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Gawande R, Rosario FK, Santiago C, Thomas J, Naganuma-Carreras J, Blot T, Aviles K, Gardiner P, Schuman-Olivier Z. Mandela Yoga: a community case study for a post-incarceration reentry service for men of color in recovery. Front Public Health 2025; 13:1514946. [PMID: 40416658 PMCID: PMC12098574 DOI: 10.3389/fpubh.2025.1514946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Accepted: 04/15/2025] [Indexed: 05/27/2025] Open
Abstract
Background Disparities in substance use treatment access and outcomes between communities with racially, economically, linguistically, and mentally/physically marginalized identities and more privileged populations are staggering. Communities of color lack access to culturally resonant treatment options that incorporate the role of racial oppression, address the chronic effects of stress on the nervous system, provide culturally-and linguistically-matched community support in substance use recovery, and contend with social determinants of health. Mandela Yoga, a community-based peer-led mindfulness intervention, was created to address disparities in health and substance use treatment access among communities of color. Mandela Yoga was co-developed by Black and Brown yoga teachers, therapists, and community leaders with lived experienced of recovery, incarceration, chronic illness, and racism. A Mandela Yoga community reentry services implementation was funded by a Massachusetts Department of Public Health Bureau of Substance Abuse Services grant for overdose risk reduction for people recently released from incarceration. Objectives In this community case study, we present a qualitative analysis of a 12-week Mandela Yoga implementation as part of a Federally Qualified Health Center reentry program focused on post-incarceration opioid overdose risk reduction among men of color. Through a community-based participatory approach, we feature the voices and lived experiences of the peer facilitator and a reentry services participant, who are co-authors and shaped the qualitative analysis. Methods We documented attendance and conducted interviews with the Mandela Yoga peer facilitator and one participant. Together we conducted a thematic analysis of the interviews to explore key elements that most impacted recovery and healing. Results We report on the delivery and attendance of the implementation. We present excerpts illustrating four key themes that emerged from the interviews: (1) Breath and Mind-Body Connection Leads to Presence; (2) Consistency; (3) Peer Connection; (4) Agency and Positive Action. Discussion We explore how Mandela Yoga may build recovery capital and the mechanisms by which it may support healing from addiction and trauma in communities of color. We discuss study limitations and considerations for future implementations. Conclusion Mandela Yoga shows promise as a mind-body-community intervention for communities of color in recovery and post-incarceration.
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Affiliation(s)
- Richa Gawande
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | | | | | - Jeffrey Thomas
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
- Mandela Yoga Project, Cambridge, MA, United States
| | | | - Tori Blot
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | | | - Paula Gardiner
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | - Zev Schuman-Olivier
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
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D'Anna-Hernandez K, Deer LK, Aran Ö, Rivera KM, Nevarez-Brewster M, Doom JR, Hankin BL, Hoffman MC, Davis EP. Experiences of discrimination during pregnancy predict altered neonatal hair cortisol at birth. Psychoneuroendocrinology 2025; 178:107482. [PMID: 40398268 DOI: 10.1016/j.psyneuen.2025.107482] [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: 09/11/2024] [Revised: 05/03/2025] [Accepted: 05/05/2025] [Indexed: 05/23/2025]
Abstract
OBJECTIVE Prenatal glucocorticoids (e.g., cortisol) are a widely proposed prenatal programming mechanism, yet few studies directly measure fetal cortisol. Neonatal hair provides a non-invasive method to assess fetal cortisol. The current studies test the association between maternal exposure to discrimination and fetal cortisol, as measured in neonatal hair, in two cohorts. METHODS Study 1: Pregnant individuals (N = 65) and their neonates (61.8 % female) participated in study 1 between 2017 and 2021. Participants self-identified as Asian (6.2 %), Black (21.5 %), Latinx (35.4 %), Multiracial or Multiethnic (35.4 %), and Native Hawaiian or Pacific Islander (1.5 %). Experiences of discrimination were measured using the Everyday Discrimination Scale. Neonatal hair samples were collected close to birth (Mediandays=1.30, IQRdays=0.96-2.03). RESULTS Study 1: Higher experiences of everyday discrimination among pregnant individuals were associated with lower hair cortisol levels in neonates (r = -.28, p = .031). METHODS Study 2: Pregnant individuals of Mexican descent (N = 73) and their neonates (50.7 % female) participated in study 2 between 2017 and 2020. Participants reported on their exposure to experiences of discrimination using the Discrimination Stress Scale, and neonatal hair samples were collected shortly after birth (Mediandays=13.0, IQRdays=11-18). RESULTS Study 2: Those who had higher discrimination stress during pregnancy had neonates with higher cortisol than those with low discrimination (F(1,70)= 3.78, p = .03), but this relation did not remain significant after controlling for gestational age. CONCLUSION Across two cohorts, higher experiences of discrimination were associated with alterations in neonatal hair cortisol. Both higher and lower neonatal hair cortisol are linked to poorer neonatal development, indicating that experiences of discrimination might be a potential source of health disparities in the next generation.
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Affiliation(s)
| | - LillyBelle K Deer
- Psychology, University of Denver, Frontier Hall, 2155 S. Race St., Denver, CO 80208, United States
| | - Özlü Aran
- Psychology, University of Denver, Frontier Hall, 2155 S. Race St., Denver, CO 80208, United States; Department of Psychology, Northeastern University, 360 Huntington Ave. 129 ISEC, Boston, MA 02115, Massachusetts.
| | - Kenia M Rivera
- Psychology, University of Denver, Frontier Hall, 2155 S. Race St., Denver, CO 80208, United States
| | - Melissa Nevarez-Brewster
- Psychology, University of Denver, Frontier Hall, 2155 S. Race St., Denver, CO 80208, United States
| | - Jenalee R Doom
- Psychology, University of Denver, Frontier Hall, 2155 S. Race St., Denver, CO 80208, United States
| | - Benjamin L Hankin
- Psychology, University of Illinois Urbana-Champaign, 308 Psychology Bldg, MC-716, 603 East Daniel St., Champaign, IL 61820, United States
| | - M Camille Hoffman
- OB-GYN-Maternal Fetal Medicine, University of Colorado Anschutz Medical Campus, 1635 Aurora Ct, Anschutz Outpatient Pavilion, 3rd Fl, Aurora, CO 80045, United States
| | - Elysia Poggi Davis
- Psychology, University of Denver, Frontier Hall, 2155 S. Race St., Denver, CO 80208, United States; Pediatrics, University of California-Irvine, 3800 W. Chapman Ave, Suite 2200, Orange, CA 92868, United States
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Espinosa A, Gette JA. Lifetime Psychiatric Diagnoses Among NESARC-III Hispanic Participants: A Relative Importance Analysis of Sociodemographic and Social Determinants of Health. J Racial Ethn Health Disparities 2025:10.1007/s40615-025-02406-9. [PMID: 40167978 DOI: 10.1007/s40615-025-02406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 03/20/2025] [Accepted: 03/21/2025] [Indexed: 04/02/2025]
Abstract
Hispanic/Latin American people comprise a health disparity population, in part due to having higher rates of mental illness relative to White counterparts. Much of the extant literature on understanding Hispanic mental health has focused on single outcomes (e.g., substance use, depression) or single indicators (e.g., adverse childhood experiences). However, given the multifinality of mental health outcomes and their predictors, research is needed to understand how protective and risk factors relate to mental health more broadly (i.e., internalizing and externalizing symptomology). Using a sample of Hispanic adults (N = 7037) who participated in the National Epidemiologic Survey on Alcohol and Related Conditions-III, we used structural equation modeling to estimate a correlated common factors model with latent variables for lifetime externalizing and internalizing disorders. Using the discrimination stress, coping, and mental health framework as guide, we examined the associations between latent factor scores, sociodemographic characteristics, and social determinants of health (SDOH). The SDOH included adverse childhood experiences (ACEs), nativity status, ethnic discrimination, ethnic identity, and religiosity/spirituality. Finally, we employed relative importance analyses to assess the comparative importance of significant correlates of psychopathology. ACE was the strongest correlate of both internalizing and externalizing psychopathology, underscoring the importance of prevention and ACEs screening to mitigate adverse mental health outcomes. Discrimination and being US born were the next strongest correlates of having internalizing and externalizing psychopathology. Ethnic identity emerged as the strongest negative correlate of both psychopathology factors. The findings are important for improving Hispanic mental health and informing healthcare policy.
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Affiliation(s)
- Adriana Espinosa
- Department of Psychology, The City College of New York and The Graduate Center, CUNY, New York, USA.
| | - Jordan A Gette
- Center of Alcohol & Substance Use Studies & Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ, USA
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Chiang SC, Rahal D, Bai S, Linden-Carmichael AN. Age-varying association between discrimination, childhood family support, and substance use disorders among Latin American immigrants in the United States. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024; 30:917-926. [PMID: 38780598 PMCID: PMC11872141 DOI: 10.1037/cdp0000677] [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] [Indexed: 05/25/2024]
Abstract
OBJECTIVES The cultural stress theory posits that immigrants experience a constellation of cultural stressors such as discrimination that could exacerbate alcohol- and other substance-related problems. Drawing on cultural stress theory, this study investigated the age-varying association between past-year discrimination and substance use disorders (SUDs) among Latin American immigrants aged 18-60 and whether childhood family support moderated the above association. METHOD We used data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) among adults aged 18-60 who identified as a Latin American immigrant (N = 3,049; 48% female). RESULTS Time-varying effect models (TVEMs) revealed that experiencing past-year discrimination was associated with greater odds of having a SUD during young and middle adulthood for Latin American immigrants. Furthermore, for immigrants with lower childhood family support, discrimination was associated with SUD risk in young and middle adulthood. CONCLUSION The present study documents that past-year discrimination was linked to greater SUD risk during young and middle adulthood. Childhood family support may serve as a protective factor in the association between discrimination and risk for SUD among Latin American immigrants. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Shou-Chun Chiang
- Department of Human Development and Family Studies, The Pennsylvania State University
| | - Danny Rahal
- Department of Psychology, University of California, Santa Cruz
| | - Sunhye Bai
- The Ballmer Institute for Children’s Behavioral Health, University of Oregon
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Cruz-Vespa I, Dembling SJ, Han BH, Inagaki TK. Associations between vicarious racism and psychoactive substance use depend on strength of ethnic identity. Sci Rep 2024; 14:17217. [PMID: 39060300 PMCID: PMC11282253 DOI: 10.1038/s41598-024-67202-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Racism is a pervasive threat to health with differential impact based on race and ethnicity. Considering the continued perpetration and visibility of racism online and in the news, vicarious racism, or "secondhand" racism when hearing about or witnessing racism being committed against members of one's ethnic or racial group, is a particularly urgent threat in the context of such disparities and their subsequent health consequences. The current study examines if frequency of exposure to vicarious racism and the emotional impact of those experiences are linked to psychoactive substance use, and explores the role of ethnic identity in moderating these relationships. In a cross-sectional survey, 504 adult participants aged 18-78 (M age = 30.15, SD = 11.52, 52.6% female) identifying as Black/African American or Latine reported on their experiences with vicarious racism and alcohol, marijuana, and tobacco use over the past 30 days. Logistic regression was utilized to test hypotheses. Primary findings indicate that greater emotional impact of vicarious racism was associated with a 50% increase in odds of alcohol consumption and that ethnic identity moderated the association between vicarious racism and marijuana use. Greater emotional impact of vicarious racism was related to more marijuana use for those lower on ethnic identity, whereas there was no association for those higher on ethnic identity. Vicarious racism was not related to tobacco use. Results suggest that ethnic identity might be protective in the association of vicarious racism on substance use. Further research on this topic is needed as vicarious racism becomes an increasingly common experience among marginalized populations.
