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Espinosa A, Ruglass LM, Conway FN. The relative contribution of ethnic identity and ethnic discrimination on alcohol, tobacco, and other drug use disorders among Hispanic/Latin American individuals. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 153:208963. [PMID: 37654011 DOI: 10.1016/j.josat.2023.208963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/09/2022] [Accepted: 01/17/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Racial/ethnic discrimination and ethnic identity, the affiliation and connection to one's ethnic group, are important for understanding alcohol, tobacco, and drug use disorders (AUD, TUD, DUD, respectively) among Hispanic/Latin American individuals. Although discrimination is a well-recognized risk factor, the role of ethnic identity is less understood. Moreover, no study has examined which of these factors is more important for informing AUD, TUD, and DUD. This information is necessary for creating effective prevention and treatment programs tailored for Hispanic/Latin American people. Herein we examined the role and relative importance of racial/ethnic discrimination and Hispanic ethnic identity on past year AUD, TUD, and DUD. METHODS Hispanic/Latin American participants of the National Epidemiologic Survey on Alcohol and Related Conditions-III constituted the sample for this cross-sectional secondary data analysis. Participants (N = 7037) were 39.93 years old on average (SD = 15.32). More than half were female (56.1 %) and had family incomes below the median household income in the United States (58.7 %). Most had national origins in North America (79.3 %), including US dependent territories and Mexico. Confirmatory factor analysis (CFA) verified the psychometric properties of the discrimination and Hispanic ethnic identity measures. Logistic regressions, supplemented with dominance analysis, estimated the role and relative contribution of discrimination and Hispanic ethnic identity on the probability of past year AUD, TUD, and DUD. RESULTS The CFAs yielded adequate convergent validity and reliability for each construct. More racial/ethnic discrimination and a higher Hispanic ethnic identity related to a higher and lower probability of AUD, TUD, and DUD, respectively. The magnitude of the association between Hispanic ethnic identity and the probability of TUD exceeded that of racial/ethnic discrimination, but the converse was the case for AUD and DUD. CONCLUSIONS Prevention and treatment programs for TUD that highlight the value of having a strong sense of self as a member of a Hispanic ethnic group, and that encourage the individual to explore their Hispanic ancestry may prove effective among Hispanic/Latin American individuals, particularly those who have experienced racial/ethnic discrimination. Programs for AUD and DUD tailored for Hispanic Latin/American adults should also incorporate coping strategies to address experiences with racial/ethnic discrimination.
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Affiliation(s)
- Adriana Espinosa
- Department of Psychology, The City College of New York, CUNY, United States of America; Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, United States of America.
| | - Lesia M Ruglass
- Department of Psychology, The City College of New York, CUNY, United States of America; Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, United States of America
| | - Fiona N Conway
- Steve Hicks School of Social Work, The University of Texas at Austin, United States of America
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Intersectional stigma subgroup differences in unhealthy drinking and disordered marijuana use among Black and Latino cisgender sexual minority young men. Drug Alcohol Depend 2022; 241:109652. [PMID: 36332595 PMCID: PMC10082566 DOI: 10.1016/j.drugalcdep.2022.109652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/18/2022] [Accepted: 09/27/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND We investigated associations of intersectional stigma subgroups with alcohol and marijuana use among Black and Latino sexual minority young men. Subgroups included Minimal Stigma (low to no stigma), Select Social Stigma (occasional stigma in social relationships), Multiform Heterosexism (internalized and interpersonal heterosexism from family/friends), Multiform Racism (racism across diverse contexts), Compound Stigma (frequent, ubiquitous racism and heterosexism). METHODS Cohort of Black and Latino cisgender sexual minority young men (n = 414; baseline ages 16-25) surveyed semiannually 2016-2019. Generalized estimating equations integrated with latent class analysis modeled linear and quadratic age effects and association of stigma subgroups with past 6-month alcohol use, marijuana use, unhealthy drinking, and marijuana use disorder symptoms. RESULTS All past 6-month substance use peaked between ages 21-23 years old. Across all ages and relative to Minimal Stigma, odds of drinking were higher in every subgroup and highest in Compound Stigma (OR=2.72, 95% CI 1.17-6.35); unhealthy drinking was higher in every subgroup and highest in Multiform Heterosexism (β = 3.31, 95% CI 1.92-3.89); marijuana use disorder symptoms were higher in most subgroups and highest in Compound Stigma (β = 1.30, 95% CI 0.76-1.85). Marijuana use odds did not differ among groups. CONCLUSION By examining intersectional stigma subgroups, we identified subgroups for whom substance use was elevated during a development period when use tends to be highest. Young men experiencing stigma patterns characterized primarily by heterosexism or heterosexism together with racism may be especially at risk for developing unhealthy drinking behaviors and marijuana use disorder symptoms.
