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Lebeaut A, Zegel M, Healy NA, McGrew SJ, Viana AG, Vujanovic AA. Posttraumatic Stress and Alcohol Use Among Hispanic/Latinx University Students: A Moderated Indirect Effect Model of Coping-Related Drinking and Anxiety Sensitivity. J Dual Diagn 2024:1-15. [PMID: 38569201 DOI: 10.1080/15504263.2024.2335177] [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] [Indexed: 04/05/2024]
Abstract
Objective: Posttraumatic stress symptoms (PTSS) and anxiety sensitivity (AS) are associated with increased alcohol use and coping-motivated drinking among university students. This study among trauma-exposed Hispanic/Latinx university students sought to examine the indirect effect of PTSS on alcohol use severity through coping-motivated drinking and test the moderating role of AS and AS subfacets. Methods: University students who identified as Hispanic/Latinx (N = 830) were recruited from a large, urban, southern university and completed online, self-report questionnaires. Results: A significant interactive effect of PTSS and AS on coping-motivated drinking emerged. PTSS exerted a significant indirect effect on alcohol use severity, through coping-motivated drinking. Simple slope analyses revealed that PTSS was associated with coping-motivated drinking across all levels of AS. Post hoc results revealed unique biological sex differences in probable diagnosis odds ratios. Conclusions: These findings indicate that PTSS and AS are associated with coping-motivated drinking and alcohol use severity in trauma-exposed, Hispanic/Latinx university students.
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Affiliation(s)
- Antoine Lebeaut
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Maya Zegel
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Nathaniel A Healy
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Shelby J McGrew
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
| | - Andres G Viana
- Department of Psychiatry and Behavioral Sciences, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
- Department of Psychiatry and Behavioral Sciences, Texas A&M School of Medicine, Bryan, Texas, USA
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Lee CS, Nalven T, Hai A, Pinedo M, Lopez V, Morris M, Delva J, Cano M. The relationship between discrimination, alcohol use severity, and PTSD symptoms among Latinx heavy drinkers. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 159:209263. [PMID: 38103830 PMCID: PMC10947868 DOI: 10.1016/j.josat.2023.209263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 11/01/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Discrimination is linked to alcohol use severity among Latinx adults, who also show high prevalence rates of PTSD compared to non-Latinx adults. We know little about whether PTSD symptoms affects the relationship between discrimination and alcohol use severity. We hypothesized that the association between discrimination and alcohol use severity might differ by level of PTSD symptom severity. METHODS This is a secondary cross-sectional analysis of data collected at baseline from a completed randomized clinical trial testing the relative efficacy of a culturally adapted motivational interview designed to address discrimination and drinking behavior against an unadapted motivational interview for Latinx adults. Eligible participants screened positive for the NIAAA Single Alcohol Screening Question for heavy drinking days, identified as Latinx, and were 18-65 years old. We assessed the Everyday Discrimination Scale, Primary Care PC-PTSD screener, Alcohol Use Disorder Identification Test, and the Short Acculturation Scale for Hispanics. The study analyzed the main and interactive effects of discrimination and PTSD symptoms on alcohol use severity, while controlling for age, sex, household income, and acculturation. RESULTS After controlling for covariates in model 2, the interaction of discrimination and PTSD symptoms was significantly related to alcohol use severity. Simple slopes analysis indicated that discrimination was positively related to alcohol use severity among those with high (1 SD above the mean) but not low (1 SD below the mean) levels of PTSD symptoms. CONCLUSIONS Evidence suggests that the experiences of discrimination were associated with alcohol use severity among those who reported more PTSD symptoms. Specifically, discrimination may have a stronger effect on alcohol use severity among Latinx adults who report more PTSD symptoms. Screening Latinx adults for heavy drinking days, discrimination, and PTSD symptoms is clinically important. Culturally adapted alcohol interventions that target discrimination may be particularly effective for Latinx individuals with more PTSD symptoms.
