Introduction

There is a paucity of information about the association between acculturation and alcohol consumption in rural-to-urban migrants who move to urban environments usually characterized by a higher prevalence of alcohol consumption than their rural places of origin.

Objectives

To evaluate the cross-sectional association between surrogates of acculturation and alcohol consumption in Peruvian rural-to-urban migrants; to explore the effects of sex and age at migration on these associations; and to explore this association longitudinally.

Methods

Data from the PERU MIGRANT Study, which evaluated a cohort of Peruvian rural-to-urban migrants from 2007 to 2012, were analyzed. Four acculturation surrogates were evaluated: language preference on the radio, language spoken at home, Spanish proficiency, and length of residence in urban area. Alcohol consumption was defined as having consumed alcohol in the last year at the time of the baseline survey, while onset of alcohol consumption was defined as having consumed alcohol in the last year at the follow-up survey. Poisson regressions with robust variance were performed to estimate crude and adjusted prevalence ratios (PR) and relative risks (RR) with a 95% confidence interval (95% CI) to cross-sectional and longitudinal analyses respectively.

Results

Data from 567 rural-to-urban migrants, mean age 47.6 years (SD ±11.5), 52% females, was included in the study. Crude cross-sectional analyses showed an association between acculturation surrogates and alcohol consumption, but these were not observed in adjusted regressions. In the sex-stratified analyses, only women showed an association between Spanish proficiency and alcohol consumption, where those with higher language proficiency had a 22% higher prevalence of alcohol consumption (PR: 1.22, 95% CI: 1.04-1.43). Analyses stratified by age at migration showed no association between acculturation surrogates and alcohol consumption. On the longitudinal analyses, acculturation surrogates were not associated with the onset of alcohol consumption.

Conclusions

No association between acculturation surrogates and alcohol consumption in cross-sectional and longitudinal analyses were found. The only exception was observed in female migrants according to their Spanish proficiency and alcohol consumption .

Drinking motives, cultural orientations, and alcohol use among Hispanic college students at the U.S.-Mexico border

Hispanic college students at the U.S.-Mexico border are at higher risk for alcohol use and negative drinking consequences relative to their counterparts in non-border areas. Hispanic students at the U.S.-Mexico border (N = 219, Mage = 20.14; 71.2% women) completed an online survey. U.S. orientation was negatively associated with alcohol consumption. Enhancement motives predicted alcohol consumption, whereas coping and conformity motives predicted negative drinking-related consequences. Cultural orientations did not moderate the relations between social motives and alcohol use outcomes. Results highlight the need to consider alcohol-related cognition and to better contextualize U.S. and heritage cultural orientations among Hispanics in the U.S.-Mexico areas.

Health risk behaviours among migrants by duration of residence: protocol for a systematic review and meta-analysis

INTRODUCTION

International migrants' health has often been found to deteriorate in new countries, partly due to changes in health risk behaviours such as alcohol consumption, tobacco use, physical inactivity, and poor dietary habits. However, limited efforts have been made to comprehensively evaluate the extent to which migrants adopt unhealthy risk behaviours with longer duration of residence. This systematic review and meta-analysis will summarise evidence on international migrants' behavioural patterns by duration of residence in multiple country contexts.

METHODS AND ANALYSIS

PubMed/MEDLINE, Web of Science and ProQuest databases will be searched for quantitative or mixed-method observational studies published in peer-reviewed scientific journals between 1 January 2000 and 31 December 2019. Studies comparing foreign-born individuals by duration of residence will be included. Information on study characteristics, descriptive statistics and measures of effect will be extracted. All included studies will be quality assessed using a modified Newcastle-Ottawa scale. The review will include narrative synthesis and, if sufficient and comparable data are available, random effects meta-analyses. The review will be conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

ETHICS AND DISSEMINATION

Ethical approval is not required since previously published information from peer-reviewed studies will be assessed. The results of this review will be published in peer-reviewed journals and presented at scientific conferences. Other forms of dissemination will include communication to broader audiences using well-established channels, including through university-based press releases. Progress will be regularly updated on the International Prospective Register of Systematic Reviews to ensure full transparency.

PROSPERO REGISTRATION NUMBER

CRD42018108881.

English use/proficiency, ethnic discrimination, and alcohol use disorder in Hispanic immigrants

PURPOSE

Acculturation-related measures, often based on language, have traditionally been identified as predictors of drinking outcomes for US Hispanics. However, a sole focus on acculturation may obscure the role of societal factors such as discrimination. The present study evaluated ethnic discrimination as a mediator in the relationship between English use/proficiency and alcohol use disorder in US Hispanic immigrants.

METHODS

The study examined data from the 2222 self-identified Hispanic immigrant adults in the National Epidemiologic Survey on Alcohol and Related Conditions-III who reported alcohol use within the past year. The study utilized multivariable binomial logistic regression analyses to test relationships between English use/proficiency and perceived ethnic discrimination; English use/proficiency and DSM-5 alcohol use disorder; ethnic discrimination and DSM-5 alcohol use disorder. Statistical mediation examined ethnic discrimination as a mediator in the relationship between English use/proficiency and alcohol use disorder.