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Chen S, Mallory AB. The effect of racial discrimination on mental and physical health: A propensity score weighting approach. Soc Sci Med 2021; 285:114308. [PMID: 34399293 PMCID: PMC8451383 DOI: 10.1016/j.socscimed.2021.114308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 07/19/2021] [Accepted: 08/05/2021] [Indexed: 02/07/2023]
Abstract
RATIONALE The preponderance of research documents the negative consequences of racial discrimination for the mental and physical well-being across several racial/ethnic groups including Black Americans, Hispanic Americans, and Asian Americans. Despite this large body of research, few studies have attempted to evaluate racial discrimination as a casual factor of worse health among racial minority groups. The current study utilized nationally representative data to estimate the causal effect of racial discrimination on cardiovascular disease (CVD), self-rated physical health (SRH), body mass index (BMI), depression disorder, and substance use disorder. In addition, we examined whether the effect of racial discrimination on health was moderated by socio-demographic characteristics (i.e., age, race/ethnicity, sex, socioeconomic status, marital status, geographic location, and health insurance coverage). METHODS Data were from the combined National Survey of American Life and the National Latino and Asian American Study. We applied a propensity score weighting approach to estimate the differences between individuals who reported ever (N = 4358) or never (N = 1836) experiencing racial discrimination on a list of health outcomes (e.g., CVD, SRH, BMI, depression disorder, and substance use disorder). RESULTS Participants who reported ever experiencing racial discrimination were about 5 % higher CVD risk, had 0.12 points lower SRH, a 3 % higher probability of a depression disorder, and a 2 % higher probability of a substance use disorder. Moderation effects by race/ethnicity, sex, socioeconomic status, geographic region, and health insurance coverage were found. CONCLUSION Our study represents one of the first attempts to apply a propensity score weighting approach to causally link racial discrimination to worse health for racial minority individuals. This study adds to a larger body of research documenting the negative association between racial discrimination and health.
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Affiliation(s)
- Shanting Chen
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton Street, Stop A2702, Austin, TX, 78712, United States.
| | - Allen B Mallory
- Human Development and Family Science, The Ohio State University, United States.
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Waldron KA, Turrisi RJ, Mallett KA, Romano E. Examining parental permissiveness toward drinking and perceived ethnic discrimination as risk factors for drinking outcomes among Latinx college students. Addict Behav 2021; 118:106900. [PMID: 33743494 PMCID: PMC8026724 DOI: 10.1016/j.addbeh.2021.106900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite almost 1 in 5 college students being Latinx, research examining risk factors for college alcohol misuse and consequences to inform prevention efforts for Latinx is limited. The current study attempts to address a health disparity among Latinx college students by examining the effects of parental permissiveness of underage drinking and perceived ethnic discrimination on drinking outcomes. METHODS Latinx students from three large and geographically diverse public universities (N = 215; 73% female) completed measures during the fall of their first (T1) and second (T2) years. Analyses used moderated regression with bootstrapping to obtain asymmetrical 95% confidence intervals. Parental permissiveness of underage drinking and perceived ethnic discrimination were assessed as predictors at T1. Drinking outcomes were assessed at T2 as typical weekly drinking, peak blood alcohol content (BAC), and alcohol-related consequences. RESULTS T1 permissiveness was significantly positively associated with T2 peak BAC. T1 discrimination significantly moderated the association between T1 permissiveness and T2 peak BAC as well as T2 consequences. The effects of T1 permissiveness on T2 peak BAC and T2 consequences were stronger among Latinx who experienced above-average levels of T1 discrimination. CONCLUSIONS Results suggest that among Latinx parental permissiveness of underage drinking and perceived ethnic discrimination are risk factors for peak BAC and alcohol-related consequences. The positive associations between parental permissiveness and peak BAC/consequences were stronger among Latinx students who experienced high levels of ethnic discrimination. Efforts to address these risk factors in future culturally sensitive parent-based interventions for Latinx college students are warranted.
