Unpacking disparities in substance-related outcomes among racial, ethnic, sexual, and gender minoritized groups during adolescence and emerging adulthood

Homelessness and Food Insecurity During Emerging Adulthood: Associations With Changes in Behavioral and Physical Health Over a Two-Year Period

PURPOSE

For emerging adults in the United States, economic instability is a widespread problem with implications for the successful transition to adulthood. This study examines how two indicators of economic instability, homelessness and food insecurity, are associated with changes in health-related outcomes over a two-year period.

METHODS

The analytic sample (N = 2,182) completed online surveys in 2019-2020 (mean age 23 years) and 2021-2022 (mean age 25 years). Regression analyses were conducted for the full sample, as well as by sexual or gender diverse (SGD) identity (17.8% of sample identified as SGD) and race/ethnicity (76.3% identified as non-White).

RESULTS

At age 23, 8.2% of participants reported homelessness and 31.2% reported food insecurity. In the full sample, homelessness and food insecurity were associated with increased depression, anxiety, physical ailments, and drug problems two years later. A similar pattern emerged for those identifying as non-SGD. The only associations for SGD-identifying participants were food insecurity with increased anxiety, depression, and physical ailments. Racial/ethnic differences indicated that homelessness was associated with increased depression and anxiety among Hispanics, and physical ailments and drug consequences among Asians, but fewer drug problems among Whites. Food insecurity was associated with increased depression in all racial/ethnic groups, anxiety among Hispanics and Asians, physical ailments among Whites and Asians, and drug problems among Asians.

DISCUSSION

Homelessness and food insecurity predicted worse health outcomes during the transition to adulthood, with varying results across SGD and racial/ethnic subgroups. It is important for future research to continue examining long-term effects of economic instability on health disparities during this important developmental period.

Mental Telehealth Utilization Patterns Among High School Students from Racial and Ethnic Minority Backgrounds Affected by Violence and Substance Use

BACKGROUND

Recent data show high school students from racial and ethnic minority (REM) backgrounds in the United States confront a twofold challenge, marked by the highest rates of firearm-related homicides since 1994 and increased youth substance use. The pandemic increased online and telehealth usage opportunities for at-risk REM youth. Therefore, this study investigated (1) the frequency and prevalence of co-occurring youth violence and substance use among REM adolescents, (2) racial/ethnic, age, and natal sex (as gender data was not collected) differences in patterns and trends in co-occurring youth violence and substance use among REM adolescents, and (3) the relationship between these syndemic issues and REM adolescent mental telehealth use during the pandemic.

METHODS

Data was sourced from a nationally representative sample of U.S. 9th-12th students (n = 3241) who completed the CDC's 2021 Adolescent and Behavioral Experiences Survey (ABES). Using univariate (frequency distribution), bivariate (Pearson's chi-squared test), and multivariate logistic regression models, we examined seven violence victimization outcomes, four violence perpetration outcomes, two family violence outcomes, and six substance use outcomes and their associations with telehealth use for mental health (dependent variable) among REM adolescents.

RESULTS

This sample was primarily female (50.7%), Black or African American (48.3%), Hispanic or Latinx (20.6%), and identified as straight or heterosexual (69.5%). The study found significant sex-based differences in violence perpetration/victimization, substance use, and telehealth use for mental health. In general, mental telehealth use was significantly associated with substance use among REM adolescents (cigarette smoking, vaping, alcohol, marijuana, prescription meds, and illicit drug use) (p-value = .001). Mental telehealth use was also significantly associated with all peer and family violence outcomes (p < 0.001). Controlling for covariates, gun carrying was associated with 4.8 times higher odds of using mental telehealth. Students in a physical fight or carrying a weapon (gun, knife, or club) on school property had 2.45 times and 8.09 times the odds of utilizing mental telehealth. Bullied students were 2.5 times more likely to use mental telehealth (p-value < 0.05). Illicit drug use (cocaine, heroin, methamphetamines, and ecstasy) was associated with a higher likelihood of mental telehealth use (AOR = 1.3, p-value = .05).

CONCLUSION

Our results suggest crucial insights for shaping violence and substance use prevention strategies, with implications for the future of online and telehealth behavioral services. Mental telehealth help-seeking emerges as a crucial avenue for supporting adolescents affected by violence and substance use, especially when they face obstacles to accessing traditional services. It can work in tandem with in-person services to address these challenges.

Directional associations between posttraumatic stress disorder symptoms and cannabis use in young adults: Uncovering variation by sex, race, and ethnicity

OBJECTIVE

Prevalence rates of cannabis use and PTSD vary, with men reporting greater cannabis use than females, females reporting higher rates of PTSD than males, and race and ethnic minority persons reporting higher rates of both cannabis and PTSD compared to non-Hispanic White individuals. This study extends our understanding of directional associations between cannabis use and PTSD from early to late young adulthood (18-26 years old) using two theoretical models: symptom-driven pathway and substance-induced pathway.

METHOD

Participants provided yearly data for 14 years, and the present study utilized data from Waves 9 through 14. Those endorsing Criterion A in at least one wave of data collection (n = 1,454) were included in the analytic sample. We used autoregressive latent trajectory with structured residuals to understand reciprocal associations for the full sample, as well as by sex and race or ethnicity.

RESULTS

For the full sample, we noted support for both symptom-driven and substance-induced pathways during early young adulthood (18-20) but only support for a symptom-driven pathway during late young adulthood (21-26). Males showed the same pattern as the full sample; however, for females, only a symptom-driven pathway during late young adulthood was found. For race and ethnic minority participants, we showed full cross-lagged effects during both early and late young adulthood and no associations for non-Hispanic White individuals.

CONCLUSIONS

Results indicate that both men and individuals from minoritized racial and ethnic groups are more likely to report heightened PTSD symptomology, maladaptive coping, and worsening symptoms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).