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Affiliation(s)
- Christina S Lee
- Boston University School of Social Work, 264 Bay State Road, Room 354, Boston, MA 02215, United States of America.
| | - Tessa Nalven
- Dept. of Psychology, University of Rhode Island, United States of America
| | - Audrey Hai
- Tulane University School of Social Work, United States of America
| | - Miguel Pinedo
- Dept of Health Sciences, University of Texas at Austin, United States of America
| | | | - Melanie Morris
- Boston University School of Social Work, United States of America
| | - Jorge Delva
- Boston University School of Social Work, United States of America
| | - Miguel Cano
- Dept. of Epidemiology, University of Texas Southwestern, United States of America
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Venger O, Mysula Y, Oliynyk O, Striepetova O, Kulivets O. Structure and features of psychopathological symptoms in forced migrants and internally displaced persons. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:225-232. [PMID: 38592982 DOI: 10.36740/wlek202402106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Aim: To study the structure and characteristics of psychopathological symptoms in FM who left Ukraine as a result of the full-scale armed aggression of the Russian Federation against Ukraine, and internally displaced persons, in a comparative aspect. PATIENTS AND METHODS Materials and Methods: Examination was performed in compliance with the principles of biomedical ethics, based on informed consent. Research was provided on the basis of the Ternopil Regional Clinical Psychoneurological Hospital. Inclusion criteria were women who were forced to leave the territory of Ukraine as a result of hostilities after February 24, 2022, and who left for temporary residence in the territory of the Republic of Poland (Poland) (FM), and women who were temporarily relocated within Ukraine in connection with connection with hostilities (IDP). Exclusion criteria from the study were presence of language disorders, pronounced cognitive disorders, severe somatic condition. The examination was organized by the method of a semi-structured clinical interview according to the developed by us protocol and was conducted remotely. During the examination, depressive, anxiety-phobic, asthenic and dyssomnic disorders, addictive behavior and symptoms of PTSDwere identified and verified. Statistical and mathematical processing a was carried out using Fisher's exact test. RESULTS Results: The data we obtained indicate a significant spread of psychopathological symptoms in FM and IDP. CONCLUSION Conclusions: FM and IDP are characterized by a high incidence of psychopathological symptoms. The most frequent were: depressed mood (FM - 67.2%, IDP - 58.5%), feelings of anxiety and fear (FM -52.5%, IDP - 43.6%), obsessive thoughts (FM - 58.9 %, IDP - 49.5%).
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Affiliation(s)
- Olena Venger
- IVAN HORBACHEVSKY TERNOPІL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE
| | - Yuriy Mysula
- IVAN HORBACHEVSKY TERNOPІL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE
| | | | | | - Oleksii Kulivets
- NATIONAL MEDICAL UNIVERSITY NAMED BY O.BOHOMOLETZ, KYIV, UKRAINE
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James C. H, Maldonado-Molina MM, Schwartz SJ, García MF, Piñeros-Leaño MF, Bates MM, Montero-Zamora P, Calderón I, Rodríguez J, Salas-Wright CP. The impact of hurricane trauma and cultural stress on posttraumatic stress among hurricane Maria survivors relocated to the U.S. mainland. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2023:2024-23222-001. [PMID: 37917483 PMCID: PMC11063122 DOI: 10.1037/cdp0000623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
OBJECTIVES Following Hurricane Maria, scores of Puerto Rican "Maria migrants" fled the island with thousands permanently resettling on the United States (U.S.) mainland. Emerging evidence suggests that many Maria migrants are exposed to migration-related cultural stressors, including discrimination, negative context of reception, and language stress. The present study examines the associations of premigration hurricane trauma and postmigration cultural stress with posttraumatic stress disorder (PTSD) symptom severity and positive PTSD screens. METHOD Participants were 319 adult (age 18+, 71% female) Puerto Rican Hurricane Maria survivors on the U.S. mainland. Data were collected virtually between August 2020 and October 2021. Participants completed Spanish-language measures of hurricane-related trauma, postmigration cultural stress exposure, PTSD symptoms, and positive screens. RESULTS One in five (20.5%) Maria migrants reported PTSD scores in the range indicating a likely PTSD diagnosis (i.e., positive screen of 50+). Both hurricane trauma and migration-related cultural stressors independently predicted posttraumatic stress and positive PTSD screens. Additionally, controlling for the effect of hurricane trauma, discrimination and language stress were strongly linked with PTSD. Further, hurricane trauma and cultural stressors interact such that cultural stress predicts PTSD-positive screens at low-to-moderate levels of hurricane trauma exposure but not at high-to-very-high levels. CONCLUSION Findings underscore the importance of providing mental health and other psychosocial supports to hurricane survivors and evacuees beyond the immediate aftermath of the disaster, and the need to consider both premigration trauma and postmigration experiences in terms of the mental health of crisis migrant populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Hodges James C.