RESULTS

Perceived ethnic discrimination was significantly associated with alcohol use disorder in men (adjusted odds ratio [AOR] 1.99; 95% CI [confidence interval], 1.40-2.83), yet not women (AOR 1.32; 95% CI, 0.71-2.44), in a regression model that also included English use/proficiency. Perceived ethnic discrimination also acted as a partial mediator between English use/proficiency and DSM-5 alcohol use disorder for male, yet not female, Hispanic immigrants.

CONCLUSION

Findings show some support for the notion that experiences of ethnic discrimination, which may accompany the process of acculturation, partially explain deteriorating drinking outcomes in Hispanic immigrant men adapting to life in the US.

The Downward Spiral: Socioeconomic Causes and Consequences of Alcohol Dependence among Men in Late Young Adulthood, and Relations to Racial/Ethnic Disparities

BACKGROUND

While young adults are generally at highest risk for alcohol problems, not all age out of problem drinking. Evidence suggests that Blacks and Latinos age out more slowly than Whites, particularly among men. Targeting men, we investigated whether differences in lifecourse SES might explain racial/ethnic disparities in alcohol dependence in late young adulthood, along with how experiencing alcohol dependence at that life stage relates to subsequent SES.

METHODS

We used longitudinal, national data to (i) describe racial/ethnic disparities in late young adult alcohol dependence criteria (LYADC), (ii) examine whether income trajectory in early young adulthood contributes to these racial/ethnic disparities, and (iii) test whether LYADC reciprocally predicts income trajectory in early midlife. Data were from the 1979 National Longitudinal Survey of Youth (N = 3,993), which measured LYADC in 1994 (mean age = 33). Income trajectory classes were derived for early young adulthood (mean ages = 21 to 31) and, separately, early midlife (mean ages = 35 to 45). Analyses included negative binomial regressions and multinomial regressions.

RESULTS

Both Black and US-born Latino men reported more LYADC than White men. Further, membership in the persistently low and slow increase (vs. stable middle) early young adult income trajectory classes was associated with more LYADC. Multivariate analyses suggested that Black-White disparities in LYADC were explained by early young adult income trajectories, whereas Latino-White disparities in the same were explained by both early young adult income trajectories and early education. In controlled models, more LYADC predicted a higher likelihood of membership in the persistently low (vs. stable middle) income trajectory class in early midlife.

CONCLUSIONS

This study found that poorer SES in early adulthood contributes to alcohol dependence, which reciprocally contributes to poorer SES in early midlife. This cycle appears particularly likely to affect Black and US-born Latino men. Results underline the need to address socioeconomic factors in addressing racial/ethnic disparities in alcohol problems.

The combined relations of gender, enculturation, and depressive symptoms with health risk behaviors in Mexican-Americans: a moderated mediation analysis

Objectives: The present study investigated the relationships of enculturation and depressive symptoms with health risk behavior engagement in Mexican-American college students and examined how these relationships differed by gender. Previous research has noted consistent gender differences in health risk behavior (e.g. alcohol use, substance use, and risky sexual behavior) among Latina/os, and emphasized the role of U.S. acculturation in this difference. Research examining the role of heritage cultural retention (i.e. enculturation), and including the added influence of mental health variables, such as depressive symptoms, is currently lacking. This study sought to address this gap.Design: A large sample (N = 677) of Mexican-American college students from four universities (located in New York, California, Florida, and Texas) completed an online questionnaire assessing health risk behaviors and corresponding variables.Results: We found that males who endorsed more behavioral enculturation and depressive symptoms were more likely to engage in health risk behavior than all others in the sample. Contrary to previous literature, no relationship was found between behavioral enculturation and health risk behavior in females.Conclusion: The current study found behavioral enculturation to be associated with depressive symptoms, and in turn with health risk behaviors among the males in our sample. Additional research will be needed to identify the mechanism underlying the relationship between enculturation and depressive symptoms as well as between depressive symptoms and risky behavior.

Pre- and Post-Immigration Correlates of Alcohol Misuse among Young Adult Recent Latino Immigrants: An Ecodevelopmental Approach

Latinos in the United States experience numerous alcohol-related health disparities. There is accumulating evidence that pre-immigration factors are associated with post-immigration alcohol use, but the explanation for health disparities remains unclear. The present study is a secondary analysis of data from the Recent Latino Immigrant Study (RLIS), the first community-based cohort study to examine the pre- to post-immigration alcohol use trajectories of young adult Latino immigrants during their initial years in the United States. Exploratory analysis and hierarchical multiple logistic regression were performed to assess associations between various pre- and post-immigration factors and alcohol misuse among young adult Latino immigrants early in the immigration process. Using an ecodevelopmental approach, we examined potential social and environmental determinants across multiple levels of influence associated with post-immigration alcohol misuse in this population. The study sample consisted of 474 young adult Latino immigrants between the ages of 18-34. The sample was comprised of the following national/regional origins: Cuban (43%), South American (28.7%), and Central American (28.3%). Approximately half of the sample (49.6%) reported a family history of substance use problems (FHSUP+). Participants who reported FHSUP+ and who engaged in alcohol misuse prior to immigrating to the US were more likely to engage in post-immigration alcohol misuse. Results revealed various social and environmental factors associated with pre-immigration alcohol misuse in this population. Study findings can inform culturally tailored prevention interventions aimed at mitigating problem drinking behaviors among young adult recent Latino immigrants.