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Affiliation(s)
| | - Sarah J Dembling
- Department of Psychology, San Diego State University, San Diego, USA
- SDSU-UC San Diego Joint Doctoral Program, San Diego, USA
| | | | - Tristen K Inagaki
- Department of Psychology, San Diego State University, San Diego, USA
- SDSU-UC San Diego Joint Doctoral Program, San Diego, USA
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Kcomt L, Boyd CJ, Evans-Polce RJ, Veliz P, Engstrom C, West BT, McCabe SE. Ethnic Discrimination, Sexual Orientation Discrimination, and DSM-5 Alcohol Use Disorder Among U.S. Latino or Hispanic Adults. JOURNAL OF HOMOSEXUALITY 2024; 71:1970-1990. [PMID: 37272895 PMCID: PMC10696128 DOI: 10.1080/00918369.2023.2217516] [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] [Indexed: 06/06/2023]
Abstract
We aimed to assess the probability of past-year DSM-5 alcohol use disorder (AUD) and past-year moderate-to-severe DSM-5 AUD as a function of past-year ethnic discrimination among U.S. Latino/Hispanic adults and as a function of past-year discrimination types among Latino/Hispanic sexual minorities (SM). We used data from the 2012-2013 National Epidemiological Survey on Alcohol and Related Conditions-III (n = 36,309 U.S. adults aged ≥18 years). Our sample consisted of 6,954 Latino/Hispanic adults. Multivariable logistic regression analyses estimated the association of past-year ethnic discrimination with past-year AUD and past-year moderate-to-severe AUD among the overall Latino/Hispanic population. We tested the association between discrimination types (i.e. none, ethnic or sexual orientation discrimination, both) with AUD and moderate-to-severe AUD among Latino/Hispanic SM adults. Among Latino/Hispanic adults, 13.4% met criteria for past-year AUD and 6.4% met criteria for past-year moderate-to-severe AUD. Ethnic discrimination was significantly associated with AUD (AOR = 1.09, 95% CI = 1.07-1.12) and moderate-to-severe AUD (AOR = 1.10, 95% CI = 1.06-1.13). Latino/Hispanic SMs who experienced both ethnic and sexual orientation discrimination were more likely to meet criteria for AUD (AOR = 3.44, 95% CI = 1.97-6.03) and moderate-to-severe AUD (AOR = 2.69, 95% CI = 1.25-5.82) compared to those who did not experience discrimination. Discrimination is a risk factor for AUD and moderate-to-severe AUD among Latino/Hispanic overall and SM populations.
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Affiliation(s)
- Luisa Kcomt
- School of Social Work, Wayne State University, Detroit, MI
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Carol J. Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI
- Addiction Center, Department of Psychiatry, Rachel Upjohn Building, University of Michigan, Ann Arbor, MI
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Phil Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Curtiss Engstrom
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Brady T. West
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
- Institute for Social Research, University of Michigan, Ann Arbor, MI
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI
- Institute for Social Research, University of Michigan, Ann Arbor, MI
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI
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Tam CC, Gilder DA, Li L, Karriker-Jaffe KJ, Duhart Clarke SE, Ehlers CL. Age of onset and alcohol and cannabis use disorders among Mexican American young adults: Robust substance-specific effects of early use as a risk factor. J Ethn Subst Abuse 2024; 23:450-470. [PMID: 36093789 PMCID: PMC9998803 DOI: 10.1080/15332640.2022.2111388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
We investigated the substance-specific and cross-substance risk associated with early onset (before age 15) of drunkenness and cannabis use in the subsequent development of alcohol (AUD) and cannabis use disorder (CUD) in Mexican American young adults. Survival analyses employed Cox proportional hazards models for AUD and CUD, separately. In cross-risk analyses, we modeled estimates for those participants reporting lifetime use of both substances. Early onset of drunkenness and early onset of cannabis use were associated with shorter time to AUD and CUD, respectively, even after accounting for psychiatric disorders. While there were no cross-risk associations, adjusting for psychiatric disorders and early onset cannabis use attenuated the association of early drunkenness with AUD.
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Affiliation(s)
- Christina C Tam
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | | | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - Katherine J Karriker-Jaffe
- Center for Behavioral Health Epidemiology, Implementation, and Evaluation Research, RTI International, Berkeley, California
| | - Sarah E Duhart Clarke
- Center for Behavioral Health Epidemiology, Implementation, and Evaluation Research, RTI International, Berkeley, California
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Lee B, Jeong S, Veloria C, Dlugolenski E, Falcon L. Explaining Substance Use among Puerto Rican Older Adults: Impact of Perceived Discrimination, Perceived Stress, and Social Activities. Subst Use Misuse 2024; 59:1595-1603. [PMID: 38898584 DOI: 10.1080/10826084.2024.2367988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Background: Despite Puerto Ricans having one of the highest rates of substance use among Hispanic groups in the United States, limited research has focused on the impact of perceived discrimination and stress on substance use among older adults. Individuals who experience stressful events are inclined to engage in harmful behaviors as a coping mechanism. Objectives: Based on the propositions of the General Strain Theory, the current study explores the relationship between perceived discrimination, perceived stress, social activities, and the use of alcohol and cigarettes. Methods: Baseline data from the Boston Puerto Rican Health Study collected in 2014 was used to conduct a logistic regression analysis. Results: The findings reveal that while perceived discrimination is significantly linked to both types of substance use, social activities may serve as a protective factor for cigarette use. Conclusion/Importance: Our study findings emphasize the need to examine perceived discrimination as a stressor impacting the health and well-being of Puerto Ricans in later adulthood. Policy implications for reducing substance use and directions for future research are discussed.
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Affiliation(s)
- Byung Lee
- Central Connecticut State University, New Britain, Connecticut, USA
| | - Seokjin Jeong
- University of Texas at Arlington, Arlington, Texas, USA
| | - Carmen Veloria
- Central Connecticut State University, New Britain, Connecticut, USA
| | - Eric Dlugolenski
- Central Connecticut State University, New Britain, Connecticut, USA
| | - Luis Falcon
- University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Jacobs W, Qin W, Riley TN, Parker ES, Owora AH, Leventhal A. Race/ethnic differences in the association of anxiety, depression, and discrimination with subsequent nicotine and cannabis use among young adults: A prospective longitudinal study. Addict Behav 2024; 153:107979. [PMID: 38394958 PMCID: PMC11152197 DOI: 10.1016/j.addbeh.2024.107979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/15/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION The shifting patterns in nicotine and cannabis use among young adults is taking place at a time when there is also increased reports of psychosocial stressors such as anxiety, depression, and everyday discrimination. Although race/ethnicity has been found to moderate the impact of psychosocial stressors, there is limited research examining the association of anxiety, depression, and discrimination with patterns of nicotine and/or cannabis product use among diverse young adults. METHODS Data were from a longitudinal study of 2478 US young adults surveyed between 2019 and 2021. General estimating equation models were used to examine associations of self-reported psychological symptoms (depression, anxiety) and social stressors (discrimination) with substance use (any nicotine and cannabis product use; nicotine and cannabis vaping). RESULTS Young adults from different racial/ethnic groups differed significantly in their depression and discrimination scores with young adults of color having higher mean scores. Overall, higher depression and everyday discrimination score was associated with increased odds of past 6-month use of any nicotine/tobacco and cannabis products. Higher generalized anxiety score increased odds of any nicotine/tobacco and dual nicotine and cannabis product use. Higher everyday discrimination score was associated with increased odds nicotine and cannabis vaping overall. Stratified models showed variation in associations among different racial/ethnic groups. CONCLUSIONS Psychosocial stressors are associated with increased substance use odds among young adults. However, these stressors have a differential impact on substance use odds among young adults from different racial/ethnic contexts.
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Affiliation(s)
- Wura Jacobs
- Department of Applied Health Science, School of Public Health, Indiana University, United States.
| | - Weisiyu Qin
- Department of Applied Health Science, School of Public Health, Indiana University, United States.
| | - Tennisha N Riley
- Department of Counseling and Educational Psychology, Indiana University, United States.
| | - Erik S Parker
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, United States.
| | - Arthur H Owora
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, United States.
| | - Adam Leventhal
- Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
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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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Silva MA, Añez LM, Carroll KM, Jaramillo Y, Kiluk BD, Frankforter T, Ball SA, Gordon MA, Paris M. Computer-based training for cognitive behavioral therapy for Spanish-speaking substance users: adaptation and satisfaction. J Ethn Subst Abuse 2024; 23:251-271. [PMID: 35714996 PMCID: PMC10350903 DOI: 10.1080/15332640.2022.2086194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There are few available culturally and linguistically adapted behavioral health interventions for substance use among Spanish-speaking adults. The authors describe the cultural adaptation of an innovative computer-based training for cognitive behavioral therapy program (CBT4CBT). Based in cognitive-behavioral skills training, CBT4CBT utilizes a telenovela to teach monolingual Spanish-speaking adults who have migrated to the United States to recognize triggers; avoid these situations; and cope more effectively with the consequences of substance use. Participants endorsed high levels of satisfaction with the program content and found the material to be easy to understand and relevant to their life experiences.
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Affiliation(s)
- Michelle A Silva
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Luis M Añez
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Kathleen M Carroll
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Yudilyn Jaramillo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Brian D Kiluk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Tami Frankforter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Samuel A Ball
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Melissa A Gordon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Manuel Paris
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
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Takada S, Seamans MJ, Javanbakht M, Bone C, Ijadi-Maghsoodi R, Shoptaw S, Gelberg L. Nativity and the risk of opioid use disorder among Hispanic/Latinx women in primary care in Los Angeles, CA. J Ethn Subst Abuse 2024:1-15. [PMID: 38327151 PMCID: PMC11303597 DOI: 10.1080/15332640.2023.2297392] [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: 02/09/2024]
Abstract
BACKGROUND While rates of opioid use disorder (OUD) are lower among women compared to men, nativity may have disproportionate impacts on OUD risk among Hispanic/Latinx women but remain understudied. OBJECTIVE To assess the association between country of birth and reported OUD risk among low-income Hispanic/Latinx women in primary care in Los Angeles, CA. METHODS This was a cross-sectional study of 1189 non-pregnant, Hispanic/Latinx women attending two federally qualified health centers in Los Angeles between March and July 2013. OUD risk was assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and moderate-to-high risk was defined as ASSIST score ≥ 4. RESULTS Overall, 4.2% of women (n = 49) were at moderate-to-high risk for OUD. Risk for OUD was higher among US-born women compared to foreign-born women (6.7 vs. 1.7%; p < .01), those who reported 2+ chronic medical conditions (p < .01), and those who were at moderate-to-high risk for other substance use disorders (p < .01). In multivariable logistic regression analyses, being U.S.-born was independently associated with being at moderate-to-high risk for OUD among Hispanic/Latinx women as compared to those who were foreign-born (AOR = 2.8; 95% CI 1.2-6.8). CONCLUSION Among low-income Hispanic/Latinx women presenting to primary care, one in twenty patients is at-risk for OUD. The odds of moderate-high risk of OUD were three times as high in US-born compared to foreign-born women, and higher among those with chronic medical conditions and those at risk of other substance use disorders. Gender-specific and culturally-tailored screening for OUD may inform overdose prevention interventions for US-born Hispanic/Latinx women.