- Boston College, School of Social Work, Chestnut Hill, Massachusetts, USA
| | - Mildred M. Maldonado-Molina
- University of Florida, School of Health and Human Performance, Department of Health Education in Behavior, Gainesville, Florida, USA
| | - Seth J. Schwartz
- University of Texas at Austin, College of Education, Department of Kinesiology and Health Education, Austin, Texas, USA
| | | | | | - Melissa M. Bates
- University of Florida, School of Health and Human Performance, Department of Health Education in Behavior, Gainesville, Florida, USA
| | - Pablo Montero-Zamora
- University of Texas at Austin, College of Education, Department of Kinesiology and Health Education, Austin, Texas, USA
| | - Ivonne Calderón
- University of Florida, School of Health and Human Performance, Department of Health Education in Behavior, Gainesville, Florida, USA
| | - José Rodríguez
- Iglesia Episcopal Jesús de Nazaret, Orlando, Florida, USA
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Wheeler PB, Miller-Roenigk B, Jester J, Stevens-Watkins D. PTSD diagnosis and nonmedical use of benzodiazepines among African American incarcerated men: the mitigating effect of John Henry active coping. J Ethn Subst Abuse 2022:1-14. [PMID: 35876082 PMCID: PMC9868189 DOI: 10.1080/15332640.2022.2101575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The current study examined the relationship between PTSD and nonmedical use of benzodiazepines (BZDs) based on level of John Henry Active Coping (JHAC) among African American incarcerated men. Data were derived from the Helping Incarcerated Men (HIM) Study (n = 208). Nonmedical use of BZDs was measured for the 30 days before incarceration. Current PTSD diagnosis and JHAC were determined using DSM-5 criteria and the JHAC Scale. Adjusted logistic regression analyses showed PTSD diagnosis was significantly associated with nonmedical BZD use (p = .011), but that JHAC did not significantly mitigate this relationship. African American incarcerated men may experience an unmet need with regards to mental health treatment.