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Affiliation(s)
- Katja A Waldron
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Robert J Turrisi
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA; Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA
| | - Kimberly A Mallett
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA 16802, USA
| | - Eduardo Romano
- Pacific Institute for Research and Evaluation, Calverton, MD 20705, USA
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Stepanova EV, Echevarria DJ, Collier AD, Cruz CS, Kirkland N, Drobes DJ. Discrimination, Stress and Reactivity to Alcohol Cues. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2019. [DOI: 10.1521/jscp.2019.38.10.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Our study investigated whether discrimination affects psychologi-cal/physiological stress and alcohol craving. Method: Participants (N = 92) were asked to recall and write about (a) a neutral, (b) a negative, or (c) a discriminatory experience in the past and then completed a cue-reactivity procedure assessing their alcohol craving. In addition, we assessed levels of perceived stress before and after the discrimination manipulation, chronic substance use and craving, prior perceived discrimination, and strength of racial/ethnic identity. Results: Results revealed a small effect in which the discrimination condition increased alcohol cue-elicited craving relative to the other conditions. Chronic craving moderated effects of discrimination on cortisol levels. Self-reported stress levels were increased in the discrimination and negative memory conditions relative to baseline. Strength of racial identity served as a protective factor for substance abuse in those who reported chronic high levels of discrimination. Discussion: We discussed the direct link established between acute exposure to discrimination and craving, and experimental evidence for the relationship between discrimination and self-reported stress, but also addressed potential limitations of this work. It is further discussed how some individual differences factors (e.g., chronic craving) predict physiological stress in discriminatory settings. This work underscored the role of racial identity as a protective factor against alcohol abuse in individuals reporting high levels of discrimination.
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Molina KM, Jackson B, Rivera-Olmedo N. Discrimination, Racial/Ethnic Identity, and Substance Use Among Latina/os: Are They Gendered? Ann Behav Med 2016; 50:119-29. [PMID: 26489844 DOI: 10.1007/s12160-015-9738-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os. PURPOSE The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables. METHODS We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder. RESULTS Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome. CONCLUSIONS Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity.
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Vargas ED, Winston NC, Garcia JA, Sanchez GR. Latina/o or Mexicana/o?: The Relationship between Socially Assigned Race and Experiences with Discrimination. SOCIOLOGY OF RACE AND ETHNICITY (THOUSAND OAKS, CALIF.) 2016; 2:498-515. [PMID: 27709119 PMCID: PMC5047666 DOI: 10.1177/2332649215623789] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Discrimination based on one's racial or ethnic background is one of the oldest and most perverse practices in the United States. While much of this research has relied on self-reported racial categories, a growing body of research is attempting to measure race through socially-assigned race. Socially-assigned or ascribed race measures how individuals feel they are classified by other people. This paper draws on the socially assigned race literature and explores the impact of socially assigned race on experiences with discrimination using a 2011 nationally representative sample of Latina/os (n=1,200). While much of the current research on Latina/os has been focused on the aggregation across national origin group members, this paper marks a deviation by using socially-assigned race and national origin to understand how being ascribed as Mexican is associated with experiences of discrimination. We find evidence that being ascribed as Mexican increases the likelihood of experiencing discrimination relative to being ascribed as White or Latina/o. Furthermore, we find that being miss-classified as Mexican (ascribed as Mexican, but not of Mexican origin) is associated with a higher likelihood of experiencing discrimination compared to being ascribed as white, ascribed as Latina/o, and correctly ascribed as Mexican. We provide evidence that socially assigned race is a valuable complement to self-identified race/ethnicity for scholars interested in assessing the impact of race/ethnicity on a wide range of outcomes.
