Purpose Recent research suggests that acculturation is a multifaceted construct with implications for substance use among Hispanics. However, few, if any, studies examining profiles of acculturation have been conducted using national samples. Moreover, no cluster-based studies have examined how acculturation relates to discrimination and substance use disorders among Hispanics in the United States. Methods The present study, employing Wave 2 data on Hispanics (n = 6,359) from the National Epidemiologic Survey of Alcohol and Related Conditions, aims to address these gaps. We use latent profile analysis to identify profiles of acculturation among Hispanics in the United States and, in turn, examine the relationships between membership in these profiles and experiences of discrimination and the prevalence of substance use disorders. Results A five-class solution was the optimal modeling of the data. Classes were identified as Class 1: Spanish-dominant/strongly separated (17 %), Class 2: Spanish-dominant/separated (18 %), Class 3: bilingual/bicultural (33 %), Class 4: English-dominant/bicultural (16 %), and Class 5: English-dominant/assimilated (16 %). Bilingual/bicultural Hispanics (Class 3) reported the highest prevalence of discrimination (31 %). Spanish-language dominant Hispanics (Classes 1 and 2) reported the lowest prevalence of substance use disorders. Significant differences in the prevalence of substance use disorders were observed between the bilingual/bicultural (Class 3) and English-dominant/assimilated classes (Class 5), but no differences were noted between the two English-dominant classes (Classes 4 and 5). Conclusions Study findings indicate that acculturation is heterogeneous in its expression among Hispanics and suggest that Hispanics who maintain their Spanish-language capacity are at a substantially lower risk for a variety of substance use disorders.
Background Characterizing smoking behavior is important for informing etiologic models and targeting prevention efforts. This study explored the effects of both individual- and community-level variables in predicting cigarette use vs. non-use and level of use among adolescents as they transition into adulthood. Methods Data on 14,779 youths (53% female) were drawn from the National Longitudinal Study of Adolescent Health (Add Health); a nationally representative longitudinal cohort. A cohort sequential design allowed for examining trajectories of smoking typologies from age 13 to 32 years. Smoking trajectories were evaluated by using a zero-inflated Poisson (ZIP) latent growth analysis and latent class growth analysis modeling approach. Results Significant relationships emerged between both individual- and community-level variables and smoking outcomes. Maternal and peer smoking predicted increases in smoking over development and were associated with a greater likelihood of belonging to any of the four identified smoking groups versus Non-Users. Conduct problems and depressive symptoms during adolescence were related to cigarette use versus non-use. State-level prevalence of adolescent smoking was related to greater cigarette use during adolescence. Conclusions Individual- and community-level variables that distinguish smoking patterns within the population aid in understanding cigarette use versus non-use and the quantity of cigarette use into adulthood. Our findings suggest that efforts to prevent cigarette use would benefit from attention to both parental and peer smoking and individual well-being. Future work is needed to better understand the role of variables in the context of multiple levels (individual and community-level) on smoking trajectories.
ABSTRACT. Objective: A growing number of studies have examined the "immigrant paradox" with respect to the use of licit and illicit substances in the United States. However, there remains a need for a comprehensive examination of the multigenerational and global links between immigration and substance use disorders among adults in the United States. Method: The present study, using data from the National Epidemiologic Survey on Alcohol and Related Conditions, aimed to address these gaps by comparing the prevalence of substance use disorders of fi rst-generation (n = 3,338) and second-generation (n = 2,515) immigrants with native-born American adults (n = 15,733) in the United States. We also examined the prevalence of substance use disorders among fi rst-generation emigrants from Asia, Africa, Europe, and Latin America in contrast to second-generation and native-born Americans. Results:The prevalence of substance use disorders was highest among native-born Americans, slightly lower among second-generation immigrants, and markedly lower among fi rst-generation immigrants. Adjusted risk ratios were largest among individuals who immigrated during adolescence (ages 12-17 years) and adulthood (age 18 years or older). Results were consistent among emigrants from major world regions. Conclusions: Consistent with a broad body of literature examining the links between the immigrant paradox and health outcomes, results suggest that nativity and age at arrival are signifi cant factors related to substance use disorders among fi rst-and second-generation immigrants in the United States. (J. Stud. Alcohol Drugs, 75, 958-967, 2014)
Perceived discrimination is a major source of health-related stress. The purpose of this study was to model the heterogeneity of everyday-discrimination experiences among African American and Caribbean Blacks and to identify differences in the prevalence of mood and substance use outcomes, including generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder among the identified subgroups. The study uses data from the National Survey of American Life obtained from a sample of African American and Caribbean Black respondents (N = 4,462) between 18 and 65 years. We used latent profile analysis and multinomial regression analyses to identify and validate latent subgroups and test hypotheses, yielding 4 classes of perceived everyday discrimination: Low Discrimination, Disrespect and Condescension, General Discrimination, and Chronic Discrimination. Findings show significant differences exist between the Low Discrimination and General Discrimination classes for major depressive disorder, alcohol-use disorder, and illicit drug-use disorder. Moreover, we find significant differences exist between the Low Discrimination and Chronic Discrimination classes for the four disorders examined. Compared with the Chronic Discrimination class, members of the other classes were significantly less likely to meet criteria for generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder. Findings suggest elevated levels of discrimination increase risk for mood and substance-use disorders. Importantly, results suggest the prevalence of mood and substance-use disorders is a function of the type and frequency of discrimination that individuals experience.
Perceived discrimination is an important health-related stressor. As suggested by the stress-coping model, substance use often serves as a means to reduce the negative effects of perceived discrimination. This study uses data from the National Survey of American Life-Adults to examine the structural relationship of perceived discrimination and depressive symptoms with lifetime and recent substance use among African American and African Caribbean young adults. Respondents (N = 1,910) were18–35 years old. Compared with African Caribbeans, African Americans report significantly higher levels of depressive symptoms and both lifetime and recent substance use. Multiple-group structural equation modeling is used to evaluate model fit and test hypothesized models. Results show good fit of the hypothesized models in both African Americans and African Caribbeans. Full measurement and structural invariance is found across ethnicity. Mediation models explain 18.5% and 47.4% of the variance in lifetime substance use for African Americans and African Caribbeans, respectively, and 23.5% and 35.0% of the variance in recent substance use for African Americans and African Caribbeans, respectively. Mediation tests indicate depressive symptoms partially mediate the relationship between perceived discrimination and lifetime substance use and fully mediated this relationship for recent substance use. This study is the first to demonstrate a positive association between perceived racial discrimination and substance use among African Caribbean young adults. Study findings illuminate the influence of perceived discrimination on substance use and the mechanisms of this relationship among African American and African Caribbean young adults.
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