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Affiliation(s)
- Sae Takada
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Marissa J Seamans
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Curtis Bone
- Department of Family and Community Medicine, Penn State Milton Hershey Medical Center, Hershey, Pennsylvania
| | - Roya Ijadi-Maghsoodi
- Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Lillian Gelberg
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
- Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, California
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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: 0.5] [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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Essien-Aleksi IE, Zhang Y, Koren A, Palacios N, Falcon LM, Tucker KL. Sociocultural factors associated with persistent prescription opioid use (PPOU) among Puerto Rican adults in Massachusetts. PLoS One 2023; 18:e0290104. [PMID: 37607191 PMCID: PMC10443880 DOI: 10.1371/journal.pone.0290104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/01/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Increasing numbers of opioid-overdose deaths have been witnessed among Hispanics and other underserved populations in Massachusetts. Puerto Rican adults (PRs) have a disproportionately higher prevalence of chronic diseases than non-Hispanic White adults-conditions linked to increased prescription opioid use and misuse. Stress indicators, including low acculturation, low social support, and perceived discrimination, have been recognized as correlates of chronic diseases. However, little research has been undertaken on how these socio-cultural factors relate to persistent prescription opioid use among PRs. This study evaluated the prevalence of prescription opioid use and socio-cultural factors associated with persistent prescription opioid use among PRs. METHODS Data from the prospective population-based Boston Puerto Rican Health Study, at baseline, ~2-year, and ~ 6-year follow-up, were used to estimate prescription opioid use prevalence and its associations with acculturation, social support, and perceived discrimination. Analyses were conducted using multivariable binary logistic regression modeling. RESULTS The study sample was comprised of 798 PRs (age 56.5 ± 7.5y) with data at all three-time points. A high prevalence of prescription opioid use was observed and was associated with lower household income. PRs with experiences of perceived discrimination had higher odds of persistent prescription opioid use (y/n; OR = 2.85, 95% CI: 1.46-5.58). No significant associations were found between acculturation, social support, and persistent prescription opioid use. CONCLUSION Our study reported a high prevalence of prescription opioid use in PRs, with persistent prescription opioid use significantly associated with perceived discrimination. Future programs to limit discrimination practices may reduce persistent prescription opioid use and opioid-related complications among PRs.
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Affiliation(s)
- Inyene E. Essien-Aleksi
- School of Nursing and Health Sciences, Merrimack College, North Andover, Massachusetts, United States of America
| | - Yuan Zhang
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America
| | - Ainat Koren
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America
| | - Natalia Palacios
- Department of Public Health, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America
| | - Luis M. Falcon
- College of Fine Arts, Humanities & Social Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America
| | - Katherine L. Tucker
- Department of Biomedical & Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America
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15
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Majeno A, Molina KM, Frisard CF, Lemon SC, Rosal MC. Discrimination and Sleep: Differential Effects by Type and Coping Strategy. Ann Behav Med 2023; 57:442-452. [PMID: 36534964 PMCID: PMC10205141 DOI: 10.1093/abm/kaac071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Discrimination has been posited as a contributor of sleep disparities for Latinxs. The strategy used to cope with discrimination may reduce or exacerbate its effects on sleep. This study examined whether different types of discrimination (everyday and major lifetime discrimination) were associated with sleep indices (quality, disturbances, efficiency) and whether coping strategy used moderated associations. METHOD Data of Latinx adults (N = 602; 51% women, 65% Dominican, Mage = 46.72 years) come from the Latino Health and Well-being Project, a community-based, cross-sectional study of Latinxs in Lawrence, MA. Multiple linear regressions were estimated separately for each sleep outcome. RESULTS Everyday discrimination was significantly associated with poorer sleep quality and greater disturbances; major lifetime discrimination was significantly associated with worse sleep across the three sleep indices. Coping strategy moderated associations between discrimination and sleep. Compared with Latinxs who used passive coping, those who used passive-active coping strategies had poorer sleep quality the more they experienced everyday discrimination. Latinxs who used any active coping strategy, compared with passive coping, had greater sleep disturbances the more frequently they experienced major lifetime discrimination. CONCLUSIONS Findings show that everyday discrimination and major lifetime discrimination are associated with different dimensions of sleep and suggest that coping with discrimination may require the use of different strategies depending on the type of discrimination experienced.
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Affiliation(s)
- Angelina Majeno
- Department of Psychological Science, University of California–Irvine, Irvine, CA, USA
| | - Kristine M Molina
- Department of Psychological Science, University of California–Irvine, Irvine, CA, USA
| | - Christine F Frisard
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Stephenie C Lemon
- Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Milagros C Rosal
- Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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Ricci F, Torales J, Bener A, Castaldelli-Maia JM, Chumakov E, Bellomo A, Ventriglio A. Mental health of ethnic minorities: the role of racism. Int Rev Psychiatry 2023; 35:258-267. [PMID: 37267026 DOI: 10.1080/09540261.2023.2189951] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 06/03/2023]
Abstract
Racism and racial discrimination heavily impact on health and mental health of ethnic minorities. In this conceptual paper and narrative review, we aim to report on relevant evidence from the international literature describing the prevalence and the qualitative aspects of mental illness due to racism and ethnic- discrimination in different settings and populations. Some variables related to racism, such as cultural, institutional, interpersonal factors, as well as the concepts of perceived and internalised racism will be described and discussed. These are relevant characteristics in the explanatory model of the relationship between racism and mental health. Epidemiological data on the prevalence of depressive and psychotic symptoms as well as substance abuse/misuse among ethnic minorities in large catchment areas, such as United States and United Kingdom, will be represented. We conclude that anti-racism policies are essential in order to address racism and racial discrimination around the world. Pluralistic societies should be promoted in order to understand mental illnesses among ethnic and cultural minorities. Also, anti-racism programs should be delivered in the educational and health-care settings and their impact evaluated.
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Affiliation(s)
- Fabiana Ricci
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción, Paraguay
| | - Abdulbari Bener
- Department of Biostatistics and Public Health, Schools of Medicine, Dentistry and Pharmacy, Istanbul Medipol University, İstanbul, Turkey
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
| | - Egor Chumakov
- Department of Psychiatry and Addiction, St. Petersburg State University, St. Petersburg, Russia
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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17
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Zvolensky MJ, Shepherd JM, Clausen BK, Garey L, Redmond BY, Asfar T. Perceived racial/ethnic discrimination in relation to smoking abstinence expectancies among adult Latinx smokers in the United States. Addict Behav 2023; 140:107627. [PMID: 36701904 DOI: 10.1016/j.addbeh.2023.107627] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Hispanic/Latinx (hereafter Latinx) individuals in the United States (US) face unique smoking-related health disparities, including limited access to care and health insurance for smoking treatment. Social determinants of health (SDoH) have received increased recognition in their role of smoking behavior and cessation. However, research on SDoH in Latinx smoking populations has been limited. Past research on non-Latinx white individuals has found smoking abstinence expectancies to be an integral cognitive process related to multiple aspects of smoking behavior, and its role has also been understudied in Latinx individuals. Perceived racial/ethnic discrimination is one SDoH, but its role in relation to abstinence expectancies among Latinx smokers has not been explored. Therefore, the present investigation sought to evaluate perceived racial/ethnic discrimination in terms of smoking abstinence expectancies among Latinx smokers living in the US. METHODS Participants included 338 English-speaking Latinx adult daily cigarette smokers (Mage = 35.5 years; SD = 8.65; age range 18-61; 37.3 % female) recruited nationally throughout the US using Qualtrics Panels. RESULTS Results supported statistically significant main effects for perceived racial/ethnic discrimination in relation to increased smoking abstinence expectancies of negative mood, somatic symptoms, harmful consequences, and positive consequences (p's < 0.001). DISCUSSION Overall, the results of the present investigation build from a limited body of work on perceived racial/ethnic discrimination and smoking and provide novel evidence of consistent and moderate incremental associations between perceived racial/ethnic discrimination and negative and positive smoking abstinence expectancies among Latinx smokers.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, United States; HEALTH Institute, University of Houston, United States.
| | | | - Bryce K Clausen
- Department of Psychology, University of Houston, United States
| | - Lorra Garey
- Department of Psychology, University of Houston, United States
| | | | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, and Sylvester Comprehensive Cancer Center, United States
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18
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Yan Y, Yoshihama M, Hong JS, Jia F. Substance Use Among Asian American Adults in 2016-2020: A Difference-in-Difference Analysis of a National Survey on Drug Use and Health Data. Am J Public Health 2023; 113:671-679. [PMID: 36996372 DOI: 10.2105/ajph.2023.307256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Objectives. To compare substance use among Asian American adults in 2020, when anti-Asian violence increased, with substance use among the same group during the previous 4 years and compare this with that of non-Hispanic Whites. Methods. Using data from the National Survey on Drug Use and Health, 2016 to 2020, we investigated changes in substance use among Asian Americans compared with non-Hispanic Whites before and during the COVID-19 pandemic. We performed difference-in-difference analyses to estimate adjusted changes in past-month substance use in the 2 groups. Results. The incidence rate ratio (IRR) among Asian Americans' past-month alcohol use, cocaine use, and tranquilizer misuse in 2020 versus in 2016 to 2019 was 1.3 times, 3.0 times, and 17.2 times, respectively, the same IRR among Whites. Conclusions. The significant increase in misuse of several substances among Asian Americans relative to Whites in 2020 calls for careful assessment, identification, and treatment of this understudied population group. Public Health Implications. Besides increasing Asian substance users' access to socioculturally responsive treatment programs, policy and resources should be focused on multilevel violence prevention efforts such as antiracial discrimination public education programs. (Am J Public Health. Published online ahead of print March 30, 2023:e1-e9. https://doi.org/10.2105/AJPH.2023.307256).