Acculturation profiles and alcohol use among Hispanic Americans

Hazardous alcohol use among Hispanics makes for a critical public health issue that warrants empirical examination. Whereas research shows positive associations between alcohol-related outcomes and acculturation, it is unclear how enculturation and acculturation x enculturation are linked to alcohol use. Hispanic American undergraduate and graduate students (N = 348, 61.8% women, M_age = 21.82, 83.3% undergraduates) completed questionnaires assessing their levels of acculturation, enculturation, and alcohol use. Enculturation was negatively associated with social drinking-related consequences. Acculturation was positively associated with alcohol consumption, and enculturation buffered this association. Findings highlight the utility of considering acculturation profiles in understanding Hispanic alcohol use.

Pregaming among Latina/o emerging adults: Do acculturation and gender matter?

Among ethnic minority groups, Latina/o emerging adults are most likely to engage in pregaming, a risky drinking practice. This study examined how U.S. acculturation and enculturation are associated with pregaming and the extent to which gender moderates this relation in a sample of 312 Latina/o emerging adults (18 - 25 years of age). Results indicated that men consumed more alcohol when pregaming than women, but there were no gender differences in pregaming frequency. Results also showed that lower levels of U.S. acculturation were associated with greater alcohol consumption while pregaming for men, but not women. Gender did not moderate the association between acculturation and pregaming frequency. This study highlights the need to account for gender when examining sociocultural determinants of high risk drinking behaviors such as pregaming among Latina/o emerging adults.

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.

Alcohol use, acculturation and socioeconomic status among Hispanic/Latino men and women: The Hispanic Community Health Study/Study of Latinos

The objective of this study was to examine the prevalence and patterns of alcohol use among U.S. Hispanic/Latino adults of diverse backgrounds. The population-based Hispanic Community Health Study/ Study of Latinos (HCHS/SOL) enrolled a cohort of Hispanic/Latino adults (N = 16,415) ages 18–74 years at time of recruitment, from four US metropolitan areas between 2008–11. Drinking patterns and socio-demographics questionnaires were administered as part of the baseline examination. The relationship between age, sex, socio-demographics, acculturation, current alcohol use, and alcohol risk disorder, defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) [no risk (i.e., never drinker), low risk (i.e., women<7 drinks/week; men<14 drinks/week), and at-risk (i.e., women>7 drinks/week; men>14 drinks/week)] were assessed in unadjusted and adjusted multinomial logistic regression analyses. Men reported a higher prevalence than women of at-risk drinking. For women, increased odds of at-risk alcohol use was associated with: a younger age, greater education, full-time employment, and acculturation after adjustment. For men, having a lower income (vs. higher income) or a higher income (vs. not reported) and being employed fulltime (vs. retired) was associated with at-risk alcohol use. For both men and women, there were variations in odds of at-risk drinking across Hispanic/Latino heritage backgrounds, after adjustment. Exact values, odds ratios and p-values are reported within the text. Common factors across sex associated with at-risk drinking included being of Mexican background and being employed full-time. Intervention strategies should consider diversity within the Hispanic/Latino community when designing alcohol abuse prevention programs.

Differences in alcohol consumption and drinking patterns in Ghanaians in Europe and Africa: The RODAM Study

BACKGROUND

Little is known about alcohol consumption among Africans living in rural and urban Africa compared to African migrants in Europe. We compared the patterns of alcohol consumption in a group of Ghanaians living in different locations in Ghana and in Europe and examined the factors associated with drinking alcohol.

METHODS

Data were from a cross-sectional study (RODAM) of Ghanaians aged 25-70 years living in rural and urban Ghana and in Amsterdam, Berlin and London. Information on how often participants consumed at least one standard alcoholic drink in the preceding 12 months, the type of alcoholic beverage and the average serving size was obtained using a food propensity questionnaire. The associations between drinking alcohol and socio-demographic variables, and frequency of attending religious services were investigated using logistic regression models stratified by site and sex. For Ghanaians living in Europe, the number of years since migration and acculturation were also included in the model as covariates.

RESULTS

4280 participants (62.2% women) were included in the analyses. In both men and women, the prevalence of drinking and amount of alcohol consumed per day was highest in Berlin (prevalence of drinking 71.0% and 61.7%) and lowest in urban Ghana (41.4% and 26.8%). After adjustment for age and education in both men and women in Europe, those attending religious services less frequently reported higher levels of drinking alcohol than non-attendants (never attend/no religion compared to attending service at least once a week men OR 4.60 95% CI 2.85, 7.44; women OR 1.80 95% CI 1.12, 2.90) p-trend with frequency <0.001 in men; 0.002 in women); this association was seen also in men in rural Ghana (p-trend = 0.001) and women in urban Ghana (p-trend = 0.02). The prevalence of drinking was positively associated with years since migration in both men and women in Europe ((OR per years increase in time lived in Europe 1.25 (95% CI 1.02,1.53) test for trend p = 0.03 in women; OR 1.29 (95% CI 1.03, 1.62 p = 0.03 in men) but no association was found with self-reported measures of acculturation (ethnic identity, cultural orientation or social networks).