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Affiliation(s)
- Edward D. Vargas
- Center for Women’s Health and Health Disparities Research, University of Wisconsin-Madison
| | - Nadia C. Winston
- Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College
| | - John A. Garcia
- Emeritus Professor at both the (ICPSR-Institute for Social Research-ISR (the University of Michigan), and School of Government and Public Policy (University of Arizona)
| | - Gabriel R. Sanchez
- Department of Political Science and RWJF Center for Health Policy, University of New Mexico
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Ornelas IJ, Lapham GT, Salgado H, Williams EC, Gotman N, Womack V, Davis S, Penedo F, Smoller S, Gallo LC. Binge drinking and perceived ethnic discrimination among Hispanics/Latinos: Results from the Hispanic community health study/study of Latinos sociocultural ancillary study. J Ethn Subst Abuse 2016; 15:223-239. [PMID: 26643869 PMCID: PMC5214998 DOI: 10.1080/15332640.2015.1024374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The study assessed whether overall perceived ethnic discrimination and four unique discrimination types were associated with binge drinking in participants from the Hispanic Community Health Study/Study of Latinos who also completed the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (n = 5,313). In unadjusted analyses that were weighted for sampling strategy and design, each unit increase in discrimination type was associated with a 12-63% increase in odds of binge drinking; however, after adjusting for important demographic variables including age, sex, heritage group, language, and duration of U.S. residence, there was no longer an association between discrimination and binge drinking. Further research still needs to identify the salient factors that contribute to increased risk for binge drinking among Hispanics/Latinos.
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Affiliation(s)
- India J Ornelas
- a Department of Health Services , University of Washington , Seattle , Washington
| | - Gwen T Lapham
- b Group Health Research Institute , Seattle , Washington
| | - Hugo Salgado
- c Graduate School of Public Health , San Diego State University , San Diego , California
| | - Emily C Williams
- d Veterans Affairs (VA) Puget Sound Health Care System , Health Services Research & Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care , Seattle , Washington
| | - Nathan Gotman
- e Collaborating Studies Coordinating Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina
| | - Veronica Womack
- f Feinberg School of Medicine , Northwestern University , Chicago , Illinois
| | - Sonia Davis
- e Collaborating Studies Coordinating Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina
| | - Frank Penedo
- f Feinberg School of Medicine , Northwestern University , Chicago , Illinois
| | - Sylvia Smoller
- g Department of Epidemiology & Population Health , Albert Einstein College of Medicine , Bronx , New York, New York
| | - Linda C Gallo
- c Graduate School of Public Health , San Diego State University , San Diego , California
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Gilbert PA, Zemore SE. Discrimination and drinking: A systematic review of the evidence. Soc Sci Med 2016; 161:178-94. [PMID: 27315370 PMCID: PMC4921286 DOI: 10.1016/j.socscimed.2016.06.009] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 11/17/2022]
Abstract
Although it is widely accepted that discrimination is associated with heavy and hazardous drinking, particularly within stress and coping frameworks, there has been no comprehensive review of the evidence. In response, we conducted a systematic review of the English language peer-reviewed literature to summarize studies of discrimination and alcohol-related outcomes, broadly defined. Searching six online data bases, we identified 938 non-duplicative titles published between 1980 and 2015, of which 97 met all inclusion criteria for our review and reported quantitative tests of associations between discrimination and alcohol use. We extracted key study characteristics and assessed quality based on reported methodological details. Papers generally supported a positive association; however, the quantity and quality of evidence varied considerably. The largest number of studies was of racial/ethnic discrimination among African Americans in the United States, followed by sexual orientation and gender discrimination. Studies of racial/ethnic discrimination were notable for their frequent use of complex modeling (i.e., mediation, moderation) but focused nearly exclusively on interpersonal discrimination. In contrast, studies of sexual orientation discrimination (i.e., heterosexism, homophobia) examined both internalized and interpersonal aspects; however, the literature largely relied on global tests of association using cross-sectional data. Some populations (e.g., Native Americans, Asian and Pacific Islanders) and types of discrimination (e.g., systemic/structural racism; ageism) received scant attention. This review extends our knowledge of a key social determinant of health through alcohol use. We identified gaps in the evidence base and suggest directions for future research related to discrimination and alcohol misuse.