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Amiri S. Global prevalence of anxiety and PTSD in immigrants: a systematic review and meta-analysis. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2022; 36:69-88. [PMID: 35147917 DOI: 10.1007/s40211-022-00411-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/09/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND A systematic and meta-analysis of the prevalence of anxiety and posttraumatic stress disorder (PTSD) in immigrants was conducted. METHODS Based on the keywords, scientific databases were systematically searched to identify articles. The search included the three databases PubMed, Google Scholar and Research Gate until June 2020. The analysis was performed to assess the prevalence of anxiety and PTSD; subgroups were examined based on anxiety disorders. RESULTS The prevalence of agoraphobia, PTSD, generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), social phobia and specific phobia were 4, 25, 9, 4, 3, 5 and 8%, respectively. CONCLUSIONS Considering the findings of the present study regarding the significant prevalence of anxiety and PTSD in the immigrant population, it is necessary to pay special attention to the mental health of this population.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Vazquez V, Rojas P, Cano MÁ, De La Rosa M, Romano E, Sánchez M. Depressive symptoms among recent Latinx immigrants in South Florida: The role of premigration trauma and stress, postimmigration stress, and gender. J Trauma Stress 2022; 35:533-545. [PMID: 34973038 PMCID: PMC9035034 DOI: 10.1002/jts.22768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 09/02/2021] [Accepted: 09/05/2021] [Indexed: 11/11/2022]
Abstract
In the past decade, recent Latinx immigrants (RLIs) from South and Central America have arrived in the United States seeking asylum from countries affected by war, political upheaval, and high crime and poverty rates. The premigration stress and trauma they experience are further compounded by postimmigration stress due to discrimination, lack of access to health care, and financial instability. Evidence suggests RLIs who experience such stress and trauma have an increased risk of developing depressive symptoms. We examined the combined effect of premigration stress and trauma and postimmigration stress on postimmigration depressive symptoms; we also explored the moderating effect of gender. Hierarchical multiple regression and moderation analyses were conducted on a cross-sectional sample of 540 young adult RLIs (age range: 18-34 years, 50.2% men) in South Florida. Higher levels of postimmigration stress, β = .37, p < .001, were associated with increased postimmigration depressive symptoms. No significant associations emerged between premigration stress and trauma and postimmigration depressive symptoms. Moderation analyses revealed no significant interaction effect of gender. Post hoc analyses indicated that country/region of origin moderated the relation between postimmigration stress and depressive symptoms such that the association was stronger among Venezuelan, β = 1.51, p < .001; other South American, β = 1.06, p < .001; and Central American/Mexican RLIs, β = 1.38, p < .001, compared with Caribbean RLIs, β = .45, p = .122. These findings suggest that interventions focused on addressing postimmigration stress early in the immigration process can potentially lower subsequent depressive symptoms among RLIs.
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Affiliation(s)
- Vicky Vazquez
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Patria Rojas
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Miguel Ángel Cano
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Eduardo Romano
- Pacific Institute for Research and Evaluation (PIRE), Beltsville, Maryland, USA
| | - Mariana Sánchez
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
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Phipps R, Stivers R, Dawson V, Harris J. Thematic Analysis of Intergenerational Transmission of Trauma in Latinx Immigrant Families in the Southern US. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2022. [DOI: 10.1007/s10447-022-09467-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Westrick AC, Vazquez V, De La Rosa M, Romano E, Rojas P, Sanchez M. Prescription Drug and Cannabis Use among Recent Latinx Immigrants Pre- and Post-Immigration to the US. Subst Use Misuse 2022; 57:175-184. [PMID: 34898352 PMCID: PMC8813903 DOI: 10.1080/10826084.2021.1990342] [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] [Indexed: 01/03/2023]
Abstract
Introduction: Shifts in the sociopolitical context of Latin America have led to steep increases in recent Latinx immigrants (RLI) arriving in the US within the context of forced migration. Yet, little is known about how adverse experiences of RLIs before and after immigration may impact their health including drug use. The purpose of this study was to examine prescription drug and cannabis use before and just after immigration among RLIs and how this drug use is influenced by pre-and post-immigration factors. Methods: This study utilized baseline data from a study examining pre- to post-immigration drinking and driving trajectories among RLI in the United States (US). Baseline criteria included: self-identifying as a Latinx immigrant, 18 - 34 years old, who recently immigrated from a Latin American country. Multivariate logistic regression was conducted to determine predictors of drug use both prior to and after immigrating. Results: There were 540 RLI, 50.2% male and 47.8% subjected to forced migration. Prescription and illicit drug use decreased post-immigration with sedatives being the most common. Higher levels of education was associated with increased odds of pre-immigration prescription drug use and cannabis use. Those experiencing forced migration were more likely to engage in prescription drug use before and after immigration, while no associations were found for cannabis use. Conclusion: Findings suggest a need for increased substance use and mental health services among RLIs arriving within the context of forced migration. More research is needed to understand the trajectories of drug use among RLI as their time in the US increases.