CONCLUSION

There are marked differences in alcohol consumption between Ghanaians living in Europe and in Ghana suggesting migration has an important influence of drinking patterns and also suggesting the possibility of requiring different strategies in alcohol reduction campaigns among Ghanaians in different locations.

Comparison of subjective response to alcohol in Caucasian and Hispanic/Latino samples

Individual differences in subjective response (SR) to alcohol (e.g., stimulation, sedation) are a significant predictor of negative alcohol outcomes. Previous studies have reported ethnic differences in SR (e.g., between some Asian populations and Caucasians), but very few studies have examined SR among Hispanic/Latino individuals. To address this gap in the literature, the present study utilized data from a large-scale, placebo-controlled alcohol administration study to examine differences in SR between Hispanic/Latino and Caucasian individuals. Social drinkers (N = 447) aged 21 to 25 years were randomized to receive either a dose of alcohol targeting a blood alcohol concentration (BAC) of .08 g% or placebo. Only non-Hispanic Caucasian participants (n = 234) and Hispanic/Latino participants (n = 87) were utilized in analyses. SR was assessed at baseline, on the ascending limb of the blood alcohol curve, at peak BAC, and on the descending limb. Repeated measures ANCOVA was utilized to examine interactions between beverage condition, ethnicity, and time predicting SR. The interaction between beverage condition, ethnicity, and time was significant only for low-arousal negative SR (negative sedative effects), such that Hispanic/Latino individuals experienced stronger sedative effects under alcohol (vs. placebo) compared with Caucasian individuals. Caucasians and Hispanic/Latinos showed a similar profile of response with respect to positive aspects of SR (e.g., stimulation). In summary, Hispanic/Latino individuals reported stronger negative SR to alcohol compared with Caucasian individuals, which may be protective against alcohol-related problems. However, future studies are needed to investigate why Hispanic/Latino males remain at relatively high risk for alcohol problems despite stronger negative SR relative to Caucasians. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A Critical Review and Meta-Analysis of the Associations Between Acculturation and Alcohol Use Outcomes Among Hispanic Americans

Acculturation has been studied as one key sociocultural determinant that helps explain ethnic disparities in alcohol use outcomes among Hispanic Americans. Primary studies and other systematic reviews have found between-study inconsistencies regarding the extent to which acculturation is associated with alcohol use outcomes among Hispanic Americans. To better examine whether acculturation is distinctly linked to drinker status, drinking frequency, volume, intensity, binge drinking, and hazardous alcohol use/drinking problems, and to identify individual and methodological factors that moderate these associations, we conducted a comprehensive research synthesis. A systematic review was conducted on research pertaining to the associations between acculturation and alcohol use among Hispanics. We included 88 independent study samples (N = 68,282) coded from 68 manuscripts published in 1987 to 2017. Standard and robust variance estimation (RVE) meta-analyses were conducted to calculate the correlations between acculturation and overall alcohol use. We also conducted a series of analyses to examine the weighted mean correlations between acculturation and 6 specific drinking outcomes. We found a statistically significant correlation between acculturation and overall alcohol use (r = 0.09, p < 0.001). Acculturation was associated with drinker status (r = 0.10, p < 0.001), drinking intensity (r = 0.09, p = 0.001), binge drinking (r = 0.05, p = 0.006), and hazardous alcohol use/drinking problems (r = 0.06, p = 0.006), but not drinking frequency (r = 0.02, p = 0.56) or volume (r = 0.01, p = 0.73). Gender, acculturation dimension, acculturation domain, age group, and sampling settings were found to explain between-study variability in some of these associations. Findings show small relations between acculturation and various alcohol use outcomes, but the effects are relatively more robust among Hispanic women, adults, and when studies measured U.S. cultural orientation, linguistic acculturation, and behavioral practices.

Self-schema as a non-drinker: a protective resource against heavy drinking in Mexican-American college women

Alcohol use is considered less acceptable for women than men in the Mexican culture. However, recent studies of Mexican-American (MA) women show that prevalence and rates of alcohol use are escalating, particularly in those with high acculturation to Western standards. Building on recent studies that demonstrated that drinking-related identities (self-schemas) are important predictors of alcohol use in college populations, this secondary data analysis investigated the association between acculturation, MA cultural values, and acculturative stress, drinking-related self-schemas and heavy drinking over time in college-enrolled MA women. Data were drawn from a 12-month longitudinal study of self-schemas and health-risk behaviors in 477 college-enrolled MA women. Drinking-related self-schemas, acculturation, MA cultural values and acculturative stress were measured at baseline, and heavy drinking was measured at baseline, 3, 6, 9 and 12 months. Thirty-six percent of women had a non-drinker self-schema but only 3% had a drinker self-schema. Higher spirituality was protective against heavy drinking, and this effect can be partially explained by presence of a non-drinker self-schema. Interventions that emphasize the personal relevance of being a non-drinker and support the importance of spirituality may help to prevent heavy drinking in MA college women.

