Binge drinking in African American males from adolescence to young adulthood: the protective influence of religiosity, family connectedness, and close friends' substance use

Cultural considerations for substance use and substance use disorders among Black men

There are complex cultural considerations for understanding, assessing, and treating substance use disorders (SUD) among Black men, from the initiation of substance use through SUD-related outcomes. This narrative review provides insight into some of these factors, including the individual, interpersonal, and community-level risk and protective factors (e.g., family and social roles, religiosity, racism and discrimination, exposure to trauma and adversity) underlying relative risk for substance use and disparities in SUD-related outcomes. This article also highlights the ways that public attitudes and policies related to substance use have contributed to ongoing inequities in SUD treatment access for Black men. Recommendations for clinical research and practice include increasing focus on measurement equivalence, creating pathways for access to community-based and specialty treatment, and providing services that are culturally affirming, relevant, and appropriate. Comprehensive efforts are needed to reduce SUD-related inequities and promote positive well-being among Black men and their communities.

Racial Discrimination and Trajectories of Problematic Alcohol Use Among African American Emerging Adults: The Role of Organizational Religious Involvement

Racial discrimination jeopardizes a wide range of health behaviors for African Americans. Numerous studies demonstrate significant negative associations between racial discrimination and problematic alcohol use among African Americans. Culturally specific contexts (e.g., organized religious involvement) often function protectively against racial discrimination's adverse effects for many African Americans. Yet organized religious involvement may affect the degree to which racial discrimination increases problematic alcohol use resulting in various alcohol use trajectories. These links remain understudied in emerging adulthood marked by when individuals transition from adolescence to early adult roles and responsibilities. We use data from 496 African American emerging adults from the Flint Adolescent Study (FAS) to (a) identify multiple and distinct alcohol use trajectories and (b) examine organizational religious involvement's protective role. Three trajectory classes were identified: the high/stable, (20.76% of sample; n = 103); moderate/stable, (39.52% of sample; n = 196); and low/rising, (39.72% of the sample; n = 197). After controlling for sex, educational attainment, and general stress, the interaction between racial discrimination and organized religious involvement did not influence the likelihood of classifying into the moderate/stable class or the low/rising class, compared with the high/stable class. These results suggest organized religious involvement counteracts, but does not buffer racial discrimination's effects on problematic alcohol use. Findings emphasize the critical need for culturally sensitive prevention efforts incorporating organized religious involvement for African American emerging adults exposed to racial discrimination. These prevention efforts may lessen the role of racial discrimination on health disparities related to alcohol use.

Adverse childhood experiences, racial microaggressions, and alcohol misuse in Black and White emerging adults

OBJECTIVE

Research indicates that emerging adults (EAs) are at an increased risk for heavy drinking and its associated alcohol problems, and that both proximal and distal stressors (e.g., adverse childhood experiences [ACEs], and subtle racial discrimination [racial microaggressions]) may contribute to these high-risk outcomes. We investigated the relationship of ACEs with alcohol consumption and alcohol problems in a sample of Black and White EAs, and racial microaggressions with alcohol consumption and alcohol problems in the Black EAs in our sample.

METHOD

Six hundred two EAs (41.5% Black, 47% White; 57.3% women) completed measures assessing ACEs, alcohol consumption, and alcohol problems. One hundred ninety-six Black EAs in the sample were also asked to complete a measure of racial microaggressions that assessed their level of distress related to these experiences.

RESULTS

Regression analyses demonstrated a positive association of ACEs with alcohol consumption and alcohol problems. Sex moderated the relation of ACEs with alcohol consumption such that the positive relationship between ACEs and alcohol consumption was minimally stronger for females. College status moderated the relation of ACEs with alcohol consumption such that the relationship between ACEs and alcohol consumption was stronger for college students than non-college students. Racial microaggressions were positively associated with alcohol problems, but not alcohol consumption.