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Affiliation(s)
- Ashly C Westrick
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Vicky Vazquez
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA
| | - Mario De La Rosa
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA
| | - Eduardo Romano
- Pacific Institute for Research and Evaluation (P.I.R.E.), Calverton, Maryland, USA
| | - Patria Rojas
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA.,Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mariana Sanchez
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA.,Pacific Institute for Research and Evaluation (P.I.R.E.), Calverton, Maryland, USA
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Blakey SM, Campbell SB, Simpson TL. Associations Between Lifetime Panic Attacks, Posttraumatic Stress Disorder, and Substance Use Disorders in a Nationally Representative Sample. J Dual Diagn 2022; 18:21-32. [PMID: 34965200 DOI: 10.1080/15504263.2021.2013096] [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] [Indexed: 10/19/2022]
Abstract
Objective: Rates of lifetime substance use disorder (SUD) are high among people with lifetime posttraumatic stress disorder (PTSD). Panic attacks are also prevalent among trauma survivors and people with SUD, yet studies on PTSD/SUD have rarely examined comorbid panic. This potentially creates additional barriers to effective treatment for people with PTSD/SUD, in that panic may be under-diagnosed among people with PTSD/SUD and consequently attenuate treatment outcome. Additionally, research on PTSD/SUD often combines people with alcohol use disorder (AUD) and people with drug use disorders (DUDs) into a single group despite evidence that these two PTSD/SUD subgroups differ along important sociodemographic and clinical variables. This study tested the hypothesis that among adults with lifetime PTSD, panic attacks would be associated with greater lifetime risk for both AUD and DUD. We also explored whether panic attacks were associated with specific DUDs that frequently co-occur with PTSD (cannabis, sedatives/tranquilizers, heroin/opioids, and cocaine). Methods: Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a cross-sectional national study. Adults with lifetime PTSD (N = 2,230) were classified into one of three groups based on diagnostic interview data: adults with PTSD/AUD (i.e., met criteria for PTSD and AUD but not DUD; n = 656), adults with PTSD/DUD (i.e., met criteria for PTSD and DUD, regardless of AUD diagnostic status; n = 643), or adults with PTSD-only (i.e., met criteria for PTSD but not AUD or DUD; n = 1,031). Results: Weighted logistic regression analyses showed that lifetime risk of PTSD/AUD and PTSD/DUD, each relative to PTSD-only, was greater for adults who were younger at the time of data collection, were male, and had a history of panic attacks. Panic attacks did not predict specific DUD diagnoses comorbid with PTSD in exploratory analyses adjusting for sociodemographic and clinical covariates. Conclusions: Findings highlight the importance of assessing and targeting panic in PTSD/SUD clinics, but suggest panic may not discriminate between specific DUDs that commonly co-occur with PTSD. Study limitations and future directions are discussed.
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Affiliation(s)
- Shannon M Blakey
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.,Durham VA Health Care System, Durham, NC, USA
| | - Sarah B Campbell
- VA Puget Sound Health Care System, Seattle Division, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.,VA Health Services Research and Development Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA
| | - Tracy L Simpson
- VA Puget Sound Health Care System, Seattle Division, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.,VA Center of Excellence for Substance Addiction Treatment and Education, Seattle, WA, USA
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Beech BM, Ford C, Thorpe RJ, Bruce MA, Norris KC. Poverty, Racism, and the Public Health Crisis in America. Front Public Health 2021; 9:699049. [PMID: 34552904 PMCID: PMC8450438 DOI: 10.3389/fpubh.2021.699049] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/06/2021] [Indexed: 01/13/2023] Open
Abstract
The purpose of this article is to discuss poverty as a multidimensional factor influencing health. We will also explicate how racism contributes to and perpetuates the economic and financial inequality that diminishes prospects for population health improvement among marginalized racial and ethnic groups. Poverty is one of the most significant challenges for our society in this millennium. Over 40% of the world lives in poverty. The U.S. has one of the highest rates of poverty in the developed world, despite its collective wealth, and the burden falls disproportionately on communities of color. A common narrative for the relatively high prevalence of poverty among marginalized minority communities is predicated on racist notions of racial inferiority and frequent denial of the structural forms of racism and classism that have contributed to public health crises in the United States and across the globe. Importantly, poverty is much more than just a low-income household. It reflects economic well-being, the ability to negotiate society relative to education of an individual, socioeconomic or health status, as well as social exclusion based on institutional policies, practices, and behaviors. Until structural racism and economic injustice can be resolved, the use of evidence-based prevention and early intervention initiatives to mitigate untoward effects of socioeconomic deprivation in communities of color such as the use of social media/culturally concordant health education, social support, such as social networks, primary intervention strategies, and more will be critical to address the persistent racial/ethnic disparities in chronic diseases.