Alcohol use Exacerbates Acculturative Stress Among Recently Immigrated, Young Adult Latinas

Associations between theorized sociocultural factors and acculturative stress were examined among Latina immigrants (aged 18-23 years) during their initial months in the US. Participants' quantity of alcohol use was hypothesized to be linked with more acculturative stress. Using respondent-driven sampling, 530 Latinas who recently immigrated to Miami-Dade County, Florida, were recruited from community activities, Latino health fairs, advertisements at community agencies, and online postings. A path analysis revealed associations between acculturative stress and more time in the US and greater commitment to ethnic identity. Marianismo gender role beliefs differentially related with acculturative stress. Quantity of alcohol use moderated the positive association between time in US and acculturative stress, such that women in the US for less time who drank more alcohol experienced higher levels of acculturative stress than their peers. Findings suggest quantity of alcohol use may exacerbate acculturative stress during some Latina young adult immigrants' initial months in the US.

Age at Immigration and Substance Use and Problems Among Males and Females at the U.S.-Mexico Border

OBJECTIVE

Although substance use and problems among Mexican Americans are associated with both immigration to the United States and living at the U.S.-Mexico border, little is known about relationships between age at immigration and substance use by gender within the border context. The purpose of this study was to analyze the association of age at immigration with heavy alcohol use, alcohol use disorders (AUD), and drug use among Mexicans Americans living both on and off the U.S.-Mexico border.

METHOD

Household surveys were conducted, using area probability sampling of 2,336 Mexican Americans (1,185 female), ages 18-65, living at the Texas-Mexico border in the metropolitan areas of Laredo and McAllen/Brownsville, and in the nonborder location of San Antonio.

RESULTS

Females immigrating before age 12 were less likely to report heavy alcohol use (odds ratio [OR] = 0.309), and those immigrating before age 21 were less likely to report any drug use during the last year compared with their U.S.-born counterparts (OR = 0.473; OR = 0.386, respectively). Males immigrating after age 20 were less likely to report heavy alcohol use (OR = 0.478), and those immigrating between ages 12 and 20 were less likely to report AUD (OR = 0.479) and drug use (OR = 0.255) compared with their U.S.-born counterparts. Early age at immigration (before age 12) was significantly associated with drug use for males living on the border compared with those living off the border.

CONCLUSIONS

Findings suggest that among females, immigrating before age 12 (vs. being born in the United States) is protective against heavy alcohol and drug use, but among males, immigrating before age 12 results in similarly heavy patterns of use as their U.S.-born counterparts, partially supporting previous findings that early immigration is particularly risky in relation to substance use and AUD.

Pain and Alcohol Use among Latinos in Primary Care: Examining Rumination as an Explanatory Factor

BACKGROUND

Alcohol is a widely abused substance among Latinos. Yet, little is known regarding factors underlying hazardous drinking in this population. Growing work has linked pain to hazardous drinking, although highly limited work has focused on Latinos.

OBJECTIVES

The aim of the current study was to test rumination as an underlying mechanism explaining relations between pain severity and alcohol use among Latinos.

METHODS

Data from 252 low-income Latino adults (Mage = 38.7 years, SD = 10.8; 86.1% female) attending a community-based primary health care clinic were available. Participants completed measures of pain, rumination, and alcohol use. Structural equation modeling was used to evaluate the indirect effect of pain severity via rumination on alcohol use.

RESULTS

The model displayed good fit to the data. There was a statistically significant indirect effect of pain severity via rumination on alcohol use. Conclusions/Importance: The current findings suggest that rumination may underlie associations of pain and alcohol use among Latinos. Future work in primary care medical settings may benefit from targeting ruminative thinking among Latinos who are experiencing pain to address hazardous drinking.

Assessment of culture and environment in the Adolescent Brain and Cognitive Development Study: Rationale, description of measures, and early data

Neurodevelopmental maturation takes place in a social environment in addition to a neurobiological one. Characterization of social environmental factors that influence this process is therefore an essential component in developing an accurate model of adolescent brain and neurocognitive development, as well as susceptibility to change with the use of marijuana and other drugs. The creation of the Culture and Environment (CE) measurement component of the ABCD protocol was guided by this understanding. Three areas were identified by the CE Work Group as central to this process: influences relating to CE Group membership, influences created by the proximal social environment, influences stemming from social interactions. Eleven measures assess these influences, and by time of publication, will have been administered to well over 7,000 9-10 year-old children and one of their parents. Our report presents baseline data on psychometric characteristics (mean, standard deviation, range, skewness, coefficient alpha) of all measures within the battery. Effectiveness of the battery in differentiating 9-10 year olds who were classified as at higher and lower risk for marijuana use in adolescence was also evaluated. Psychometric characteristics on all measures were good to excellent; higher vs. lower risk contrasts were significant in areas where risk differentiation would be anticipated.