CONCLUSION

Findings underscore the importance of childhood stressors with alcohol consumption and problems for EAs, and the need for additional research on racial microaggressions and alcohol problems in Black EAs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Role of Parent Engagement in Overcoming Barriers to Care for Youth Returning Home After Incarceration

We sought to understand the role of parent engagement in overcoming barriers to care for youth re-entering the community following incarceration. For this mixed methods study, we conducted quantitative surveys on healthcare needs and access with youth (n = 50) at 1-month post-incarceration, and semi-structured interviews with a subset of these youth (n = 27) and their parents (n = 34) at 1, 3, and 6-months post-incarceration (total 94 interviews). Differences by race/ethnicity and gender were assessed using Chi square test of proportions. We performed thematic analysis of interview transcripts to examine the role of parent engagement in influencing youths' access to healthcare during reentry. Most youth were from racial/ethnic minority groups and reported multiple ACEs. Girls, compared to boys, had higher ACE scores (p = 0.03), lower family connectedness (p = 0.03), and worse general health (p = 0.02). Youth-identified barriers to care were often parent-dependent and included lack of: affordable care (22%), transportation (16%), and accompaniment to health visits (14%). Two major themes emerged from the qualitative interviews: (1) parents motivate youth to seek healthcare during reentry and (2) parents facilitate the process of youth seeking healthcare during reentry. Parents are instrumental in linking youth to healthcare during reentry, dispelling prevailing myths that parents of incarcerated youth are inattentive and that youth do not want their help. Efforts that support and enhance parent engagement in access to care during reentry, such as by actively involving parents in pre-release healthcare planning, may create stronger linkages to care.

The association between racial and socioeconomic discrimination and two stages of alcohol use in blacks

BACKGROUND

This study aimed to characterize the associations of racial and socioeconomic discrimination with timing of alcohol initiation and progression from initiation to problem drinking in Black youth.

METHODS

Data were drawn from a high-risk family study of alcohol use disorder. Mothers and their offspring (N = 806; M_age = 17.87, SD_age = 3.91; 50% female) were assessed via telephone interview. Cox proportional hazards regression analyses were used to examine associations between discrimination and timing of first drink and progression from first drink to problem drinking in two separate models. Predictor variables were considered in a step-wise fashion, starting with offspring racial and socioeconomic discrimination, then adding (2) maternal racial and/or socioeconomic discrimination experiences; (3) religious service attendance and social support as potential moderators; and (4) psychiatric and psychosocial risk factors and other substance use.

RESULTS

Offspring racial discrimination (HR: 2.01, CI: 1.17-3.46 ≤ age 13) and maternal experiences of discrimination (HR: 0.79, CI: 0.67-0.93) were associated with timing of initiation in the unadjusted model only; offspring socioeconomic discrimination predicted timing of initiation among female offspring, even after adjusting for all covariates (HR: 1.49, CI: 1.14-1.93). Socioeconomic discrimination predicted a quicker transition from first use to problem drinking exclusively in the unadjusted model (HR: 1.70, CI: 1.12-2.58 ≤ age 18). No moderating effects of religious service attendance or social support were observed for either alcohol outcome.

CONCLUSIONS

Findings suggest socioeconomic discrimination is a robust risk factor for initiating alcohol use in young Black female youth and should be considered in the development of targeted prevention programs.

What Is the Relationship Between Incarceration of Children and Adult Health Outcomes?

OBJECTIVE

We sought to quantify the association between child incarceration in the United States and subsequent adult health outcomes.

METHODS

We analyzed National Longitudinal Study of Adolescent to Adult Health data from 1727 adult (Wave IV) participants first incarcerated at age <25 years. Using chi-square tests and multivariate logistic regression models, we compared adult health outcomes (ie, mobility limitations, depressive symptoms, and suicidal thoughts) among those first incarcerated at age ≤14 years, 15 to 17 years, and 18 to 20 years, with those first incarcerated at 21 to 24 years as the reference group.

RESULTS

Of the 1727 participants, 105 (6.7%) were first incarcerated at age ≤14 years ("child incarceration category"), 315 (19.3%) were first incarcerated at 15 to 17 years, 696 (38.5%) were first incarcerated at 18 to 20 years, and 611 (35.6%) were first incarcerated at 21 to 24 years. Those first incarcerated as children (age ≤14 years) were disproportionately black or Hispanic compared with those first incarcerated at 15 to 24 years. Compared with first incarceration at age 21 to 24 years, child incarceration independently predicted adult mobility limitations (adjusted odds ratio [OR], 3.74; P = .001), adult depression (OR, 1.98; P = .034), and adult suicidal thoughts (OR, 4.47; P = .005).