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Affiliation(s)
- Bettina M. Beech
- Department of Health Systems and Population Health Science, University of Houston College of Medicine, Houston, TX, United States
| | - Chandra Ford
- Department of Community Health Sciences, Center for the Study of Racism, Social Justice and Health at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Roland J. Thorpe
- Department of Health, Behavior, and Society, Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Marino A. Bruce
- Program for Research on Faith, Justice, and Health, Department of Behavioral and Social Sciences, University of Houston College of Medicine, Houston, TX, United States
| | - Keith C. Norris
- Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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Salama ES, Castaneda AE, Lilja E, Suvisaari J, Rask S, Laatikainen T, Niemelä S. Pre-migration traumatic experiences, post-migration perceived discrimination and substance use among Russian and Kurdish migrants-a population-based study. Addiction 2020; 115:1160-1171. [PMID: 31797477 PMCID: PMC7317749 DOI: 10.1111/add.14904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 02/01/2019] [Accepted: 11/08/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS The associations between traumatic events, substance use and perceived discrimination have been rarely studied among migrants in host countries. We examined whether pre-migration potentially traumatic experiences (PTEs) or perceived discrimination (PD) are associated with substance use among migrants with voluntary (Russians) and forced (Kurds) migration backgrounds. DESIGN Cross-sectional interview and health examination data from the Finnish Migrant Health and Wellbeing Study were used. The target sample (n = 1000 for each group) was drawn from the national population register using stratified random sampling by participants' country of birth and native language. SETTING Population-based data were collected from six cities in Finland during 2010-12. PARTICIPANTS The participation rates were 68% (Russians) and 59% (Kurds). The analytical sample size varied (Russians n = 442-687, Kurds n = 459-613), as some participants completed only interview, health examination or short interview. The majority of Kurds had a refugee background (75%) while Russians had mainly migrated for other reasons (99%). MEASUREMENTS The three main outcomes were self-reported binge drinking, daily smoking and life-time cannabis use. PTEs and PD were self-reported in the interview. Socio-demographic background, migration-related factors and current affective symptoms were adjusted for. FINDINGS Among Kurds, PTEs were associated with binge drinking [adjusted odds ratio (aOR) = 2.65, 95% confidence interval (CI) = 1.30-5.42] and PD was associated with life-time cannabis use (aOR = 3.89, 95% CI = 1.38-10.97) after adjusting for contextual factors. Among Russians, PTEs were associated with life-time cannabis use adjusting for contextual factors (aOR = 2.17, 95% CI = 1.12-4.18). CONCLUSIONS In Finland, pre-migration traumatic experiences appear to be associated with life-time cannabis use among the Russian migrant population (voluntary migration) and binge drinking among the Kurdish migrant population (forced migration). Perceived discrimination in Finland appears to be associated with life-time cannabis use among Kurdish migrants.