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Affiliation(s)
- Yueqi Yan
- Yueqi Yan is with the Health Science Research Institute, University of California, Merced. Mieko Yoshihama is with the School of Social Work, University of Michigan, Ann Arbor. Jun Sung Hong is with the School of Social Work, Wayne State University, Detroit, MI, and the Department of Social Welfare, Ewha Womans University, Seoul, South Korea. Fan Jia is with the Department of Psychological Sciences, University of California, Merced
| | - Mieko Yoshihama
- Yueqi Yan is with the Health Science Research Institute, University of California, Merced. Mieko Yoshihama is with the School of Social Work, University of Michigan, Ann Arbor. Jun Sung Hong is with the School of Social Work, Wayne State University, Detroit, MI, and the Department of Social Welfare, Ewha Womans University, Seoul, South Korea. Fan Jia is with the Department of Psychological Sciences, University of California, Merced
| | - Jun Sung Hong
- Yueqi Yan is with the Health Science Research Institute, University of California, Merced. Mieko Yoshihama is with the School of Social Work, University of Michigan, Ann Arbor. Jun Sung Hong is with the School of Social Work, Wayne State University, Detroit, MI, and the Department of Social Welfare, Ewha Womans University, Seoul, South Korea. Fan Jia is with the Department of Psychological Sciences, University of California, Merced
| | - Fan Jia
- Yueqi Yan is with the Health Science Research Institute, University of California, Merced. Mieko Yoshihama is with the School of Social Work, University of Michigan, Ann Arbor. Jun Sung Hong is with the School of Social Work, Wayne State University, Detroit, MI, and the Department of Social Welfare, Ewha Womans University, Seoul, South Korea. Fan Jia is with the Department of Psychological Sciences, University of California, Merced
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Pahl K, Williams SZ, Capasso A, Lewis CF, Lekas HM. A longitudinal pathway from ethnic-racial discrimination to sexual risk behaviors among Black women and Latinas: Ethnic-racial identity exploration as a protective factor. Soc Sci Med 2023; 316:115061. [PMID: 35637046 PMCID: PMC11479667 DOI: 10.1016/j.socscimed.2022.115061] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Black women and Latinas in their thirties continue to be at risk for HIV transmission via heterosexual intercourse. METHODS Informed by the Theory of Gender and Power, this study investigated a longitudinal path model linking experiences of ethnic-racial discrimination in late adolescence to sexual risk behaviors in adulthood among 492 Black women and Latinas. We also tested whether ethnic-racial identity exploration served as a resilience asset protecting women against the psychological impact of ethnic-racial discrimination. Survey data from female participants in the Harlem Longitudinal Development Study, which has followed a cohort of New York City Black and Latinx youth since 1990, were analyzed. Data for this analysis were collected at four time points when participants were on average 19, 24, 29, and 32 years of age. Structural equation modeling was used to examine a hypothesized pathway from earlier ethnic-racial discrimination to later sexual risk behaviors and the protective role of ethnic-racial identity exploration. RESULTS Results confirmed that ethnic-racial discrimination in late adolescence was linked with sexual risk behaviors in the early thirties via increased levels of affective distress in emerging adulthood, experiences of victimization in young adulthood, and substance use in the early thirties among women low in ethnic-racial identity exploration. We also found that ethnic-racial identity served as a resilience asset, as the association between discrimination in late adolescence and affective distress in emerging adulthood was not significant among women with higher levels of ethnic-racial identity exploration. CONCLUSIONS The results provide important preliminary evidence that ethnic-racial identity exploration may serve as a resilience asset among Black women and Latinas confronting racial discrimination. Further, we suggest that ethnic-racial identity exploration may constitute an important facet of critical consciousness.
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Affiliation(s)
- Kerstin Pahl
- Department of Psychiatry, New York University Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY, 10016, USA; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Sharifa Z Williams
- Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
| | - Ariadna Capasso
- NYU School of Global Public Health, New York University, 708 Broadway, New York, NY, 10003, USA
| | - Crystal Fuller Lewis
- Department of Psychiatry, New York University Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY, 10016, USA; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
| | - Helen Maria Lekas
- Department of Psychiatry, New York University Grossman School of Medicine, One Park Avenue, 8th Floor, New York, NY, 10016, USA; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
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20
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Wen W, Chen S, Hazen-Swann N, Lorenzo-Blanco EI, Shen Y, Kim SY. Cultural stressors, internalizing symptoms, and parent-child alienation among Mexican-origin adolescents. FAMILY RELATIONS 2022; 71:1977-1992. [PMID: 38170013 PMCID: PMC10760991 DOI: 10.1111/fare.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 04/16/2022] [Indexed: 01/05/2024]
Abstract
Objective The current study investigated the relation of various cultural stressors, parent-child alienation, and Mexican-origin adolescents' internalizing symptoms at both between- and within-person levels across the course of adolescence. Background Positive parent-child relationships can be a critical buffer against cultural stressors for Mexican-origin adolescents. However, it is unclear whether low levels of parent-child alienation (a) buffer the negative effects of different types of cultural stressors on internalizing symptoms and (b) function at the individual level more generally or during specific periods when adolescents experience high cultural stressors. Method The current study used a three-wave longitudinal dataset of 604 Mexican-origin adolescents (Wave 1: Mage = 12.41, SD = 0.97, 54% female, 75% born in the United States) and conducted multilevel regression analysis. Results At the between-person level, overall low parent-child alienation buffered the adverse effects of ethnic discrimination on anxiety and cultural misfit on depressive symptoms. There were no significant within-person-level interactions of parent-child alienation and cultural stressors on adolescent internalizing symptoms. Implication The findings suggest that interventions should aim to reduce parent-child alienation throughout the course of adolescence to alleviate the impact of cultural stressors on internalizing symptoms among Mexican-origin adolescents.
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Affiliation(s)
- Wen Wen
- Human Development and Family Sciences, The University of Texas at Austin, Austin, TX
| | - Shanting Chen
- School of Education and Social Policy, Northwestern University, Evanston, IL
| | - Nancy Hazen-Swann
- Human Development and Family Sciences, The University of Texas at Austin, Austin, TX
| | | | - Yishan Shen
- School of Family and Consumer Sciences, Texas State University, San Marcos, TX
| | - Su Yeong Kim
- Human Development and Family Sciences, The University of Texas at Austin, Austin, TX
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21
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Guevara AMM, White RMB, Johnson SL, Nair RL, Roche KM. School racial-ethnic discrimination, rule-breaking behaviors and the mediating role of trauma among Latinx adolescents: Considerations for school mental health practice. PSYCHOLOGY IN THE SCHOOLS 2022; 59:2005-2021. [PMID: 38188531 PMCID: PMC10768846 DOI: 10.1002/pits.22562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 04/15/2021] [Indexed: 01/09/2024]
Abstract
Much of the literature linking adversity to trauma fails to account for racialized experiences, including racial-ethnic discrimination, which is a highly prevalent form of adversity for youth of color in the U.S. Adversity and trauma often result in students experiencing elevated rule-breaking behaviors, exacerbating existing racial-ethnic disparities in disproportionate school discipline. Drawing from race-based trauma theory, the present study explored trauma as a mediator of the longitudinal association between racial-ethnic discrimination from teachers, other adults, and students in schools and rule-breaking behaviors among Latinx youth. Data were from a longitudinal study of 547 Latinx students in a southeastern U.S. state. Across gender and nativity groups, school racial-ethnic discrimination and trauma positively predicted later rule-breaking behaviors. Additionally, for girls only, increased levels of trauma partially explained the association between school racial-ethnic discrimination and rule-breaking behaviors. The study highlights the importance of addressing school racial-ethnic discrimination and trauma in equitable school metal health systems. Indeed, efforts aimed at reducing disproportionate school discipline among Latinx students should focus on reducing their exposure to school racial-ethnic discrimination and increasing access to trauma-informed and restorative justice approaches.
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Affiliation(s)
- Ana Maria Meléndez Guevara
- T. Denny Sanford School of Social and Family Dynamics, Family and Human Development, Arizona State University, Tempe, Arizona, USA
| | - Rebecca M B White
- T. Denny Sanford School of Social and Family Dynamics, Family and Human Development, Arizona State University, Tempe, Arizona, USA
| | - Sarah Lindstrom Johnson
- T. Denny Sanford School of Social and Family Dynamics, Family and Human Development, Arizona State University, Tempe, Arizona, USA
| | - Rajni L Nair
- College of Integrative Science and Arts, Science, Mathematics and Social Sciences, Arizona State University, Tempe, Arizona, USA
| | - Kathleen M Roche
- Milken Institute School of Public Health, Prevention and Community Health, The George Washington University, Washington, USA
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22
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Ertl MM, Martin JL, Dillon FR, Sheu HB. Associations Between Ethnic Identity Commitment, Discrimination, and Sexism With Sexual Risk Among Latina College Students. JOURNAL OF LATINX PSYCHOLOGY 2022; 10:207-224. [PMID: 36189328 PMCID: PMC9524159 DOI: 10.1037/lat0000206] [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: 08/03/2023]
Abstract
According to intersectionality theory, oppression predisposes individuals from disadvantaged groups to experience disparities in health. Such disparities are evident in the sexual health among college-aged Latina women living in the U.S., who tend to report significantly higher rates of sexually transmitted infections and unintended pregnancies than their White peers. Guided by intersectionality theory, the present study examined sexual risk behaviors (i.e., inconsistent condom use, number of sexual partners) in relation to ethnic identity development and reported experiences of discrimination and sexism among 450 Latina college students (ages 18-26 years old). Notably, results indicated that Latinas who reported relatively lower levels of ethnic identity commitment had, on average, approximately five more sexual partners when they had reported greater lifetime experiences of sexism. Findings highlight how sexist experiences contributed to an increased number of partners among Latinas reporting relatively lower levels of ethnic identity commitment, demonstrating that strong ethnic identity commitment was protective against risk in accordance with past research. Results indicate a continued need for sexual health interventions with Latina college students.
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Affiliation(s)
- Melissa M. Ertl
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies at Columbia University
- Division on Substance Use Disorders, New York State Psychiatric Institute
| | - Jessica L. Martin
- Department of Educational and Counseling Psychology, University at Albany-State University of New York
| | - Frank R. Dillon
- Department of Counseling and Counseling Psychology, Arizona State University
| | - Hung-Bin Sheu
- Department of Educational and Counseling Psychology, University at Albany-State University of New York
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Pascoe EA, Lattanner MR, Richman LS. Meta-analysis of interpersonal discrimination and health-related behaviors. Health Psychol 2022; 41:319-331. [PMID: 35467901 PMCID: PMC11924412 DOI: 10.1037/hea0001147] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This article comprehensively examines the relationship between interpersonal discrimination (IPD) and health-related behavior (HB), expanding upon Pascoe and Richman's (2009) meta-analysis and research synthesis. METHOD One hundred and twenty one articles providing zero-order correlations (or information allowing their calculation) between perceptions of IPD and a variety of HB outcomes were coded and analyzed using a random-effects meta-analysis model. One hundred and fifty six articles examining this relationship using multivariate models were also coded and summarized within a research synthesis. Subanalyses were performed for articles examining smoking, alcohol use/abuse, substance use/abuse, sexual risk, and diet/eating behaviors. Potential mediators of the IPD-HB relationship were also tallied when available. RESULTS Compared to the original analysis, results suggest an overall attenuated but stable relationship between IPD and HBs. CONCLUSIONS The documented meta-analytic associations between perceptions of IPD and a variety of HB provide supportive evidence for one pathway through which IPD heightens risk for negative physical health outcomes among marginalized groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | - Laura S Richman
- Department of Population Health Sciences, Duke University School of Medicine, Duke University
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Cariello AN, Perrin PB, Williams CD, Espinoza GA, Paredes AM, Moreno OA. Moderating Influence of Social Support on the Relations between Discrimination and Health via Depression in Latinx Immigrants. JOURNAL OF LATINX PSYCHOLOGY 2022; 10:98-111. [PMID: 35434535 PMCID: PMC9012262 DOI: 10.1037/lat0000200] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
The purpose of this study was to examine the relations among discrimination, depression, and health among a sample of diverse Latinx immigrants. A secondary aim was to examine whether direct and indirect effects among these variables were moderated by social support. A sample of 204 Latinx immigrants completed questionnaires in community centers, health clinics, and retail establishments. Depression was found to mediate the effect of discrimination on physical health. Social support was found to moderate this indirect effect, wherein higher levels of social support weakened the effect. Results from this study indicate that through depression, health can be impacted by minority stressors, and these relationships can be buffered by links to cultural strengths including social support.