CONCLUSIONS

Child incarceration displays even wider sociodemographic disparities than incarceration generally and is associated with even worse adult physical and mental health outcomes.

Are There Gender, Racial, or Religious Denominational Differences in Religiosity's Effect on Alcohol Use and Binge Drinking Among Youth in the United States? A Propensity Score Weighting Approach

BACKGROUND

Alcohol use/misuse is a prevalent health issue among youth and may lead to adverse consequences. Religiosity has been identified as a protective factor against alcohol use/misuse among youth. Identifying moderators in the religiosity-alcohol relationship has important implications for intervention development.

OBJECTIVE

This study aims to examine whether gender, race, or religious denomination moderate the religiosity-alcohol relationship.

METHOD

This study overcame previous studies' limitations by using longitudinal data from a nationally representative sample and robust analytical methods (N = 1969). This study used the propensity score weighting method to control for a large number of confounders. Propensity score weights were estimated using Generalized Boosted Models.

RESULTS

Findings indicate that gender and religious denomination might not moderate the religiosity-alcohol relationship, whereas racial difference was present. Among White youth, religiosity was found to have a buffering effect against alcohol use (average treatment effect [ATE] = -0.57, CI_.95 = -0.83, -0.32) and binge drinking (ATE = 0.54, CI_.95 = 0.38, 0.71). However, among non-White youth, religiosity was not found to have an effect on alcohol use (ATE = 0.08, CI_.95 = -0.31, 0.47) or binge drinking (ATE = 1.07, CI_.95 = 0.68, 1.64).

CONCLUSIONS

Findings suggest that preventions/interventions of youth alcohol involvement that are religiously based may not need to adapt their efforts based on youth's gender or religious denominations. More importantly, when addressing alcohol use/misuse issue among White American youth, religious and faith-based organizations, youth religious group leaders, and clergy should be included in the prevention/intervention efforts.

Trajectories of Racial Discrimination that Predict Problematic Alcohol Use among African American Emerging Adults

The association between racial discrimination (discrimination) and problematic alcohol use in African American (AA) emerging adults is well documented. Few researchers, however, have studied the longitudinal relationship between discrimination and problematic alcohol use among AA male and female emerging adults. In a sample of 681 AAs aged 19-25 (51% male), we explored multiple, distinct trajectories of discrimination and socio-demographic predictors of the trajectory classifications. We also examined the relation between discrimination trajectories and problematic alcohol use and the extent to which sex modified these associations. Collectively, the findings revealed that three trajectories - high-stable, low-rising, and low-declining - characterized discrimination experiences for AA emerging adults. Males in the high-stable trajectory class reported more problematic alcohol use than males in other trajectory classes and all females. These findings lay the foundation for future research that examines gender-specific mechanisms in the discrimination-health link.

Predictors and psychological pathways for binge drinking among South African men

OBJECTIVE

To develop targeted interventions for high-risk drinkers among South African men, we assessed whether sociodemographic factors and history of childhood sexual abuse predicted binge drinking at six-month follow-up assessment and their psychological pathways according to the extended Theory of Reasoned Action (TRA).

DESIGN

Survey responses with a sample of 1181 South African men from randomly selected neighbourhoods in Eastern Cape Province were collected at baseline and six-month follow-up. Multiple logistic regression analysis examined the baseline predictors of binge drinking. Serial multiple mediation analysis examined the psychological pathways.

MAIN OUTCOME MEASUREMENTS

Binge drinking at six-month follow-up.

RESULTS

Age (OR = 1.03, 95% CI: 1.01, 1.05), religious participation (OR = .73, CI: .65, .82) and history of childhood sexual abuse (OR = 1.82, CI: 1.32, 2.51) were significant predictors of binge drinking. Predictions of religious participation and history of childhood sexual abuse were partially mediated through attitude, subjective norm, descriptive norm and intention to binge drinking.