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Affiliation(s)
- Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145N. Riverside Drive, N414 CPHB, Iowa City, IA 52242, USA; Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA.
| | - Sarah E Zemore
- Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA
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Abraído-Lanza AF, Echeverría SE, Flórez KR. Latino Immigrants, Acculturation, and Health: Promising New Directions in Research. Annu Rev Public Health 2016; 37:219-36. [PMID: 26735431 DOI: 10.1146/annurev-publhealth-032315-021545] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This article provides an analysis of novel topics emerging in recent years in research on Latino immigrants, acculturation, and health. In the past ten years, the number of studies assessing new ways to conceptualize and understand how acculturation-related processes may influence health has grown. These new frameworks draw from integrative approaches testing new ground to acknowledge the fundamental role of context and policy. We classify the emerging body of evidence according to themes that we identify as promising directions--intrapersonal, interpersonal, social environmental, community, political, and global contexts, cross-cutting themes in life course and developmental approaches, and segmented assimilation--and discuss the challenges and opportunities each theme presents. This body of work, which considers acculturation in context, points to the emergence of a new wave of research that holds great promise in driving forward the study of Latino immigrants, acculturation, and health. We provide suggestions to further advance the ideologic and methodologic rigor of this new wave.
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Affiliation(s)
- Ana F Abraído-Lanza
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032;
| | - Sandra E Echeverría
- Department of Community Health Education, School of Urban Public Health, City University of New York-Hunter College, New York, NY 10035;
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Mendez-Luck CA, Bethel JW, Goins RT, Schure MB, McDermott E. Community as a source of health in three racial/ethnic communities in Oregon: a qualitative study. BMC Public Health 2015; 15:127. [PMID: 25884852 PMCID: PMC4340096 DOI: 10.1186/s12889-015-1462-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/26/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND A 2011 report by the Oregon Health Authority and the Department of Human Services documented disparities in its Latino and American Indian populations on multiple individual-level health indicators. However, research is lacking on the social contexts in which Latinos and American Indians in Oregon live and how these environments influence the health of communities as a whole. To help fill this gap, this study sought to contextualize the social environments that influence the health of Latinos and American Indian residents in three Oregon communities. METHODS Guided by an ecological framework, we conducted one-time semi-structured qualitative interviews with 26 study participants to identify the prominent health-related issues in the communities and to examine the factors that study participants perceived as enabling or inhibiting healthy lifestyles of community residents. We used a grounded theory approach to perform content and thematic analyses of the data. RESULTS Study participants identified preventable chronic conditions, such as diabetes, obesity, and hypertension, as the most pressing health concerns in their communities. Results showed that traditional and cultural activities and strong family and community cohesion were viewed as facilitators of good community health. Poverty, safety concerns, insufficient community resources, and discrimination were perceived as barriers to community health. Three themes emerged from the thematic analyses: social connectedness is integral to health; trauma has an ongoing negative impact on health; and invisibility of residents in the community underlies poor health. CONCLUSIONS This study's findings provide insight to the social contexts which operate in the lives of some Latinos and American Indians in Oregon. While participants identified community-level factors as important to health, they focused more on the social connections of individuals to each other and the relationships that residents have with their communities at-large. Our findings may also help to explain how the intra- and inter-personal levels, the community/institutional level, and the macro level/public policy contexts can serve to influence health in these communities. For example, trauma and invisibility are not routinely examined in community health assessment and improvement planning activities; nonetheless, these factors appear to be at play affecting the health of residents.
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Affiliation(s)
- Carolyn A Mendez-Luck
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, 97331, USA.
| | - Jeffrey W Bethel
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, 97331, USA.
| | - R Turner Goins
- Department of Social Work, Western Carolina University, Cullowhee, NC, 28723, USA.
| | - Marc B Schure
- Veterans Affairs-Health Services Research & Development, Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, 98108, USA.
| | - Elizabeth McDermott
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, 97331, USA.