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Affiliation(s)
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University
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Cabrera Tineo YA, Dillon FR, Ertl MM, Rentería R, De La Rosa M. Discrimination-Based Acculturative Stress, Depression, and Alcohol Use among Latina Emerging Adults During Initial Months in the USA. Int J Ment Health Addict 2022; 20:553-568. [PMID: 35321450 PMCID: PMC8937027 DOI: 10.1007/s11469-020-00386-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background The present study examined the links between discrimination-based acculturative stress (DAS), depressive symptoms, and alcohol use among recently immigrated Latina young adults and explored potential within-group Latina ethnic differences. Methods Structural equation modeling was used to assess these relations among 530 Latina young adults (age 18-23) who had immigrated to the U.S. within approximately 12 months prior to assessment. Results Women reporting more DAS indicated more depressive symptoms and alcohol use than counterparts reporting less DAS. Women reporting more time in the U.S. experienced higher levels of DAS. Undocumented participants, and those who had lived in the U.S. for less time, reported more depressive symptoms than their peers. Discussion Findings highlight the need for mental health clinicians to attend to their local sociopolitical climate context for discriminatory practices and integrate cultural factors in mental health and alcohol use interventions targeting Latina young adults who recently immigrated to the U.S.
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Affiliation(s)
- Yajaira A. Cabrera Tineo
- Department of Educational & Counseling Psychology, University at Albany, State University of New York, Albany, NY
| | - Frank R. Dillon
- Counseling & Counseling Psychology, Arizona State University, Tempe, AZ
| | - Melissa M. Ertl
- Department of Educational & Counseling Psychology, University at Albany, State University of New York, Albany, NY
| | - Roberto Rentería
- Counseling & Counseling Psychology, Arizona State University, Tempe, AZ
| | - Mario De La Rosa
- Center for Research on U. S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL
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Bommersbach TJ, Jegede O, Stefanovics EA, Rhee TG, Rosenheck RA. Diagnostic remission of substance use disorders: Racial differences and correlates of remission in a nationally representative sample. J Subst Abuse Treat 2021; 136:108659. [PMID: 34785084 DOI: 10.1016/j.jsat.2021.108659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/27/2021] [Accepted: 11/05/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Research has shown racial/ethnic minorities to have similar risk of developing substance use disorders (SUDs) as Whites. However, few studies have compared the likelihood of diagnostic remission (i.e., no longer meeting criteria for current SUDs). METHODS Using nationally representative survey data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), we examined all adults with lifetime SUDs; compared the proportions experiencing diagnostic remission; and used logistic regression analyses to compare Black, Hispanic, and other racial/ethnic minorities to Whites. The research team initially used bivariate comparisons to identify potentially confounding factors also associated with remission. The study used multivariable-adjusted logistic regression analyses to adjust for these potentially confounding covariates. The team conducted separate analyses for alcohol use disorder (AUD) and drug use disorders (DUDs). RESULTS Of 10,916 individuals with lifetime SUDs, 5120 no longer met criteria for an SUD in the past year (55.2% of White, 34.0% of Black, 38.5% Hispanic, and 40.1% of other individuals). In unadjusted analyses, Black, Hispanic, and others were significantly and about half as likely as Whites to have remitted with odds ratios (ORs) of 0.42 (95% CI 0.36-0.48), 0.51 (0.45-0.58), and 0.55 (0.45-0.65), respectively. The study found similar results for both AUD and DUDs. Adjusting for potentially confounding factors only modestly improved the likelihood of remission among racial/ethnic minorities compared to White individuals. CONCLUSION Minority race/ethnicity is robustly associated with reduced likelihood of diagnostic remission from SUDs even after adjusting for other factors. This study could identify only partial moderators of these disparities; these moderators deserve further study.
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Affiliation(s)
- Tanner J Bommersbach
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT, USA.
| | - Oluwole Jegede
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT, USA
| | - Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT, USA; U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, 950 Campbell Avenue, West Haven, CT, USA
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT, USA; U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, 950 Campbell Avenue, West Haven, CT, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, USA
| | - Robert A Rosenheck
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT, USA; U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, 950 Campbell Avenue, West Haven, CT, USA
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Saint-Fleur AL, Anglin DM. Does Ethnic Identity Moderate the Relationship between Racial Discrimination and Cannabis Use among US- and non-US Born Black Emerging Adults? J Psychoactive Drugs 2021; 53:439-451. [PMID: 34747344 DOI: 10.1080/02791072.2021.1990444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Race-based experiences of discrimination (EOD) have been documented as a risk factor for substance use among Black individuals, particularly during emerging adulthood, with ethnic identity serving as a protective influence. Our study extends epidemiologic research on EOD and cannabis use by examining this relation in U.S. and non-U.S. born Black emerging adults across immigrant generations (N = 466, 30% first-generation immigrants, 49% second-generation immigrants, and 21% non-immigrants). Results from self-reported data indicated EOD were associated with an increased likelihood of lifetime cannabis use, while ethnic identity was not significantly related to any odds of lifetime cannabis use. Odds of lifetime use was lower among first-generation immigrants compared to non-immigrants. Although the interaction between ethnic identity and EOD was not significantly associated with cannabis use, the results indicated that for second-generation immigrants, the probability of lifetime use decreased as ethnic identity increased. These findings underscore the importance of ethnic identity as a protective factor for cannabis use, especially among Black immigrants who have been racialized over generations in the United States, providing implications for future study and intervention.
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Affiliation(s)
- Ashley L Saint-Fleur
- The Sophie Davis Biomedical Education Program at the Cuny School of Medicine, The City College of New York, City University of New York, New York, NY, USA
| | - Deidre M Anglin
- Department of Psychology, The City College of New York, City University of New York, New York, Ny, USA.,Department of Psychology, The Graduate Center, City University of New York, New York, Ny, USA
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Espinosa A, Bonner M, Alexander W. The Differential Contribution of Adverse Childhood Experiences and Perceived Discrimination on Substance Use among Hispanic Emerging Adults. J Psychoactive Drugs 2021; 53:422-430. [PMID: 34706633 DOI: 10.1080/02791072.2021.1986242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adverse childhood experiences (ACE) are widely documented risk factors for substance use among Hispanic emerging adults. Studies seldom examine whether distinct ACEs differentially relate to substance use in emerging adulthood, and if said association varies in the context of additional stressors disproportionately experienced by Hispanic people. This examination is necessary for understanding the etiology of substance use disorders and related outcomes among Hispanic individuals. Using a sample of Hispanic emerging adults, the goals of this study were two-fold. First, it examined differences in substance use between subgroups of varying ACEs. Second, it assessed whether substance use in the presence of discrimination differed between ACE subgroups. Latent class analysis identified two emerging ACE subgroups: [1] Parental Separation and [2] Physical & Emotional. On average, individuals in the Physical & Emotional subgroup endorsed a higher likelihood of tobacco, cannabis, and illegal drug use than those in the Parental Separation subgroup. For the latter, the likelihood of binge drinking was higher than that of the Physical & Emotional subgroup if they also perceived discrimination in emerging adulthood. These findings highlight the importance of considering the intersection of multiple social determinants of health for understanding the lifetime risk of substance use among Hispanic individuals.
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Affiliation(s)
- Adriana Espinosa
- Department of Psychology, The City College of New York, CUNY, NY, USA
| | | | - Wynta Alexander
- Department of Psychology, The City College of New York, CUNY, NY, USA
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29
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Glasman LR, Dickson-Gomez J, Corbett AM, Rosado NA, Galletly CL, Salazar J. Contextual influences on Latino men's sexual and substance use behaviors following immigration to the Midwestern United States. ETHNICITY & HEALTH 2021; 26:827-844. [PMID: 30592225 PMCID: PMC6599544 DOI: 10.1080/13557858.2018.1562051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
Objectives: Latinos in the United States experience a disproportionate number of HIV and other sexually transmitted infections (STIs) and higher use of alcohol and illegal drugs, which has been attributed to increases in risk behaviors following immigration. Whereas substantial research documents these behavioral changes, little is known about how immigrants increase their risk or why some immigrants increase their risk and other immigrants do not. This study explored how the social and normative context affects sexual and substance use behaviors among Latino immigrant men in a midsized Midwestern city of the United States.Methods: We interviewed 64 Latino immigrant men recruited from community sites in Milwaukee, Wisconsin (mean age = 32.6 years). Participants reported the social and normative contexts preceding and following immigration, including social networks and support, perceptions of the law, and familiar and peer normative influences.Results: Immigrants attributed changes in their sexual and substance use behaviors to their immigration goals, social support, peer and familial normative influences, and restrictions related to their immigrant status. Immigration for economic and personal advancement was generally protective from behaviors that would interfere with those goals as were extended familial networks that could provide support, resources, and normative control. The need to stay under the radar of authorities, the proportion of Latinos in the community, the social and normative changes associated with immigrants' age, and the higher perceptions of risk for HIV in the United States compared with their home countries also influenced immigrants' sexual and substance use behaviors.Conclusions: Changes in risk behavior after immigration to the United States reflect a combination of social and normative factors and personal goals. Interventions and policies aiming to prevent HIV and substance use among Latino immigrants should understand the contextual conditions that decrease or increase their risk behaviors in the United States.
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Affiliation(s)
- Laura R. Glasman
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Julia Dickson-Gomez
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - A. Michelle Corbett
- Center for Urban Population Health, University of Wisconsin School of Medicine & Public Health, Milwaukee, Wisconsin, United States
| | - Noel A. Rosado
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Carol L. Galletly
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - José Salazar
- Sixteenth Street Community Health Centers, Milwaukee, Wisconsin, United States
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Abuelezam NN, El-Sayed A, Galea S, Gordon NP. Understanding differences within ethnic group designation: comparing risk factors and health indicators between Iranian and Arab Americans in Northern California. BMC Public Health 2021; 21:1074. [PMID: 34090389 PMCID: PMC8178892 DOI: 10.1186/s12889-021-11121-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Middle Eastern and North African (MENA) ethnic group is a diverse group composed of two primary subsets in the United States: Iranian and Arab Americans. We aimed to compare health risk factors, chronic health conditions, and mental health conditions of Iranian and Arab American adults in Northern California. METHODS We used cross-sectional electronic health record (EHR) data from a 2016 Northern California health plan study cohort to compare adults classified as Iranian or Arab American based on ethnicity, language, or surname. We produced age-standardized prevalence estimates of obesity, smoking, hyperlipidemia, prediabetes, diabetes, hypertension, depression, and anxiety for Iranian and Arab American men and women by age group (35-44, 45-64, and 65-84) and overall (35-84). We used generalized linear models to calculate prevalence ratios (PR) to compare Iranian and Arab American adults ages 35-84 on all health indicators. RESULTS Compared to Arab Americans, Iranian Americans had a lower prevalence of obesity (PR: 0.77, 95% confidence interval, CI: 0.73, 0.82), current smoking (PR: 0.80, 95% CI: 0.73, 0.89), and ever smoking (PR: 0.95, 95% CI: 0.91, 0.99), but a higher prevalence of hyperlipidemia (PR: 1.09, 95% CI: 1.06, 1.12), prediabetes (PR: 1.12, 95% CI: 1.09, 1.16), depression (PR; 1.41, 95% CI: 1.30, 1.52), and anxiety (PR: 1.52, 95% CI: 1.42, 1.63). Similar patterns were observed for men and women. CONCLUSION This work supports the need to collect granular data on race and ethnicity within the MENA ethnic group to improve identification in clinical care settings and population health reporting to better address the physical and mental health needs of different MENA subgroups.
