Substance Use Disorders Among First- and Second-Generation Immigrant Adults in the United States: Evidence of an Immigrant Paradox?

Abstract

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)

Differences in all-cause mortality

“…Immigrants may adopt some of the habits of the host population and this may increase or decrease mortality, depending on the prevalence of the behavior in question in the country of origin relative to that in the host population (i.e., whether migrants move from a low risk to a high risk country or vice versa). In general, immigrants to European countries tend to drink less alcohol than the host population, concurrent with earlier Norwegian findings (Kumar et al 2008;Salas-Wright et al 2014). On the other hand, some studies show that some immigrant groups are more likely to smoke, less physically active, and obese (Carlsson et al 2014;Westerling and Rosen 2002), and this too concurs with a Norwegian Study (Kumar et al 2008).…”

Incidence and prevalence of mental disorders among immigrants and native Finns: a register-based study

“…Finland has a high level of alcohol consumption and alcohol use disorders, [42] whereas immigrants in Finland report much lower rates of alcohol consumption than the native population [17], and in a previous Finnish study, lower alcohol-related mortality explained a large share of the lower mortality among immigrants [5]. Similar findings of lower alcohol use disorder prevalence have been reported from the Netherlands and the US [43,44].…”

Drinking, Alcohol Use Disorder, and Treatment Access and Utilization Among U.S. Racial/Ethnic Groups

“…However, the reasons for the existence of this paradox are still debated. Many have proposed that immigrant groups are self-selected and as such, physically and psychologically healthier (Alegria et al, 2008; Salas-Wright et al, 2014a; Salas-Wright et al, 2014b). Others suggest that some immigrant groups possess protective characteristics such as family cohesion that may be lost in future generations of the U.S.-born (Marsiglia et al, 2009b; Rivera et al, 2008; Canino et al, 2008; Estrada-Martinez, et al, 2011).…”