Acculturation and drinking behavior among Latinxs: a narrative review

Research suggests that acculturation is associated with increased alcohol consumption among Latinxs. The purpose of this narrative review is to contribute to this literature by examining the association between acculturation and alcohol use within current theoretical and etiological frameworks on cultural norms, acculturative stress, and acculturative gaps. This review also compares the utility of these explanatory frameworks for guiding future research. Two databases (PubMed and PsycInfo) were used to identify peer-reviewed studies pertaining to the associations between acculturation and alcohol use among Latinxs. Studies that examined drinking norms, acculturative stress, acculturation gaps, and drinking behavior in Latinxs were included. The types of study approaches and designs included quantitative, qualitative, cross-sectional, cohort, and longitudinal studies published between January 2000 and December 2021. Quality assessment and data synthesis were conducted by two reviewers. A total of 65 articles reporting empirical studies were included in the final review. Eighteen studies did not utilize a specific framework, but generally supported that acculturation is associated with increased alcohol consumption and alcohol related consequences among Latinxs. Additionally, sixteen studies examined cultural norms, twenty-two examined acculturative stress, while only nine utilized a gap discrepancy framework. Studies examining drinking norms appeared to largely explain changes in drinking behavior among Latinas, while studies examining acculturative stress seemed to be better equipped to explain changes in drinking behavior among Latino men. Meanwhile, the Gap Discrepancy Model articulates the gap between old and new cultural influences and can be conceptualized as an additional dimension of acculturative stress.

Hispanic immigrants in the USA: social and mental health perspectives

Hispanic immigration in the USA and its effect on many areas of US society are of great relevance to health care, public health, mental health, and medical and social sciences. In this report, we review and discuss pertinent literature on causes, procedures, and eventual outcomes of Hispanic migration waves throughout the last four decades. Hispanic immigrants do not constitute a monolithic group, despite the clear predominance of Mexican and Mexican-American segments. Common features of Hispanic immigrants include a younger average age, higher presence of married households, and lower educational levels than the overall US population. Differences within the Hispanic immigrant population are present in naturalisation figures, English language fluency, occupational and income status, health insurance coverage, and sense of accomplishment in the host society. We examine most of these aspects in the context of the so-called Hispanic paradox, presented as both a cause and a result of a heavily discussed acculturative process. We investigate prevalence and other data on depression, anxiety, substance abuse, and psychotic syndromes, with emphasis on the need to do further neurobiological, epigenetic, and sociocultural research in the Hispanic population.

Factors Explaining Variation in Alcohol Use Disorder Prevalence Across Border and Nonborder Communities in Texas

BACKGROUND

U.S. border populations have been found to be at high risk for alcohol problems. However, results from the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC) revealed surprisingly large variation in alcohol outcomes even among Texas border sites, with alcohol use disorder (AUD) prevalence ~1.5 to 1.6 times greater in the border city of Laredo compared to both San Antonio and the border site of McAllen/Brownsville. Because a better understanding of this variation is important to identifying environmental influences on AUD, we developed and tested a conceptual model addressing variation in AUD prevalence across Texas UMSARC sites.

METHODS

Surveys involved in-person, household interviews with Mexican-origin residents of the Texas border cities Laredo (n = 751) and McAllen/Brownsville (n = 814), with San Antonio as an off-border comparison (n = 771). Interviews assessed past-year DSM-5 AUD; past-year heavy drinking; coping and enhancement motives; and 7 indicators of substance use climate and stress exposure hypothesized to mediate site effects. Analyses, conducted separately by gender, included regressions and structural equation modeling with Mplus.

RESULTS

Preliminary analyses revealed that site effects on AUD prevalence were, unexpectedly, exclusive to men, and that Laredan men were similar to McAllen/Brownsville men on demographics, acculturation, and cross-border mobility. However, sites differed dramatically on most of the hypothesized risk factors. Structural equation models confirmed that site effects on AUD were partially mediated via effects of site on indicators of a permissive climate (i.e., permissive drinking norms, high drug availability) and stress exposures (i.e., high exposure to violence/crime, low family support), and via downstream effects on drinking motives and heavy drinking.

CONCLUSIONS

Findings of very high rates of past-12-month AUD among Laredan men (35%) suggest the possibility of significant heterogeneity even within demographically similar border areas and underline the need for additional study of the border region. Findings regarding our conceptual model suggest that this model may constitute a useful initial framework for future research on alcohol problems at the border. However, additional research using representative samples is needed to confirm and expand this model to comprehensively address relevant individual and community factors.

Acculturation, hazardous drinking and depressive symptomatology among Hispanics enrolled in a clinical trial

BACKGROUND

Among Hispanics in the U.S., lower acculturation level has been found to be protective against alcohol abuse and depression. However, this relationship may not hold within at-risk samples. The prevalence and co-occurrence of hazardous drinking and depressive symptoms and their relationship to acculturation were examined among Hispanics enrolled in a study to reduce heavy drinking. At enrollment, all participants reported past-month heavy drinking (one or more occasions of >4/5 drinks for females/males, and average weekly consumption >7/14 drinks per week). We explored whether gender moderated the effects of acculturation on hazardous drinking and depressive symptoms.