Racial/ethnic differences in the association between alcohol use and mortality among men living with HIV

BACKGROUND

Increasing alcohol use is associated with increased risk of mortality among patients living with HIV (PLWH). This association varies by race/ethnicity among general outpatients, but racial/ethnic variation has not been investigated among PLWH, among whom racial/ethnic minorities are disproportionately represented.

METHODS

VA electronic health record data from the Veterans Aging Cohort Study (2008-2012) were used to describe and compare mortality rates across race/ethnicity and levels of alcohol use defined by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire. Within each racial/ethnic group, Cox proportional hazards models, adjusted for age, disease severity, and comorbidities, compared mortality risk for moderate-risk (AUDIT-C = 4-7) and high-risk (AUDIT-C ≥ 8) relative to lower-risk (AUDIT-C = 1-3) alcohol use.

RESULTS

Mean follow-up time among black (n = 8518), Hispanic (n = 1353), and white (n = 7368) male PLWH with documented AUDIT-C screening (n = 17,239) was 4.3 years. Black PLWH had the highest mortality rate among patients reporting lower-risk alcohol use (2.9/100 person-years) relative to Hispanic and white PLWH (1.8 and 2.3, respectively) (p value for overall comparison = 0.011). Mortality risk was increased for patients reporting high-risk relative to lower-risk alcohol use in all racial/ethnic groups [black adjusted hazard ratio (AHR) = 1.36, 95% confidence interval (CI) 1.12-1.66; Hispanic AHR = 2.18, 95% CI 1.30-3.64; and white AHR = 2.04, 95% CI 1.61-2.58]. For only white PLWH, mortality risk was increased for patients reporting moderate-relative to lower-risk alcohol use (black AHR = 1.09, 95% CI 0.93-1.27; Hispanic AHR = 1.36, 95% CI 0.89-2.09; white AHR = 1.51, 95% CI 1.28-1.77).

CONCLUSION

Among all PLWH, mortality risk was increased among patients reporting high-risk alcohol use across all racial/ethnic groups, but mortality risk was only increased among patients reporting moderate-risk relative to lower-risk alcohol use among white PLWH, and black patients appeared to have higher mortality risk relative to white patients at lower-risk levels of alcohol use. Findings of the present study further underscore the need to address unhealthy alcohol use among PLWH, and future research is needed to understand mechanisms underlying observed differences.

Social, Occupational, and Spatial Exposures and Mental Health Disparities of Working-Class Latinas in the US

Grounded in ecosocial theory, this paper discusses the mental health disparities of working-class Latinas from multiple perspectives. An overview of working-class Latinas' prevalent mental health disorders, barriers to care and suggestions for interventions and future studies are provided.

Gender differences in trajectories of alcohol use from ages 13 to 33 across Latina/o ethnic groups

BACKGROUND

Research examining alcohol use trajectories among Latina/os is scarce. Further, prior findings on alcohol use by ethnic group and gender is mixed. The purpose of this study was twofold: (a.) to examine developmental trajectories for two types of alcohol (drunkenness and heavy drinking) use across four Latina/o ethnic groups (Cubans, Puerto Ricans, Central/South American, and Mexican Americans) and, (b.) to examine the role of gender and ethnicity in developmental trajectories of drunkenness and heavy drinking among Latina/os.

METHODS

Data were drawn from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health. The sample consisted of 1670 Latina/os that were followed from adolescence into adulthood. Multi-level logistic regression models were used to estimate drunkenness and heavy drinking trajectories and trajectories by gender.

RESULTS

indicate that, for all four ethnic groups examined, the probability of drunkenness and heavy drinking gradually increased in adolescence, peaked in "emerging adulthood", and decreased as they transitioned into adulthood. Findings also show divergent age trajectories by gender, but patterns varied across ethnicity and alcohol use outcome.

CONCLUSIONS

Key findings from this study demonstrate that among Latina/os, there are critical developmental periods for reported drunkenness and heavy drinking in the last 12 months, and that ethnicity and gender play substantial roles in the development of hazardous alcohol use over the life course.

Review: Environmental influences on alcohol use: Informing research on the joint effects of genes and the environment in diverse U.S. populations

BACKGROUND AND OBJECTIVES

This review aimed to inform the current state of alcohol research on the joint effects of genes and the environment conducted in U.S. racial/ethnic minority populations, focusing on African Americans, Latinos/Hispanics, Asians, and American Indians.

METHODS

A key-word and author-based search was conducted and supplemented with direct contact to researchers in this area to ensure a comprehensive inclusion of published, peer-reviewed studies. These studies were considered in terms of the racial/ethnic population groups, phenotypes, genetic variants, and environmental influences covered. Research findings from alcohol epidemiologic studies were highlighted to introduce some potential environmental variables for future studies of gene and environment (G-E) relationships.

RESULTS

Twenty-six (N = 26) studies were reviewed. They predominantly involved African American and Asian samples and had a very limited focus on Latinos/Hispanics and American Indians. There was a wide range of alcohol-related phenotypes examined, and studies almost exclusively used a candidate gene approach. Environmental influences focused on the most proximate social network relationships with family and peers. There was far less examination of community- and societal-level environmental influences on drinking. Epidemiologic studies informing the selection of potential environmental factors at these higher order levels suggest inclusion of indicators of drinking norms, alcohol availability, socioeconomic disadvantage, and unfair treatment.