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Affiliation(s)
- Nadia N Abuelezam
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
| | - Abdulrahman El-Sayed
- College of Literature, Science, & the Arts & Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA, USA
| | - Nancy P Gordon
- Kaiser Permanente Division of Research, Oakland, CA, USA
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Amaro H, Sanchez M, Bautista T, Cox R. Social vulnerabilities for substance use: Stressors, socially toxic environments, and discrimination and racism. Neuropharmacology 2021; 188:108518. [PMID: 33716076 PMCID: PMC8126433 DOI: 10.1016/j.neuropharm.2021.108518] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/17/2021] [Accepted: 03/05/2021] [Indexed: 12/13/2022]
Abstract
Applying a social determinants of health framework, this review brings attention to evidence from social sciences and neuroscience on the role of selected social factors in individual and population-level vulnerability to substance use and substance use disorders (SUDs). The understanding that social vulnerability to substance use and SUDs is multifaceted and occurs across different levels of influence (individual, interpersonal, community, and societal) is underscored. We propose that socially based stressors play a critical role in creating vulnerability to substance use and SUDs, and as such, deserve greater empirical attention to further understand how they "get under the skin." Current knowledge from social sciences and neuroscience on the relationships among vulnerability to substance use resulting from stressors, exposure to socially toxic childhood environments, and racism and discrimination are summarized and discussed, as are implications for future research, practice, and policy. Specifically, we propose using a top-down approach to the examination of known, yet often unexplored, relationships between vulnerability to substance use and SUDs, related inequities, and potential differential effects across demographic groups. Finally, research gaps and promising areas of research, practice, and policy focused on ameliorating social vulnerabilities associated with substance use and SUDs across the lifespan are presented. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.
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Affiliation(s)
- Hortensia Amaro
- Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, Florida International University, United States.
| | - Mariana Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, United States.
| | - Tara Bautista
- Yale Stress Center, School of Medicine, Yale University, United States.
| | - Robynn Cox
- Suzanne Dworak-Peck School of Social Work, Schaeffer Center for Health Policy and Economics, And Edward R. Roybal Institute on Aging, University of Southern California, United States.
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32
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Ai AL, Petscher Y, Lemieux CM, Petscher ES, Clark J, Pappas A. Childhood Mistreatment, PTSD, and Substance Use in Latinx: The Role of Discrimination in an Omitted-Variable Bias. Int J Behav Med 2021; 28:602-615. [PMID: 33761115 DOI: 10.1007/s12529-021-09954-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Childhood mistreatment (CM) has been associated with adult posttraumatic disorder (PTSD) and substance use disorders (SUDs) in the general population. Few studies have examined the role of PTSD in the CM-SUD association among Latinx. This cross-sectional study evaluated a theory-driven conceptual model with a specific focus on the impact of perceived discrimination, which may interfere with these associations. METHOD Using a nationally representative sample and structural equation modeling (SEM), the study evaluated the mediation of PTSD in the CM-SUD link, adjusting for or omitting discrimination and other sociodemographic variables that are known predictors of Latinx behavioral health. Multi-subsample analyses were then conducted to review nativity differences (US-born = 924.43% and immigrant = 1630.57%). RESULTS The fully specified final model (model 1, covariates adjusted) failed to show a significant mediation of PTSD in the tested link, but a direct detrimental effect group of discrimination, for all Latinx. The mediation was only supported, when treating discrimination and other covariates as omitted variables (model 5), which also showed additional direct and indirect effect of CM on SUD. In subsample analyses, models of US-born and immigrant-Latinx subpopulations were identical but showed nativity differences when omitting covariates. CONCLUSION When discrimination and other covariates were fully adjusted, Latinx exposed to trauma were more likely to develop SUD in adulthood, regardless of when traumatic exposure occurred. This unexpected finding challenges theories explaining the CM-SUD connection, suggesting possible model misspecifications of parametric SES; namely, omitting the unique impact of perceived discrimination in Latinx can lead to biased results. From a clinical standpoint, both trauma and discrimination must be addressed when assessing Latinx behavioral health.
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Affiliation(s)
- Amy L Ai
- Departments of Social Medicine & Behavioral Health, College of Medicine, and Colleges of Social Work and Nursing, Florida State University (FSU), 2570 University Building C, Tallahassee, FL, 32306, USA.
| | | | - Catherine M Lemieux
- School of Social Work, Margaret Champagne Womack Professor in Addictive Disorders, Louisiana State University, Baton Rouge, USA
| | - Erin S Petscher
- An independent developmental psychologist, Tallahassee, FL, 32306, USA
| | - James Clark
- College of Social Work, FSU, Tallahassee, FL, 32306, USA
| | - Alexa Pappas
- Undergraduate Research Volunteer, FSU, FL, Tallahassee, 32306, USA
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Gu J, Ming X. Daily Social Pressure and Alcohol Consumption Among Chinese Women: A Cross-Sectional Study. Asia Pac J Public Health 2021; 33:396-403. [PMID: 33666091 DOI: 10.1177/1010539521998522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to examine the daily social pressure and socioeconomic factors related to women's alcohol consumption in China. Cross-sectional data were obtained from the 2012 China Family Panel Studies. A multivariate logistic regression analysis of a sample of 16 339 female adults with the mean age of 45.3 years was used to examine the relationships between dependent and independent variables. According to the results, first, the greater the daily social pressure, the more likely women were to engage in general alcohol consumption (odds ratio = 1.061) and risk drinking (odds ratio = 1.057). Second, while there is a positive relationship between the general level of social pressure and women's alcohol consumption, the relationship between the severe level of social pressure and women's alcohol consumption was not significant. Finally, women in the Central region were less likely to engage in risk drinking than women in the Western region; women with secondary school education were more likely to engage in risk drinking than women with primary school education or below; and age was significantly positively associated with both general and risk drinking. In conclusion, increasing alcohol consumption among women may be due to increased social pressure.
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Affiliation(s)
| | - Xing Ming
- Shanghai University, Shanghai, China
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Andrade N, Ford AD, Alvarez C. Discrimination and Latino Health: A Systematic Review of Risk and Resilience. HISPANIC HEALTH CARE INTERNATIONAL 2021; 19:5-16. [PMID: 32380912 DOI: 10.1177/1540415320921489] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2025]
Abstract
INTRODUCTION As anti-immigrant hostility toward Latino populations grows, more fervent attention is needed to consider strength-based approaches to attenuate the effects of perceived discrimination. This systematic review synthesizes the evidence about the effects of racial/ethnic discrimination on mental, physical, and health behaviors of Latinos and examines the coping mechanisms and cultural factors that attenuate the negative association between discrimination and health among adult Latinos living in the United States. METHOD The search criteria included articles that (a) examined ethnic/racial discrimination in relationship to a health outcome, (b) had study samples composed of least 25% Latino adults, and (c) were written in English. RESULTS A total of 33 studies were included in the review. Our findings demonstrated the negative relationship between perceived discrimination, mental health, and health behaviors. The evidence for the relationship between perceived discrimination and physical health was less robust. For mental health, greater feeling of ethnic pride and belonging attenuated the negative relationship between perceived discrimination and mental health. CONCLUSIONS Our findings highlight the potential for building on ethnic identity for addressing mental health and perceived discrimination. Future research directions are outlined to address identified gaps.
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Affiliation(s)
- Nadia Andrade
- 15851Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | - Carmen Alvarez
- 15851Johns Hopkins University School of Nursing, Baltimore, MD, USA
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Read JG, Lynch SM, West JS. Disaggregating Heterogeneity among Non-Hispanic Whites: Evidence and Implications for U.S. Racial/Ethnic Health Disparities. POPULATION RESEARCH AND POLICY REVIEW 2021; 40:9-31. [PMID: 34898768 PMCID: PMC8653968 DOI: 10.1007/s11113-020-09632-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 12/18/2020] [Indexed: 11/26/2022]
Abstract
Research has made strides in disaggregating health data among racial/ethnic minorities, but less is known about the extent of diversity among Whites. Using logistic regression modeling applied to data on respondents aged 40+ from the 2008 to 2016 American Community Survey, we disaggregated the non-Hispanic White population by ancestry and other racial/ethnic groups (non-Hispanic Black, non-Hispanic Asian, and Hispanic) by common subgroupings and examined heterogeneity in disability. Using logistic regression models predicting six health outcome measures, we compared the spread of coefficients for each of the large racial/ethnic groups and all subgroupings within these large categories. The results revealed that health disparities within the White population are almost as large as disparities within other racial groups. In fact, when Whites were disaggregated by ancestry, mean health appeared to be more varied among Whites than between Whites and members of other racial/ethnic groups in many cases. Compositional changes in the ancestry of Whites, particularly declines in Whites of western European ancestry and increases in Whites of eastern European and Middle Eastern ancestry, contribute to this diversity. Together, these findings challenge the oft-assumed notion that Whites are a homogeneous group and indicate that the aggregate White category obscures substantial intra-ethnic heterogeneity in health.
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Affiliation(s)
- Jen’nan Ghazal Read
- Department of Sociology, Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC 27708, USA
| | - Scott M. Lynch
- Department of Sociology, Duke University, Durham, NC, USA
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36
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Cimarolli VR, Burack O, Minahan JM, Falzarano F, Reinhardt JP, Shi X. A Substance Misuse Intervention Program in Postacute Care: Who Declines Participation? Am J Geriatr Psychiatry 2021; 29:15-23. [PMID: 32912805 PMCID: PMC7839814 DOI: 10.1016/j.jagp.2020.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/12/2020] [Accepted: 08/12/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Alcohol and substance misuse has been under-acknowledged and underidentified in older adults. However, promising treatment approaches exist (e.g., brief interventions) that can support older adults with at-risk alcohol and substance use. Postacute rehabilitation settings of Skilled Nursing Facilities (SNFs) can offer such programs, but little is known about patient characteristics that are associated with the likelihood of participating in interventions offered in postacute rehabilitation care. Thus, the objective of this study was to identify individual patient characteristics (predisposing, enabling, and need-related factors) associated with participation in a brief alcohol and substance misuse intervention at a SNF. METHODS This cross-sectional study analyzed medical record data of postacute care patients within a SNF referred to a substance misuse intervention. Participants were 271 patients with a history of substance misuse, 177 of whom enrolled in the intervention and 94 refused. Data collected upon patient admission were used to examine predisposing, enabling, and need-related factors related to likelihood of program participation. RESULTS Older age and ethnic minority status were associated with a reduction in likelihood to participate, while widowhood increased the likelihood of participation. CONCLUSION Upon referral to a substance misuse intervention, clinicians in SNFs should be cognizant that some patients may be more likely to refuse intervention, and additional efforts should be made to engage patients at-risk for refusal.