CONCLUSION

South African men with childhood sexual abuse experience and low religious participation were at higher risk for binge drinking. The extended TRA model explains the associations of these factors to binge drinking and can contribute to the design and evaluation of interventions.

How Does Incarcerating Young People Affect Their Adult Health Outcomes?

BACKGROUND AND OBJECTIVES

Despite the widespread epidemic of mass incarceration in the US, relatively little literature exists examining the longitudinal relationship between youth incarceration and adult health outcomes. We sought to quantify the association of youth incarceration with subsequent adult health outcomes.

METHODS

We analyzed data from 14 344 adult participants in the National Longitudinal Study of Adolescent to Adult Health. We used weighted multivariate logistic regressions to investigate the relationship between cumulative incarceration duration (none, <1 month, 1-12 months, and >1 year) before Wave IV (ages 24-34 years) and subsequent adult health outcomes (general health, functional limitations, depressive symptoms, and suicidal thoughts). Models controlled for Wave I (grades 7-12) baseline health, sociodemographics, and covariates associated with incarceration and health.

RESULTS

A total of 14.0% of adults reported being incarcerated between Waves I and IV. Of these, 50.3% reported a cumulative incarceration duration of <1 month, 34.8% reported 1 to 12 months, and 15.0% reported >1 year. Compared with no incarceration, incarceration duration of < 1 month predicted subsequent adult depressive symptoms (odds ratio [OR] = 1.41; 95% confidence interval [CI], 1.11-1.80; P = .005). A duration of 1 to 12 months predicted worse subsequent adult general health (OR = 1.48; 95% CI, 1.12-1.96; P = .007). A duration of >1 year predicted subsequent adult functional limitations (OR = 2.92; 95% CI, 1.51-5.64; P = .002), adult depressive symptoms (OR = 4.18; 95% CI, 2.48-7.06; P < .001), and adult suicidal thoughts (OR = 2.34; 95% CI, 1.09-5.01; P = .029).

CONCLUSIONS

Cumulative incarceration duration during adolescence and early adulthood is independently associated with worse physical and mental health later in adulthood. Potential mechanisms merit exploration.

Religiosity/spirituality and substance use in adolescence as related to positive development: a literature review

Positive youth development interventions are strategies to address adolescent health risk behaviors and are recommended in Healthy People 2020. Although the incorporation of spirituality into these programs has been recommended, much of the empirical literature actually addresses religiosity rather than spirituality. The purpose of our review of 36 studies published between 2007 and 2013 was to (1) examine the relationship of religiosity and/or spirituality to substance use and abuse in adolescence, (2) discuss the measurement and meaning of the concept of spirituality in contrast to religiosity in adolescence, and (3) discuss the implications of these empirical studies for the concept of positive youth development. Findings from this literature review supported earlier findings of an inverse relationship between religiosity and substance use, a lack of or inconsistent definition of spirituality and religiosity as well as limited measures to address these constructs. Recommendations from this review include dedicated work by interdisciplinary teams to address consistency in definitions and creation of consistent tools that include consideration of the stages of development included in the adolescent years. From a research and clinical perspective, an interprofessional approach to clarify the concepts of spirituality and spiritual development would not only benefit research but could inform the substance abuse prevention field. This work is essential to insure that evidence-based strategies, which include religiosity and spirituality, are developed with the goal of protecting youth and supporting positive development of adolescents.

Alcohol use and church attendance among seventh through twelfth grade students, Dominican Republic, 2011

Excessive alcohol consumption increases the years of life lost to premature death and disability worldwide. Religion is a mitigating factor in alcohol consumption. A survey in the Dominican Republic showed increasing church attendance by middle and high school students (N = 3,478) was associated with a delay in age at first alcoholic drink, fewer students who had consumed alcohol in the past month (current drinkers), lower alcohol consumption levels, fewer episodes of inebriation, and less heavy episodic alcohol consumption (all P < 0.0001). The results suggested that it may be useful to conceive of church-attending youth as a subset of the adolescent social network when planning primary alcohol prevention programs for young people.