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Affiliation(s)
- Essi S. Salama
- Faculty of MedicineUniversity of TurkuTurkuFinland
- Child PsychiatryTurku University HospitalTurkuFinland
| | - Anu E. Castaneda
- National Institute for Health and Welfare (THL)HelsinkiFinland
- Faculty of Medicine, Department of Psychology and LogopedicsUniversity of HelsinkiHelsinkiFinland
| | - Eero Lilja
- National Institute for Health and Welfare (THL)HelsinkiFinland
| | - Jaana Suvisaari
- National Institute for Health and Welfare (THL)HelsinkiFinland
| | - Shadia Rask
- National Institute for Health and Welfare (THL)HelsinkiFinland
| | - Tiina Laatikainen
- National Institute for Health and Welfare (THL)HelsinkiFinland
- Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
- Joint Municipal Authority for North Karelia Social and Health Services (Siun sote)JoensuuFinland
| | - Solja Niemelä
- Department of PsychiatryUniversity of TurkuTurkuFinland
- Addiction Psychiatry UnitTurku University HospitalTurkuFinland
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13
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Salas-Wright CP, Vaughn MG, Goings TC, Oh S, Marsiglia F, Cohen M, John R, Andrade P, Schwartz S. Disconcerting levels of alcohol use among Venezuelan immigrant adolescents in the United States. Addict Behav 2020; 104:106269. [PMID: 31978757 DOI: 10.1016/j.addbeh.2019.106269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND It is estimated that more than 4 million Venezuelans have left their country as a direct result of their nation's widespread social and economic challenges. Although recent research identifies Venezuela as one of the nations with the highest rates of harmful alcohol consumption in the Americas, no research has been conducted on alcohol use among Venezuelan youth in diaspora. METHODS Data was collected between November 2018 and June 2019 from 373 Venezuelan immigrant youth ages 12-17 in the United States. The prevalence of past-month and lifetime alcohol use among Venezuelan youth is compared to that of other Hispanic and immigrant youth from the National Survey on Drug Use and Health (NSDUH), and the Construyendo Oportunidades Para Adolecentes Latinos (COPAL) study using independent sample t tests. RESULTS The prevalence of past-month and lifetime alcohol use was significantly higher among Venezuelan immigrant youth (15% and 52%, respectively) compared to other Hispanic (9% and 28%) and immigrant (4.5% and 28%) youth in the NSDUH, and youth ages 14-17 in the COPAL study (4.0% and 22%). Among Venezuelan youth reporting alcohol use initiation, 1.5% of youth ages 12-14 and 19% ages 15-17 report lifetime alcohol intoxication. DISCUSSION Although preliminary, results indicate that a disconcerting proportion of Venezuelan crisis migrant youth in the US report lifetime alcohol initiation and past-month use. These findings suggest the importance of future research to examine the prevalence and correlates of alcohol use in this population using recruitment and sampling methods that will allow for population-level estimates.
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Affiliation(s)
- Christopher P Salas-Wright
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA 02215, United States; Department of Public Health Sciences, Division of Prevention Science & Community Health, University of Miami, Miami, FL, United States
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States; Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Trenette C Goings
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Sehun Oh
- School of Social Work, Ohio State University, Columbus, OH, United States
| | - Flavio Marsiglia
- School of Social Work, Watts College of Public Service and Community Solutions, Arizona State University, Phoenix, AZ, United States
| | - Mariana Cohen
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA 02215, United States
| | - Rachel John
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA 02215, United States
| | | | - Seth Schwartz
- Department of Public Health Sciences, Division of Prevention Science & Community Health, University of Miami, Miami, FL, United States
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14
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Fortuna LR, Noroña CR, Porche MV, Tillman C, Patil PA, Wang Y, Markle SL, Alegría M. Trauma, immigration, and sexual health among Latina women: Implications for maternal-child well-being and reproductive justice. Infant Ment Health J 2019; 40:640-658. [PMID: 31335984 PMCID: PMC6972560 DOI: 10.1002/imhj.21805] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/02/2019] [Accepted: 04/03/2019] [Indexed: 11/21/2022]
Abstract
Latina immigrant women are vulnerable to traumatic stress and sexual health disparities. Without autonomy over their reproductive health and related decision‐making, reproductive justice is elusive. We analyzed behavioral health data from 175 Latina immigrant participants (M age = 35; range = 18–64) of the International Latino Research Partnership (ILRP) study. We used descriptive and inferential statistics to compare immigrant mothers of minor children to those without, regarding their psychological and reproductive health, and correlates of past exposure to sexual trauma. Over one third (38%) of ILRP participants had minor children, and 58% had citizenship in their host country. The rate for sexual assault was 30 and 61%, respectively, for physical assault; these rates were similarly high for women with and without minor children. Women who reported sexual assault scored significantly higher for depression, posttraumatic stress disorder, and substance‐abuse screens. Odds of experiencing sexual assault was highest for women who experienced physical assault (odds ratio = 10.74), and for those from the Northern Triangle (odds ratio = 8.41). Subgroups of Latina migrant mothers are vulnerable to traumatic stress and related sexual and mental health risks. Given these findings, we frame the implications in a reproductive justice framework and consider consequences for caregiver–child well‐being.