METHODS

Participants (N = 100) completed measures at baseline.

RESULTS

Eighty-nine percent of participants met criteria for hazardous alcohol use as assessed by the AUDIT and of those, 55% (n=49) also reported elevated depressive symptoms. Of those who reported elevated depressive symptoms, nearly all (94%) met AUDIT criteria for hazardous drinking. Acculturation was not related to hazardous drinking or depressive symptoms in the full sample. Highly acculturated women reported more hazardous drinking than less acculturated women. Acculturation was not associated with hazardous drinking in men, but less acculturated men reported higher levels of depression than highly acculturated men.

DISCUSSION

Depression should be assessed in alcohol interventions for Hispanics. Alcohol interventions should be tailored for acculturation level and gender to improve relevance and efficacy. Clinical Trial Registration #NCT01996280.

Decomposing associations between acculturation and drinking in Mexican Americans

BACKGROUND

Acculturation to life in the United States is a known predictor of Hispanic drinking behavior. We compare the ability of 2 theoretical models of this effect-sociocultural theory and general stress theory-to account for associations between acculturation and drinking in a sample of Mexican Americans. Limitations of previous evaluations of these theoretical models are addressed using a broader range of hypothesized cognitive mediators and a more direct measure of acculturative stress. In addition, we explore nonlinearities as possible underpinnings of attenuated acculturation effects among men.

METHODS

Respondents (N = 2,595, current drinker N = 1,351) were interviewed as part of 2 recent multistage probability samples in a study of drinking behavior among Mexican Americans in the United States. The ability of norms, drinking motives, alcohol expectancies, and acculturation stress to account for relations between acculturation and drinking outcomes (volume and heavy drinking days) were assessed with a hierarchical linear regression strategy. Nonlinear trends were assessed by modeling quadratic effects of acculturation and acculturation stress on cognitive mediators and drinking outcomes.

RESULTS

Consistent with previous findings, acculturation effects on drinking outcomes were stronger for women than men. Among women, only drinking motives explained acculturation associations with volume or heavy drinking days. Among men, acculturation was linked to increases in norms, and norms were positive predictors of drinking outcomes. However, adjusted effects of acculturation were nonexistent or trending in a negative direction, which counteracted this indirect normative influence. Acculturation stress did not explain the positive associations between acculturation and drinking.

CONCLUSIONS

Stress and alcohol outcome expectancies play little role in the positive linear association between acculturation and drinking outcomes, but drinking motives appear to at least partially account for this effect. Consistent with recent reports, these results challenge stress models of linear acculturation effects on drinking outcomes and provide (partial) support for sociocultural models. Inconsistent mediation patterns-rather than nonlinearities-represented a more plausible statistical description of why acculturation-drinking associations are weakened among men.

Binge drinking among male Mexican immigrants in Rural North Carolina

While it is clear that alcohol use among immigrants from Mexico has serious consequences, limited data exist on the correlates of this behavior for Mexican immigrants residing in rural, traditionally non-Hispanic settings. A cross-sectional survey with an outreach approach was used to target 173 male Mexican immigrants in rural eastern North Carolina. Questionnaires including demographics, pre and post immigration alcohol use, acculturation, stress, social support, and depressive symptoms were administered through oral interview by trained bilingual interpreters. Results show a higher prevalence of binge drinking in the study sample compared to rate of alcohol use by Hispanics in the United States. Relationships were identified between Pre-immigration alcohol use, lower perceived social support, socialization within one's own cultural group, and binge drinking. These findings provide a preliminary basis in the development of interventions to address the problem of binge drinking in this population. Further exploration of the interaction between social isolation and social support is also needed.

Prescription drug misuse among Asian-American adults: results from a national survey

Asians have low levels of substance use compared with other groups in the United States. Given the increase in Asian population, we believe it is important to study substance use in this population. Data from the 2002-2003 National Latino and Asian American Study are examined to address two questions. First, which Asian ethnic subgroup is at greatest risk for prescription drug misuse? Second, is acculturation significantly correlated with prescription drug misuse among Asians? Findings indicate that Filipinos are at the greater risk for prescription drug misuse. Also, Asians who are more acculturated are at greater risk for prescription drug misuse.

Maternal predictors of behavioral problems among Mexican migrant farmworker children

This study investigated the impact of maternal parenting factors on the emotional and behavioral health of Mexican Migrant Head Start children. Although the majority of children sampled in this study did not exhibit problematic behaviors, the findings concluded that children who demonstrated emotional and behavioral problems experienced a more rejecting maternal parenting style, greater parenting stress, and mothers reporting feelings of depression. Gender differences were found between the behavioral and emotional problems of sons and daughters. Surprisingly, years in the United States, maternal birthplace, income, education, and language spoken in the home were not associated with child behavioral problems.