Less drinking, yet more problems: understanding African American drinking and related problems

Researchers have found that, compared to European Americans, African Americans report later initiation of drinking, lower rates of use, and lower levels of use across almost all age groups. Nevertheless, African Americans also have higher levels of alcohol problems than European Americans. After reviewing current data regarding these trends, we provide a theory to understand this apparent paradox as well as to understand variability in risk among African Americans. Certain factors appear to operate as both protective factors against heavy use and risk factors for negative consequences from use. For example, African American culture is characterized by norms against heavy alcohol use or intoxication, which protects against heavy use but also provides within-group social disapproval when use does occur. African Americans are more likely to encounter legal problems from drinking than European Americans, even at the same levels of consumption, perhaps thus resulting in reduced consumption but more problems from consumption. There appears to be one particular group of African Americans, low-income African American men, who are at the highest risk for alcoholism and related problems. We theorize that this effect is due to the complex interaction of residential discrimination, racism, age of drinking, and lack of available standard life reinforcers (e.g., stable employment and financial stability). Further empirical research will be needed to test our theories and otherwise move this important field forward. A focus on within-group variation in drinking patterns and problems is necessary. We suggest several new avenues of inquiry.

Are there differences between young African-American and European-American women in the relative influences of genetics versus environment on age at first drink and problem alcohol use?

BACKGROUND

Differences in age at initiation of alcohol use and rates of problem drinking between African Americans and European Americans are well documented, but the association between early and problem use-and distinctions by ethnic group in this association-have yet to be examined in a genetically informative framework.

METHODS

Data were derived from a longitudinal study of female twins in Missouri. The sample was composed of 3,532 twins (13.6% African-American [AA], 86.4% European-American [EA]), who participated in the fourth wave of data collection and reported consumption of at least 1 alcoholic drink over the lifetime. Mean age at Wave 4 was 21.7 (range = 18 to 29) years. Twin modeling was conducted to estimate the relative contributions of additive genetic (A), shared environmental (C), and unique environmental (E) factors to variation in age at first drink and problem alcohol use and the cross-phenotype overlap in these influences.

RESULTS

Early initiation of alcohol use predicted problem use in EA but not AA women. Separate AA and EA twin models produced substantially different estimates (but not statistically different models) of the relative contributions of A and C to problem alcohol use but similar genetic correlations between the phenotypes. Whereas 33% of the variance in the EA model of problem use was attributed to C, no evidence for C was found in the AA model. Heritability estimates for problem alcohol use were 41% in the AA model, 21% in the EA model. Evidence for A and C were found in both AA and EA models of age at first drink, but the A estimate was higher in the EA than AA model (44% vs. 26%).

CONCLUSIONS

Findings are suggestive of distinctions between AA versus EA women in the relative contribution of genetic and environmental influences on the development of problem drinking.

Binge drinking among adolescents in Russia: prevalence, risk and protective factors

Despite evidence that alcohol misuse has been having an increasingly detrimental effect on adolescent wellbeing in Russia in recent years this phenomenon has been little researched. Using data from 2112 children from the Arkhangelsk Social and Health Assessment (SAHA) 2003, this study examined which factors acted as 'risk' or 'protective' factors for adolescent binge drinking within three domains we termed the 'family environment', the 'alcohol environment' and 'deviant behaviour'. The results showed that in the presence of comparatively moderate levels of binge drinking among both boys and girls, being able to access alcohol easily, being unaware of the risks of binge drinking and having peers who consumed alcohol increased the risk of adolescent binge drinking - as did playing truant, smoking and marijuana use, while parental warmth was protective against binge drinking for girls. Our finding that risk and protective factors occur across domains suggests that any interventions targeted against adolescent binge drinking may need to simultaneously focus on risk behaviours in different domains, while at the same time, broader social policy should act to limit the availability of alcohol to adolescents in Russia more generally.

"Drinking buddies" and alcohol dependence symptoms among African American men and women in Baltimore, MD

BACKGROUND

Social network characteristics have been found to be associated with a variety of risky behaviors, including alcohol consumption. This study assessed the relationships between the characteristics of drinking buddies and alcohol dependence symptoms among a sample of African American men and women.