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Affiliation(s)
- Lisa R Fortuna
- Boston Medical Center, Department of Psychiatry, Boston, Massachusetts
| | | | - Michelle V Porche
- Boston University, Wheelock College of Education and Human Development, Boston, Massachusetts
| | | | - Pratima A Patil
- Boston University, Wheelock College of Education and Human Development, Boston, Massachusetts
| | - Ye Wang
- Massachusetts General Hospital, Disparities Research Unit and Harvard Medical School, Boston, Massachusetts
| | - Sheri Lapatin Markle
- Massachusetts General Hospital, Disparities Research Unit and Harvard Medical School, Boston, Massachusetts
| | - Margarita Alegría
- Massachusetts General Hospital, Disparities Research Unit and Harvard Medical School, Boston, Massachusetts
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15
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Caceres BA, Veldhuis CB, Hickey KT, Hughes TL. Lifetime Trauma and Cardiometabolic Risk in Sexual Minority Women. J Womens Health (Larchmt) 2019; 28:1200-1217. [PMID: 31099702 DOI: 10.1089/jwh.2018.7381] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: Sexual minority women (SMW; such as lesbian, bisexual, and mostly lesbian) exhibit excess cardiometabolic risk, yet factors that contribute to cardiometabolic risk in this population are poorly understood. Trauma exposure has been posited as a contributor to cardiometabolic risk in SMW. Materials and Methods: An analysis of data from Wave 3 of the Chicago Health and Life Experiences of Women Study was conducted. Multinomial logistic regression was used to examine correlates of trauma. Next, multiple logistic regression was used to examine the associations of different forms of trauma throughout the life course (childhood, adulthood, and lifetime), with psychosocial and behavioral risk factors and self-reported cardiometabolic risk (obesity, hypertension, and diabetes) in SMW adjusted for relevant covariates. Results: A total of 547 participants were included. Older age was associated with higher rates of childhood and adulthood trauma. SMW of color reported higher rates of childhood trauma than white participants. Higher education was associated with lower rates of adulthood trauma. All forms of trauma were associated with probable diagnosis of post-traumatic stress disorder and lower perceived social support. Adult trauma was associated with anxiety, whereas childhood and lifetime trauma were associated with higher odds of depression. No significant associations between forms of trauma and behavioral risk factors were noted, except that childhood trauma was associated with higher odds of past-3-month overeating. Logistic regression models examining the association of trauma and cardiometabolic risk revealed that childhood trauma was an independent risk factor for diabetes. Adulthood and lifetime trauma were significantly associated with obesity and hypertension. Conclusions: Trauma emerged as an independent risk factor for cardiometabolic risk in SMW. These findings suggest that clinicians should screen for trauma as a cardiovascular risk factor in SMW, with special attention to SMW most at risk.
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Affiliation(s)
| | | | | | - Tonda L Hughes
- Columbia University School of Nursing, New York, New York
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