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Hong S, Walton E, Tamaki E, Sabin JA. Lifetime Prevalence of Mental Disorders among Asian Americans: Nativity, Gender, and Sociodemographic Correlates. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2014; 5:353-363. [PMID: 25621123 PMCID: PMC4299873 DOI: 10.1037/a0035680] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This study examines lifetime prevalence estimates of mental disorders among Asian Americans with a focus on differences by nativity, gender, and other relevant sociodemographic correlates. We analyze cross-sectional data from the National Latino and Asian American Study (NLAAS), the first national epidemiological survey of Asian Americans which used a probability sample of household resident adults in the United States (N=2,095). US-born Asian Americans are more likely to experience lifetime mood disorders, substance use disorders, and any mental disorders compared to immigrants. Lifetime substance use disorders are more likely to occur among men rather than women. Nativity and gender show joint associations with different mental disorders: US-born women are at the greatest risk for any mood disorders; US-born men are at the greatest risk for any substance use disorders; and immigrant women are at the lowest risk for substance use disorders compared to all other groups. Analysis of the sociodemographic correlates reveals that the youngest immigrant women showed significantly higher rates of any mood disorder compared to other immigrant women. Additionally, among immigrant men, those with low household income are at a higher risk for mood disorders, and those who report fair/poor English proficiency have a higher prevalence of anxiety and mood disorders. This study provides documentation of prevalence differences in detailed mental health categories along salient axes of stratification among Asian Americans and provides a foundation for future research aimed at understanding the causes and correlates of mental health disparities.
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Affiliation(s)
- Seunghye Hong
- Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa
| | | | - Emi Tamaki
- Ritsumeikan University, College of Social Sciences
| | - Janice A Sabin
- University of Washington, Department of Biomedical Informatics and Medical Education
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Otiniano Verissimo AD, Grella CE, Amaro H, Gee GC. Discrimination and substance use disorders among Latinos: the role of gender, nativity, and ethnicity. Am J Public Health 2014; 104:1421-8. [PMID: 24922159 DOI: 10.2105/ajph.2014.302011] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES We examined the relationship between discrimination and substance use disorders among a diverse sample of Latinos. We also investigated whether the relationship between discrimination and substance use disorders varied by gender, nativity, and ethnicity. METHODS Our analyses focused on 6294 Latinos who participated in the National Epidemiologic Survey on Alcohol and Related Conditions from 2004 to 2005. We used multinomial logistic regression to examine the association between discrimination and substance use disorders. RESULTS Discrimination was significantly associated with increased odds of alcohol and drug use disorders among Latinos. However, the relationship between discrimination and substance use disorders varied by gender, nativity, and ethnicity. Discrimination was associated with increased odds of alcohol and drug use disorders for certain groups, such as women, US-born Latinos, and Mexicans, but this relationship did not follow the same pattern for other subgroups. CONCLUSIONS It is important to determine which subgroups among Latinos may be particularly vulnerable to the negative effects of discrimination to address their needs.
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Affiliation(s)
- Angie Denisse Otiniano Verissimo
- Angie Denisse Otiniano Verissimo and Christine E. Grella are with the Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles Integrated Substance Abuse Programs. Hortensia Amaro is with the Office of the Provost, School of Social Work, University of Southern California, Los Angeles. Gilbert C. Gee is with the Department of Community Health Sciences, University of California, Los Angeles
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López-Cevallos DF, Harvey SM, Warren JT. Medical mistrust, perceived discrimination, and satisfaction with health care among young-adult rural latinos. J Rural Health 2014; 30:344-51. [PMID: 24576017 DOI: 10.1111/jrh.12063] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Little research has analyzed mistrust and discrimination influencing receipt of health care services among Latinos, particularly those living in rural areas. This study examined the associations between medical mistrust, perceived discrimination, and satisfaction with health care among young-adult rural Latinos. RESEARCH DESIGN This cross-sectional study analyzed data from 387 young-adult Latinos (ages 18-25) living in rural Oregon. The Behavioral Model of Vulnerable Populations was utilized as the theoretical framework. Correlations were run to assess bivariate associations among variables included in the study. Ordered logistic regression models evaluated the associations between medical mistrust, perceived discrimination, and satisfaction with health care. RESULTS On average, participants used health services 4 times in the past year. Almost half of the participants had health insurance (46%). The majority reported that they were moderately (32%) or very satisfied (41%) with health care services used in the previous year. In multivariable models, medical mistrust and perceived discrimination were significantly associated with satisfaction with health care. CONCLUSIONS Medical mistrust and perceived discrimination were significant contributors to lower satisfaction with health care among young-adult Latinos living in rural Oregon. Health care reform implementation, currently under way, provides a unique opportunity for developing evaluation systems and interventions toward monitoring and reducing rural Latino health care disparities.
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