METHODS

This is a cross-sectional study using baseline data from 721 impoverished African American men and women participating in an HIV prevention study in Baltimore, MD. Alcohol dependence symptoms were assessed through the Alcohol Use Disorders Identification Test (AUDIT) and was defined as AUDIT score≥13 for females and AUDIT score≥15 for males. Logistic regression models with generalized estimating equations (GEE) using network member as the unit of analysis were conducted to assess the associations between the gender or relationship (i.e., kin, non-kin or sex partner) of the drinking buddies and the participants' alcohol dependence symptoms.

RESULTS

Approximately 22% of the participants had alcohol dependence symptoms. Among male participants, alcohol dependence symptoms were associated with having drinking buddies who were sex partners (AOR: 2.41; 95%CI: 1.32, 4.39) or who were female (AOR: 2.29; 95%CI: 1.29, 4.05). Among female participants, association between the presence of drinking buddy and alcohol dependence symptoms did not depend on the types of relationship or the gender of the drinking buddy.

CONCLUSIONS

Social network characteristics with respect to alcohol dependence symptoms vary according to the type of relationship or the gender of the drinking buddies, especially among men. Gender-specific norm-based interventions may be a useful strategy to decrease drink problems.

Association between binge drinking, type of friends and gender: a cross-sectional study among Brazilian adolescents

BACKGROUND

Hazardous drinking among adolescents is a major public health concern. The purpose of this study was to examine the prevalence of binge drinking/alcohol consumption and its association with different types of friendship networks, gender and socioeconomic status among students in Belo Horizonte, Minas Gerais, Brazil.

METHODS

We conducted a cross-sectional study on a representative random sample of 891 adolescents (41% male, aged 15-19 years) from public and private schools in 2009-2010. Information on friendship networks and binge drinking was collected using two validated self-administered questionnaires: the Integrated Questionnaire for the Measurement of Social Capital and the first 3 items in the Alcohol Use Disorders Identification Test (AUDIT C). We used the area-based Social Vulnerability Index (SVI), mother and father's educational background, and the type of school to assess socioeconomic status. The chi-squared test was used to examine the associations between sample characteristics or the type of friends and binge drinking (p-values <0.05 were considered statistically significant). Ordinal logistic regression was used to estimate the association between binge drinking and the independent variables.

RESULTS

A total of 321 (36%) adolescents reported binge drinking (5 or more drinks in one occasion), and among them, 233 (26.2%) adolescents reported binge drinking less than monthly to monthly, and 88 (9.9%) weekly to daily. Binge drinking was associated with being male (OR = 1.52, 95% CI 1.01-2.28) and with living in a low vulnerability area (having the best housing conditions, schooling, income, jobs, legal assistance and health) (OR = 1.66, 95% CI 1.05-2.62). Students who reported that their closest friends were from school (as opposed to friends from church) had an increased risk of binge drinking (OR = 3.55, 95% CI 1.91-5.87). In analyses stratified by gender, the association was significant only among the female students.

CONCLUSIONS

The prevalence of binge drinking was high in this sample of Brazilian adolescents, and gender, low social vulnerability and friendship network were associated with binge drinking.

Adult consequences of late adolescent alcohol consumption: a systematic review of cohort studies

BACKGROUND

Although important to public policy, there have been no rigorous evidence syntheses of the long-term consequences of late adolescent drinking.

METHODS AND FINDINGS

This systematic review summarises evidence from general population cohort studies of drinking between 15-19 years old and any subsequent outcomes aged 20 or greater, with at least 3 years of follow-up study. Fifty-four studies were included, of which 35 were assessed to be vulnerable to bias and/or confounding. The principal findings are: (1) There is consistent evidence that higher alcohol consumption in late adolescence continues into adulthood and is also associated with alcohol problems including dependence; (2) Although a number of studies suggest links to adult physical and mental health and social consequences, existing evidence is of insufficient quality to warrant causal inferences at this stage.

CONCLUSIONS

There is an urgent need for high quality long-term prospective cohort studies in order to better understand the public health burden that is consequent on late adolescent drinking, both in relation to adult drinking and more broadly. Reducing drinking during late adolescence is likely to be important for preventing long-term adverse consequences as well as protecting against more immediate harms. Please see later in the article for the Editors' Summary.