CONCLUSIONS

The review of current literature identified a critical gap in the study of environments: There is the need to study exposures at community and societal levels.

SCIENTIFIC SIGNIFICANCE

These initial studies provide an important foundation for evolving the dialogue and generating other investigations of G-E relationships in diverse racial/ethnic groups. (Am J Addict 2017;26:446-460).

A Quantitative Analysis of Latino Acculturation and Alcohol Use: Myth Versus Reality

Research on health among Latinos often focuses on acculturation processes and the associated stressors that influence drinking behavior. Given the common use of acculturation measures and the state of the knowledge on alcohol-related health among Latino populations, the current analyses tested the efficacy of acculturation measures to predict various indicators of alcohol consumption. Specifically, this quantitative review assessed the predictive utility of acculturation on alcohol consumption behaviors (frequency, volume, and quantity). Two main analyses were conducted-a p-curve analysis and a meta-analysis of the observed associations between acculturation and drinking behavior. Results demonstrated that current measures of acculturation are a statistically significant predictor of alcohol use (Z = -20.75, p < 0.0001). The meta-analysis included a cumulative sample size of 29,589 Latino participants across 31 studies. A random-effects model yielded a weighted average correlation of 0.16 (95% confidence interval = 0.12, 0.19). Additional subgroup analyses examined the effects of gender and using different scales to measure acculturation. Altogether, results demonstrated that acculturation is a useful predictor of alcohol use. In addition, the meta-analysis revealed that a small positive correlation exists between acculturation and alcohol use in Latinos with a between-study variance of only 1.5% (τ²  = 0.015). Our analyses reveal that the association between current measures of acculturation and alcohol use is relatively small.

A tale of two measures: Concordance between the ARSMA-II and the BIQ acculturation scales among Latino immigrant families

Acculturation refers to the extent to which an individual immigrant (or immigrant group) acquires the customs and characteristics of a new receiving society and/or retains the customs and characteristics of the person's or group's cultural heritage. Different acculturation measures are often assumed to be interchangeable, although this assumption is rarely tested empirically. The purpose of the present study was to examine the overlap between 2 commonly used measures of acculturation among individuals of Latino/Hispanic ancestry in the United States, the Acculturation Rating Scale for Mexican Americans II (ARSMA-II) and the Bicultural Involvement Questionnaire-Short Version (BIQ-S). Specifically, we examined the ways in which scores from the 2 measures relate to one another, as well as similarities versus differences in the ways they predict external variables of interest (e.g., family functioning, parenting, and youth adjustment) that acculturation is known to influence. Findings indicate distinct patterns of results for the 2 measures. For instance, though the BIQ-S focuses entirely on language use and other cultural practices, the ARSMA-II more consistently relates to language variables. Further, adolescent BIQ-S cultural heritage scores related negatively to risks for and engagement in alcohol use-supporting prior findings-whereas ARSMA-II scores were unrelated to alcohol use. Given the largely nonoverlapping set of relationships of the BIQ-S and the ARSMA-II subscale scores with measures of language dominance and conflict, measures of parenting, and measures of youth outcomes, we recommend that studies utilize both of these measures to fully appraise acculturation in this population. (PsycINFO Database Record

Gender and race/ethnic differences in the persistence of alcohol, drug, and poly-substance use disorders

AIMS

To examine gender and racial/ethnic differences in the effect of substance use disorder (SUD) type on SUD persistence.

METHODS

Data were provided by 1025 women and 1835 men from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to examine whether gender and race/ethnicity (Non-Hispanic White, Black, Hispanic) moderate the effects of DSM-IV defined past-12 month SUD type (alcohol, drug, poly-substance) on SUD persistence at 3-year follow-up, controlling for covariates. Using gender-stratified weighted binary logistic regression, we examined predictors of SUD persistence, tested an SUD type by race/ethnicity interaction term, and calculated and conducted Bonferroni corrected pairwise comparisons of predicted probabilities.

RESULTS

SUD persistence rates at 3-year follow-up differed for SUD type by gender by race/ethnicity sub-group, and ranged from 31% to 81%. SUD persistence rates were consistently higher among poly-substance users; patterns were mixed in relation to gender and race/ethnicity. Among women, alcohol disordered Hispanics were less likely to persist than Whites. Among men, drug disordered Hispanics were less likely to persist than Whites. Also, Black men with an alcohol or drug use disorder were less likely to persist than Whites, but Black men with a poly-substance use disorder were more likely to persist than Hispanics.

CONCLUSIONS

The effect of SUD type on SUD persistence varies by race/ethnicity, and the nature of these relationships is different by gender. Such knowledge could inform tailoring of SUD screening and treatment programs, potentially increasing their impact.

Factors Associated With Drinking Behavior Among Immigrant Women in Taiwan

BACKGROUND

Transnational marriage-based immigrant women in Taiwan have moved to a country where alcohol use is prevalent and they face the challenge of adaptation into a new society, which could influence their drinking behavior.