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Affiliation(s)
| | - Orah Burack
- The New Jewish Home, Research Institute on Aging (OB, JPR), New York, NY
| | | | | | - Joann P Reinhardt
- The New Jewish Home, Research Institute on Aging (OB, JPR), New York, NY
| | - Xiaomei Shi
- LeadingAge LTSS Center @UMass Boston (VRC, XS), Washington, DC
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Piña-Watson B, Cox K, Neduvelil A. Mexican descent college student risky sexual behaviors and alcohol use: The role of general and cultural based coping with discrimination. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:82-89. [PMID: 31513462 DOI: 10.1080/07448481.2019.1656214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 05/30/2019] [Accepted: 08/12/2019] [Indexed: 06/10/2023]
Abstract
This study investigates cultural and general coping strategies as potential protective or risk factors to risky sexual behaviors (RSBs) and alcohol use in the face of discrimination for Mexican descent college students. Participants: Data collection was conducted from September 2016 to May 2017 and included 796 Mexican descent emerging adults. Methods: Linear regressions were conducted to test main and interaction effects of discrimination, and general and cultural coping strategies on RSBs and alcohol use issues. Results: Higher discrimination experiences were not associated with RSBs or alcohol use issues. Only ethnicity-based coping was found to be a significant moderator to the relationships between discrimination and the outcome variables of RSBs and alcohol use issues. Conclusions: This study has implications for the way mental health clinicians explore the intersection of ethnic identity and coping as a means of understanding the relationship among discrimination, RSBs, and alcohol use issues.
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Affiliation(s)
- Brandy Piña-Watson
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Kassidy Cox
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Ashley Neduvelil
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
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Cobb CL, Salas-Wright CP, John R, Schwartz SJ, Vaughn M, Martínez CR, Awad G, Pinedo M, Cano MÁ. Discrimination Trends and Mental Health Among Native- and Foreign-Born Latinos: Results from National Surveys in 2004 and 2013. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 22:397-407. [PMID: 33231824 PMCID: PMC10371212 DOI: 10.1007/s11121-020-01186-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2020] [Indexed: 11/30/2022]
Abstract
We examined national trends and mental health correlates of discrimination among Latinos in the USA. We used data from two nationally representative surveys based on the National Epidemiologic Survey on Alcohol and Related Conditions collected in 2004 and 2013. Results indicated that perceived discrimination, both any and recurrent, increased for Latinos across nearly every demographic, with the greatest increases occurring for Latinos who were ages 65 and older, had household incomes less than $35,000, were less educated, were immigrants, and who lived in the Midwest. Findings also indicated that any and recurrent discrimination were associated with increased odds of a mood, anxiety, or substance use disorder and this association was observed for nearly all manifestations of discrimination. We also observed a dose-response association where experiencing discrimination in a greater number of domains was associated with increased likelihood of mood, anxiety, and substance use disorders. Results suggest that discrimination is a social stressor that has increased for Latino populations in recent years and may represent a serious risk factor for the psychological and behavioral health of Latinos. Findings are discussed in terms of prior research and the potential implications for prevention scientists working with Latino populations.
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Affiliation(s)
- Cory L Cobb
- Department of Educational Psychology, University of Texas at Austin, 1912 Speedway, Ste D5000, Austin, TX, 78712, USA.
| | | | - Rachel John
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA
| | - Seth J Schwartz
- Leonard M. Miller School of Medicine, University of Miami, 1120 N.W. 14th Street, Room 1083, Miami, FL, 33136, USA
| | - Michael Vaughn
- Saint Louis University, 3550 Lindell Blvd., Room 316, St. Louis, MO, 63103, USA
| | - Charles R Martínez
- Department of Educational Psychology, University of Texas at Austin, 1912 Speedway, Ste D5000, Austin, TX, 78712, USA
| | - Germine Awad
- Department of Educational Psychology, University of Texas at Austin, 1912 Speedway, Ste D5000, Austin, TX, 78712, USA
| | - Miguel Pinedo
- Department of Kinesiology and Health Education, University of Texas at Austin, 1912 Speedway, Ste D5000, Austin, TX, 78712, USA
| | - Miguel Ángel Cano
- Florida International University, 11200 SW 8th Street AHC5, Miami, FL, 33199, USA
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Muñoz-Laboy M, Bamford L, Benitez J, Zisman-Ilani Y, Ripkin A, Del Castillo L, Esteves-Camacho T, de la Cruz M, Katumkeeryil E. "En la Lucha": Strategies to Improve HIV Care for Puerto Ricans with Opioids Use Disorders. J Immigr Minor Health 2020:10.1007/s10903-020-01091-6. [PMID: 33125632 PMCID: PMC7596834 DOI: 10.1007/s10903-020-01091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Clínica Bienestar is a comprehensive HIV primary care clinic for Spanish-speaking Latinx with opioids use disorders (OUD). This article describes the barriers and trajectories to HIV viral suppression for Puerto Ricans with a transnational profile and dual diagnoses (HIV and OUD), and the strategies applied to increase retention in care. METHODS Case study methodology was used to select two patient life histories that illustrate the most common pathways to success in reducing HIV viral load to undetectable and achieving OUD long-term recovery. RESULTS AND DISCUSSION Patients' major challenges included: (1) Persistent migrating while seeking substance use treatment services with limited or no support from their sending and hosting communities; (2) Intersectional stigmas; (3) Untreated trauma; (4) Language and cultural barriers. Clínica Bienestar's service model included ten strategies to retain patients in care (e.g., Case management to identify cases with high social isolation), six emerged as central to addressing transnational challenges.
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Affiliation(s)
- Miguel Muñoz-Laboy
- Department of Community Health and Social Medicine, School of Medicine, City University of New York, 160 Covenant Avenue, Suite 310, New York, NY, 10031, USA.
| | - Laura Bamford
- Jonathan Lax Treatment Center, Medical Leadership, FIGHT Community Health Centers, Philadelphia, PA, USA
| | - Jose Benitez
- Prevention Point Philadelphia, Philadelphia, PA, USA
| | - Yaara Zisman-Ilani
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | | | | | | | - Mario de la Cruz
- Department of Community Health and Social Medicine, School of Medicine, City University of New York, 160 Covenant Avenue, Suite 310, New York, NY, 10031, USA
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Cano M. English use/proficiency, ethnic discrimination, and alcohol use disorder in Hispanic immigrants. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1345-1354. [PMID: 32055891 DOI: 10.1007/s00127-020-01837-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/03/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Acculturation-related measures, often based on language, have traditionally been identified as predictors of drinking outcomes for US Hispanics. However, a sole focus on acculturation may obscure the role of societal factors such as discrimination. The present study evaluated ethnic discrimination as a mediator in the relationship between English use/proficiency and alcohol use disorder in US Hispanic immigrants. METHODS The study examined data from the 2222 self-identified Hispanic immigrant adults in the National Epidemiologic Survey on Alcohol and Related Conditions-III who reported alcohol use within the past year. The study utilized multivariable binomial logistic regression analyses to test relationships between English use/proficiency and perceived ethnic discrimination; English use/proficiency and DSM-5 alcohol use disorder; ethnic discrimination and DSM-5 alcohol use disorder. Statistical mediation examined ethnic discrimination as a mediator in the relationship between English use/proficiency and alcohol use disorder. RESULTS Perceived ethnic discrimination was significantly associated with alcohol use disorder in men (adjusted odds ratio [AOR] 1.99; 95% CI [confidence interval], 1.40-2.83), yet not women (AOR 1.32; 95% CI, 0.71-2.44), in a regression model that also included English use/proficiency. Perceived ethnic discrimination also acted as a partial mediator between English use/proficiency and DSM-5 alcohol use disorder for male, yet not female, Hispanic immigrants. CONCLUSION Findings show some support for the notion that experiences of ethnic discrimination, which may accompany the process of acculturation, partially explain deteriorating drinking outcomes in Hispanic immigrant men adapting to life in the US.
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Affiliation(s)
- Manuel Cano
- Department of Social Work, University of Texas at San Antonio, 501 W. César E. Chávez Blvd., San Antonio, TX, 78207, USA.
