Substance Abuse in African American Women

Limited attention to ethnicity in research on substance abuse and women has resulted in assumptions that may not fit the experience of women of color. This study employed a combined quantitative and qualitative design to investigate substance abuse in African American women ages 21 to 48. Life experiences of women with histories of chemical dependence were compared with women who were maintaining a nonabusing lifestyle. Variables examined were history of parental substance abuse and child abuse, exposure to racism and traumatic events, and social support and spirituality. The substance abusing and nonabusing women were distinguished from each other in the areas of spirituality and family connectedness. Although all participants reported high violence exposure and personal losses, significantly more substance abusing women reported being battered, experiencing homelessness, and more traumatic events. Participants described multiple experiences with racism, though their descriptions of their responses to these experiences suggested different styles of coping. Findings have significant implications for prevention of substance abuse, particularly in the areas of religious involvement, family support, and the development of active problem-solving strategies.

Racism and Illicit Drug Use Among African American Women: The Protective Effects of Ethnic Identity, Affirmation, and Behavior

Though recent evidence indicates that rates of illicit drug use among African American women are now higher than the national average, little is known about the etiology of substance use in this population. In addition, the effects of racism and other cultural factors are understudied and may be unique amongst African American women. This cross-sectional study explores risk and protective factors for drug use among 204 African American women. More specifically, associations between racism experiences and drug use are investigated in the context of potential moderating influences (i.e., psychosocial resources, social safety net variables, and cultural identity and practices). Findings suggest that racism is associated with drug use, but that its effects diminish with age. In addition, results suggest that psychosocial resources, social safety net factors and culturally specific factors like ethnic community membership and engagement in cultural practices afford African American women some protection against the detrimental effects of racism.

Look to the relationship: a review of African American women substance users' poor treatment retention and working alliance development

Emergent findings specific to African American women confirm that their substance user treatment retention rates are significantly lower than other groups, which is problematic given that substance user treatment is effective largely to the extent that clients are retained in treatment. This article reviews existing literature concerning disparities in treatment retention, highlights a significant barrier to treatment retention for this population, and presents support for an empirical focus on culturally responsive working alliance development as a promising step toward improving retention rates for African American women substance users.

Social inequality and racial discrimination: risk factors for health disparities in children of color

A child's sense of control over life and health outcomes as well as perceptions of the world as fair, equal, and just are significantly influenced by his or her social experiences and environment. Unfortunately, the social environment for many children of color includes personal and family experiences of racial discrimination that foster perceptions of powerlessness, inequality, and injustice. In turn, these perceptions may influence child health outcomes and disparities by affecting biological functioning (eg, cardiovascular and immune function) and the quality of the parent-child relationship and promoting psychological distress (eg, self-efficacy, depression, anger) that can be associated with risk-taking and unhealthy behaviors. In this article we review existing theoretical models and empirical studies of the impact of racial discrimination on the health and development of children of color in the United States. On the basis of this literature, a conceptual model of exposure to racial discrimination as a chronic stressor and a risk factor for poor health outcomes and child health disparities is presented.

Attracting women: adopting a psychological approach in primary care

There has been much written on gender in the academic world and its impact on society. Women suffer disproportionately from inequality (Haralambos & Holborn, 2000) and substance use treatment is no different. The workplace and affluence are key areas where this problem has been tackled, though with limiting results. Here Jeff Fernandez asks why women are less likely to seek help for substance use and how, using common psychological techniques, we can entice them back again.