Acculturation among Latino Youth and the Risk for Substance Use: Issues of Definition and Measurement

The purpose of this paper is to provide an overview of the acculturation literature with a specific focus on exploring acculturation as a concept as well as examining its measurement and relationship to substance use/abuse among Latino adolescents in the United States over the past 20 years. A brief overview of the development of theoretical models and instruments assessing acculturation over the past two decades is provided. In addition, studies examining the relationship between acculturation and substance use/abuse among these adolescents are reviewed. Findings indicate that the development of acculturation theory and measurement has been hampered by the lack of both clear terminology and consistency. In the majority of studies reviewed, acculturation appeared to be a risk factor for Latino adolescent substance use/abuse. A small majority of these studies utilized language as a sole measure of acculturation. Language preference, in combination with other proxy measures of acculturation were found to be a robust predictor of substance use/abuse outcomes for Latino adolescents. The findings are discussed in the context of recommendations for future research on the measurement of acculturation as well as on implications for preventive interventions.

Substance abuse prevalence and treatment among Latinos and Latinas

Substance abuse prevalence rates for Latinos/as generally mirror those of the general U.S. population; however, a number of indicators of assimilation to U.S. culture as well as sociodemographic variables predict substance use and abuse among this group. Latinos/as have poorer outcomes in substance abuse treatment programs. Yet there is little empirical evidence that explains the problems these individuals experience in treatment, and there are few studies on the use and effectiveness of mutual help groups among this population. New developments in the conceptualization and measurement of acculturation will lead to a greater understanding of the role of culture in the prevalence and treatment of substance-related problems.

Prevalence of psychiatric disorders across Latino subgroups in the United States

OBJECTIVES

We examined the prevalence of depressive, anxiety, and substance use disorders among Latinos residing in the United States.

METHODS

We used data from the National Latino and Asian American Study, which included a nationally representative sample of Latinos. We calculated weighted prevalence rates of lifetime and past-year psychiatric disorders across different sociodemographic, ethnic, and immigration groups.

RESULTS

Lifetime psychiatric disorder prevalence estimates were 28.1% for men and 30.2% for women. Puerto Ricans had the highest overall prevalence rate among the Latino ethnic groups assessed. Increased rates of psychiatric disorders were observed among US-born, English-language-proficient, and third-generation Latinos.

CONCLUSIONS

Our results provide important information about potential correlates of psychiatric problems among Latinos that can inform clinical practice and guide program development. Stressors associated with cultural transmutation may exert particular pressure on Latino men. Continued attention to environmental influences, especially among third-generation Latinos, is an important area for substance abuse program development.

Building interdisciplinary/intersectoral research partnerships for community-based mental health research with older minority adults

Community-based research often brings investigators from different disciplinary backgrounds together with community representatives to conduct research on topics of mutual concern. This paper describes a case example that illustrates an interdisciplinary/intersectoral study of depression and barriers to mental health care among older adults and illustrate the factors central to implementing a successful research partnership. It will address the following conditions that facilitate and challenge interdisciplinary/intersectoral research: (1) achieving commonality of purpose in study design and research and referral approaches; (2) ensuring the ability to develop, field-test and implement psychometrically rigorous and culturally and qualitatively appropriate instruments; (3) building effective management structures for interdisciplinary/intersectoral research partnerships; and (4) identifying, training and supporting qualified researchers to carry out a mental health study with older ethnically diverse adults. The paper concludes with strengths and limitations of the approach.

Re-examining whether and why acculturation relates to drinking outcomes in a rigorous, national survey of Latinos

BACKGROUND

Fundamental limitations have hampered conclusions surrounding acculturation's effects among Latinos. This research re-examines associations between acculturation and alcohol use, addressing the most troubling of these limitations. The research also explores mediators of the association, and the dimensional structure of acculturation.

METHODS

Linear regressions and scale analyses were used to analyze data from Latino adults in the U.S. (825 women, 761 men) sampled in the 1995 National Alcohol Survey. Analyses used a standard, reliable acculturation scale and well-validated drinking measures; systematically accounted for demographic covariates; and analyzed men and women separately.

RESULTS

As expected, higher acculturation was positively associated with a higher probability of drinking (vs. abstinence) among women, and higher average volumes and more frequent drunkenness among female drinkers. Acculturation was unrelated to alcohol use among men. Also as expected, mediational analyses of average volume supported expectations that gender-specific drinking norms would mediate acculturation's effects (though norms did not explain acculturation's associations with either drinking status or frequency of drunkenness). Analyses investigating depressive symptoms showed no support for the acculturation-stress model. Factor analyses of the acculturation scale supported the hypothesized distinctions between linguistic acculturation, attitudinal acculturation, and the social environment of acculturation. Further, items implying more intimate exposure to Anglo culture (i.e., language use) were most strongly related to drinking outcomes among women, supporting the normative interpretation of acculturation's effects on drinking.

CONCLUSIONS

Results underline acculturation's influence on alcohol consumption among Latina women, and highlight the role of drinking norms in mediating this association. Results also suggest a multidimensional view of acculturation. The article recommends further research on drinking norms and other potential mediators of acculturation's effects among Latina women.