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Cariello AN, Perrin PB, Derlan CL, Espinoza GA, Morlett-Paredes A, Moreno OA, Trujillo MA. Moderating influence of enculturation on the relations between minority stressors and physical health via anxiety in Latinx immigrants. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2020; 26:356-366. [PMID: 31556631 PMCID: PMC8153969 DOI: 10.1037/cdp0000308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The Latinx population in the United States has grown rapidly, now standing at over 56 million people. Discrimination and acculturative stress have been found to affect the mental and physical health of Latinx immigrants, yet enculturation has been identified as an important cultural strength for this population. The purpose of this study was to examine the relations among minority stressors, anxiety, and physical health in a sample of Latinx immigrants living in the United States. A secondary aim was to examine whether the direct and indirect effects among these variables were moderated by enculturation (i.e., moderated mediation). METHOD A community sample of 202 Latinx immigrants completed questionnaires measuring these constructs. RESULTS Both acculturative stress (b = -1.68, p < .001) and discrimination (b = -1.69, p < .001) yielded direct effects on physical health, as well as indirect effects (b = -.10, 95% confidence interval [-.23, -.01]; b = -.21, 95% confidence interval [-.40, -.08], respectively) through anxiety. CONCLUSIONS Psychologists and allied health care providers are recommended to assess for the impact of minority stressors on anxiety and physical health when providing care to Latinx immigrants. Future intervention research targeting Latinx mental and physical health can consider ways to include innate cultural strengths like enculturation and partner with Latinx cultural centers, churches, and local communities to make enculturation more salient. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Annahir N. Cariello
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Chelsea L. Derlan
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - G. Antonio Espinoza
- Department of History, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Oswaldo A. Moreno
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michael A. Trujillo
- Department of Psychiatry, University of California, San Francisco, San Francisco, USA
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Chin D, Loeb TB, Zhang M, Liu H, Cooley-Strickland M, Wyatt GE. Racial/ethnic discrimination: Dimensions and relation to mental health symptoms in a marginalized urban American population. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2020; 90:614-622. [PMID: 32584076 DOI: 10.1037/ort0000481] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
That racial/ethnic discrimination has adverse physical and psychological consequences, including stress, anxiety, depression, and their attendant health effects, is well documented. However, the particular dimensions within the broad construct of discrimination and their role in mental health are less well understood. This study investigates the dimensions of discrimination and explores their relation to depression and posttraumatic stress (PTS) symptoms. Using the Brief Perceived Ethnic/Racial Discrimination Questionnaire-Community Version, discrimination experiences were assessed among a community sample of African American and Latinx participants (N = 500). Factor analyses revealed 4 dimensions: Social Rejection, Stereotyping, Direct Threats/Attacks, and Police Mistreatment. In multivariate analyses, full regression models were significantly related to PTS and depression symptoms. Among the individual predictors, Social Rejection and ethnicity (Latinx) uniquely contributed to PTS symptoms in men, whereas Stereotyping and Direct Threat/Attack were associated with PTS symptoms for women. In regards to depressive symptoms, income, ethnicity (Latinx), and Social Rejection were significant predictors for men, while Social Rejection had an independent contribution for women. Thus, social rejection emerged as a significant unique predictor in 3 of the four models, suggesting that social ostracism may be a particularly harmful aspect of discrimination. Implications of these findings include the use of proactive and intervention strategies that emphasize a sense of belonging and mitigate the effects of exclusion and rejection. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Dorothy Chin
- Semel Institute for Neuroscience and Human Behavior
| | - Tamra B Loeb
- Semel Institute for Neuroscience and Human Behavior
| | - Muyu Zhang
- Semel Institute for Neuroscience and Human Behavior
| | | | | | - Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior
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NeMoyer A, Wang Y, Alvarez K, Canino G, Duarte CS, Bird H, Alegría M. Parental incarceration during childhood and later delinquent outcomes among Puerto Rican adolescents and young adults in two contexts. LAW AND HUMAN BEHAVIOR 2020; 44:143-156. [PMID: 31750677 PMCID: PMC7125033 DOI: 10.1037/lhb0000354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Childhood parental incarceration has been linked to increased rates of delinquency and arrest during adolescence and young adulthood; however, previous research has focused on White and/or Black samples rather than Latinx youth. We examined relationships between childhood parental incarceration and later delinquency and arrest among Puerto Rican youth living in Puerto Rico (majority context) and the mainland United States (minority context). HYPOTHESES We expected that childhood parental incarceration would be significantly linked to delinquent behavior and arrest. In line with acculturation theory, we hypothesized that residence (proxy for minority status) would be significantly related to delinquent outcomes and that an interaction effect would emerge between parental incarceration and residence. METHOD Longitudinal data from the Boricua Youth Study were examined for 1,294 Puerto Rican youth from the South Bronx, NY (minority context) and greater San Juan, PR (majority context). We conducted a series of negative binomial and logistic regressions to determine the effects of parental incarceration and residence in childhood on self-reported delinquent behavior and arrest in adolescence and young adulthood, while also examining factors previously linked to delinquency in Puerto Rican youth. RESULTS Childhood parental incarceration and South Bronx residence were both linked to delinquent behavior but not arrest, even when simultaneously examining several individual, diagnostic, environment/social, and family factors reported in childhood. However, we did not observe an interaction effect between parental incarceration and residence for either outcome. CONCLUSIONS Findings suggest that Puerto Rican youth with histories of parental incarceration could benefit from targeted programs aimed at preventing future delinquency. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Amanda NeMoyer
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston MA 02114, USA
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, USA
| | - Ye Wang
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston MA 02114, USA
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston MA 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, Medical Sciences Campus, Office A928 9 Floor, Rio Piedras, Puerto Rico 00935
| | - Cristiane S. Duarte
- Department of Psychiatry, Columbia University Irving Medical Center-New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Hector Bird
- Department of Psychiatry, Columbia University Irving Medical Center-New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston MA 02114, USA
- Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA
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Trajectories of heroin use: A 15-year retrospective study of Mexican-American men who were affiliated with gangs during adolescence. Drug Alcohol Depend 2019; 204:107505. [PMID: 31550612 PMCID: PMC6989031 DOI: 10.1016/j.drugalcdep.2019.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 06/04/2019] [Accepted: 06/05/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Heroin use is a public health concern in the United States. Despite the unique etiology and patterns of heroin use among U.S. Latinos, long-term heroin trajectories and health consequences among Latinos are not well understood. This study aims to document the distinct heroin use trajectories for a group of street-recruited (non-treatment), young adult Mexican American men living in a disadvantaged community who were affiliated with gangs during their youth. METHODS One-time interviews conducted between 2009-2012 in San Antonio, TX collected retrospective data from a sample of 212 Mexican American young adult men who reported using heroin at least once. Group-based trajectory modeling was applied to determine discrete developmental trajectories of heroin use. ANOVA, Chi square tests, and multinomial logistic regression examined current (past year) social and health indicators among each trajectory group. RESULTS Five discrete heroin trajectories groups were identified: low use (n = 65); late accelerating (n = 31); early decelerating (n = 26); late decelerating (n = 38); and stably high (n = 52). Varying social and health consequences were found among the trajectory groups. CONCLUSION This study describes the unique heroin use trajectories and social and health outcomes among a high-risk subgroup of Mexican American men. The findings suggest that early intervention and intervention available in easy to access non-treatment spaces may be especially useful for groups of people who use relatively less heroin.
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Salas-Wright CP, Vaughn MG, Goings TC, Miller DP, Chang J, Schwartz SJ. Alcohol-related problem behaviors among Latin American immigrants in the US. Addict Behav 2018; 87:206-213. [PMID: 30055450 DOI: 10.1016/j.addbeh.2018.06.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/27/2018] [Accepted: 06/27/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prior research indicates that Latino immigrants are less likely than US-born individuals to use alcohol and meet criteria for an alcohol use disorder. However, our understanding of alcohol-related problem behaviors among Latino immigrants remains limited. We report the prevalence of alcohol-related problem behaviors among Latino immigrants vis-à-vis the US-born and examine the relationship between alcohol-related problem behavior and key migration-related factors and injury/receipt of emergency medical care. METHODS The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes. RESULTS Foreign-born Latinos were less likely to report one or more alcohol-related problems compared to US-born Latinos (AOR = 0.41, 95% CI = 0.33-0.50) and the US-born general population (AOR = 0.38, 95% CI = 0.32-0.46). Latino immigrants arriving as children were, compared to those arriving later in life, significantly more likely to report alcohol-related problem behaviors, and experiences of discrimination were linked with greater risk of alcohol-related problem behavior as well. Latino immigrants reporting recurrent injury/emergency medical care utilization were more likely to report alcohol-related problem behavior. CONCLUSIONS Latino immigrants are significantly less likely than US-born Latinos and the US-born general population to operate a vehicle under the influence of alcohol, take part in risky behaviors or fight while drinking, or to be arrested due to alcohol consumption.
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Senreich E. The Persistent High Rates of Heroin Use Among the Puerto Rican Population in the United States: A Qualitative Study. SOCIAL WORK IN PUBLIC HEALTH 2018; 33:419-438. [PMID: 30477409 DOI: 10.1080/19371918.2018.1543626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
For a half- century, the Puerto Rican population in the United States has experienced very high rates of heroin usage with significant health ramifications. At substance misuse programs in the Bronx, New York, two focus groups consisting of a total of 13 Puerto Rican counselors, and four focus groups consisting of a total of 35 Puerto Rican clients, discussed the impact of heroin usage on Puerto Rican communities as part of a qualitative study using a phenomenological perspective. Societal marginalization and social dislocation were identified as major contributors to heroin usage in Puerto Rican communities. The findings indicate that full access to economic, vocational, and educational opportunities, along with a decrease in institutional racial discrimination, would appear to be the most effective way to decrease heroin usage among this population.
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Affiliation(s)
- Evan Senreich
- a Social Work, Lehman College , City University of New York , Bronx , New York , USA
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Cervantes RC, Gattamorta KA, Berger-Cardoso J. Examining Difference in Immigration Stress, Acculturation Stress and Mental Health Outcomes in Six Hispanic/Latino Nativity and Regional Groups. J Immigr Minor Health 2018; 21:14-20. [DOI: 10.1007/s10903-018-0714-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Childhood Abuse, Religious Involvement, and Substance Abuse Among Latino-American Men in the United States. Int J Behav Med 2017; 23:764-775. [PMID: 27098665 DOI: 10.1007/s12529-016-9561-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Childhood abuse/victimization and subsequent substance abuse are significant behavioral health problems among developed countries. In the United States (U.S.), however, few studies have examined whether this early trauma exacerbates adulthood substance abuse, viewed as a negative coping strategy, among Latino-American men. Furthermore, little is known about how collectivist cultural factors (i.e., ethnic identity, social support, and religious involvement), indicating potentially positive coping resources, were related to substance abuse in this largest minority-male population. METHOD We investigated Latino-American men (N = 1127) in a nationally representative U.S. sample, using logistic regression analysis adjusting known demographic and acculturation correlates. RESULTS The results identified considerably elevated rates of childhood physical abuse/victimization (35.7 %) and lifetime substance abuse (17.3 %). Childhood physical (not sexual) abuse/victimization was positively associated with lifetime substance abuse, alongside age, being U.S.-born, and perceived discrimination. Latino-American men with lifetime substance abuse reported more religious coping. CONCLUSION Findings may contribute to the design of culturally competent behavioral care.
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Ayón C, Messing JT, Gurrola M, Valencia-Garcia D. The Oppression of Latina Mothers: Experiences of Exploitation, Violence, Marginalization, Cultural Imperialism, and Powerlessness in Their Everyday Lives. Violence Against Women 2017; 24:879-900. [PMID: 29332490 DOI: 10.1177/1077801217724451] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite Latinos being the largest growing population in the United States, research has not examined the impact of social structures on the well-being of Latina immigrants; negative social discourse and restrictive laws exacerbate inequality and discrimination in this population. Through combined inductive/deductive analysis of in-depth semistructured interviews, we examined immigrant Mexican mothers' ( N = 32) descriptions of oppression in the United States. All five forms of oppression, described in Young's oppression framework are evident: exploitation, violence, marginalization, cultural imperialism, and powerlessness. Discrimination places a high burden on Latinas due to the intersection of forms of oppression and nondominant identities.
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Affiliation(s)
| | | | - Maria Gurrola
- 3 New Mexico State University, Las Cruces, New Mexico, USA
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Abstract
OBJECTIVE Perceived discrimination has been associated with psychosocial distress and adverse health outcomes. We examined associations of perceived discrimination measures with changes in kidney function in a prospective cohort study, the Healthy Aging in Neighborhoods of Diversity across the Life Span. METHODS Our study included 1620 participants with preserved baseline kidney function (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m) (662 whites and 958 African Americans, aged 30-64 years). Self-reported perceived racial discrimination and perceived gender discrimination (PGD) and a general measure of experience of discrimination (EOD) ("medium versus low," "high versus low") were examined in relation to baseline, follow-up, and annual rate of change in eGFR using multiple mixed-effects regression (γbase, γrate) and ordinary least square models (γfollow). RESULTS Perceived gender discrimination "high versus low PGD" was associated with a lower baseline eGFR in all models (γbase = -3.51 (1.34), p = .009 for total sample). Among white women, high EOD was associated with lower baseline eGFR, an effect that was strengthened in the full model (γbase = -5.86 [2.52], p = .020). Overall, "high versus low" PGD was associated with lower follow-up eGFR (γfollow = -3.03 [1.45], p = .036). Among African American women, both perceived racial discrimination and PGD were linked to lower follow-up kidney function, an effect that was attenuated with covariate adjustment, indicating mediation through health-related, psychosocial, and lifestyle factors. In contrast, EOD was not linked to follow-up eGFR in any of the sex by race groups. CONCLUSIONS Perceived racial and gender discrimination are associated with lower kidney function assessed by glomerular filtration rate and the strength of associations differ by sex and race groups. Perceived discrimination deserves further investigation as a psychosocial risk factors for kidney disease.
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