OBJECTIVES

To describe the prevalence of alcohol drinking and examine factors associated with drinking patterns among immigrant women in Taiwan.

METHODS

This study was a cross-sectional questionnaire survey and data were collected from June through November in 2013. Convenience samples of 757 immigrant women were recruited across Taiwan. Alcohol use patterns during the past year were divided into abstinent, low-risk drinking, and hazardous drinking based on the Alcohol Use Disorder Identification Test. Measures included subject characteristics, exposure to cigarettes and alcohol, acculturation level, and perceived stress.

RESULTS

The prevalence of drinking during the past year among immigrant women was 29.9% (low-risk drinking 27.6% and hazardous drinking: 2.3%). Multinomial logistic regression showed that women who were employed, who smoked, whose husbands drank, and who interacted with Taiwanese friends frequently were significantly more likely to be in the low-risk drinking group compared with the abstinent group. Women who were divorced/widowed, who had low education levels, who smoked, and whose husbands drank were significantly more likely to be in the hazardous drinking group compared with the abstinent group.

CONCLUSIONS

More acculturation in immigrant women as indicated by working and frequently interacting with friends in mainstream society was related to low-risk drinking behavior; adversities as indicated by loss of marriage and low education level were related to hazardous drinking behavior.

Cohort Profile: The Mexican American Mano a Mano Cohort

Hispanic Americans comprise the largest and fastest-growing ethnic minority in the USA. In Houston, Texas, 44% of the population is of Hispanic descent, with the majority being Mexican Americans (78%). This population is under-represented in health-related research despite their high prevalence of obesity and diabetes, which may predispose them to cancer and other chronic conditions. Recognizing the need for a greater research effort into the health risks of Hispanic Americans, the population-based Mexican American (Mano a Mano) Cohort study was launched in 2001. This is an open cohort with enrolment ongoing to 2019, and as of 30 June 2014, 23 606 adult participants from over 16 600 households were enrolled. Bilingual interviewers elicit information in person on demographics, acculturation, lifestyle, occupation, medical history, family cancer history, self-reported and measured height and weight, and other exposures. Urine, blood and saliva samples have been collected at baseline from 43%, 56% and 63% of participants, respectively. DNA samples are available for about 90% of participants. Incident cancers and other chronic diseases are ascertained through annual telephone re-contact and linkage to the Texas Cancer Registry and/or medical records. Molecular data such as genetic ancestry markers, blood telomere length and HbA1c, a marker of impaired glucose tolerance, are available for a substantial proportion of the participants. Data access is provided on request [manoamano@mdanderson.org]. For further information please visit [www.mano-mano.us].

Substance use and treatment outcomes among Spanish-speaking Latino/as from four acculturation types

The purpose of this study was to examine the association of acculturation with substance use treatment outcomes in a sample of treatment-seeking Latino/as (N = 405). The study used data from a multisite randomized controlled trial of a culturally adapted version of Motivational Enhancement Therapy delivered in Spanish. Berry, Kim, Minde, and Mok's (1987) acculturation model was used to divide the sample into 4 types (integrated, assimilated, separated, marginalized), based on Bicultural Involvement Questionnaire scores. One-way analyses of variance, chi-squared tests, and repeated-measures regression were used to examine baseline acculturation, posttreatment outcomes, and follow-up outcomes. All participants were of Latino/a background, and 88.4% of the sample was male. Participants with greater acculturation to American culture (i.e., integrated and assimilated acculturation types) reported more substance use and associated problems at baseline, χ²(3) = 20.5, p < .001, with the integrated type reporting the highest percentage of substance use disorder symptoms and problems (67.6%). No significant differences in substance use were detected among acculturation types posttreatment or at follow-up. Although the integrated and assimilated acculturation types were associated at baseline with more substance use and associated problems, all acculturation types seemed to benefit at posttreatment from an evidence-based culturally adapted treatment. (PsycINFO Database Record

Racial/ethnic differences in life-course heavy drinking from adolescence to midlife

Information on heavy drinking over the life course might help to explain racial/ethnic disparities in alcohol-related problems, morbidity, and mortality. Using data from the 2009-2010 U.S. National Alcohol Survey (n = 3,026), we analyzed retrospective decades-based measures of heavy drinking during respondents' teens, 20s, 30s, and 40s. Results indicate that Latino men and African American women have greater risk for persistent-high (vs. declining) heavy-drinking trajectories than Caucasian men and women, and that socioeconomic disadvantage partly accounts for this disparity in women. Prospective longitudinal studies are needed to confirm these results and to elucidate the relationship of life-course heavy-drinking patterns with health-related outcomes, and disparities in these.

Recruiting and Assessing Recent Young Adult Latina Immigrants in Health Disparities Research

The authors interviewed 4 researchers to identify facilitators in recruiting and assessing Latina immigrants. The 4 researchers recruited 530 recent Latina immigrants (ages 18-23 years) for a study of social and cultural determinants of health. Consensual qualitative research methods revealed that respondent-driven sampling was an effective recruitment method. Fear of deportation was a barrier. Stigma about sensitive topics (e.g., sex, drug use) did not affect participation. Findings can help counselors conduct health disparities research.