Alcohol Use Severity among Hispanic Emerging Adults: Examining Intragroup Marginalization, Bicultural Self-Efficacy, and the Role of Gender within a Stress and Coping Framework.

Most research on cultural stressors and alcohol has focused on intercultural stressors. Continuing to exclude intracultural stressors (e.g., intragroup marginalization) from alcohol research will yield a biased understanding of the experiences of Hispanics living in a bicultural society. As we amass more studies on intracultural stressors, research will be needed to identify mutable sociocultural factors that may mitigate the association between intracultural stressors and alcohol. To address these limitations, we examined the association between intragroup marginalization and alcohol use severity and the extent to which gender and bicultural self-efficacy may moderate this association. A convenience sample of 200 Hispanic emerging adults ages 18-25 (men = 101, women = 99) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Higher intragroup marginalization was associated with higher alcohol use severity. Gender functioned as a moderator whereby intragroup marginalization was associated with higher alcohol use severity among men, but not women. Also, higher social groundedness functioned as a moderator that weakened the association between intragroup marginalization and alcohol use severity. Role repertoire did not function as a moderator. Our findings are significant because they enhance the reliability of the association between intragroup marginalization and alcohol use severity, and the moderating effect of gender in this respective association. This emerging line of research suggests that alcohol interventions targeting Hispanics may have a significant limitation by not accounting for intracultural stressors.

Socioeconomic inequalities and Black/White disparities in US cocaine-involved overdose mortality risk.

PURPOSE: This study examined whether socioeconomic inequalities account for Black/White disparities in: (a) the prevalence of potential risk factors for overdose among adults using cocaine; and (b) national mortality rates for cocaine-involved overdose. METHODS: Data from 2162 Non-Hispanic (NH) Black or White adults (26 +) who reported past-year cocaine use in the 2015-2019 National Survey of Drug Use and Health were analyzed to obtain predicted probabilities of potential overdose risk factors by race and sex, using marginal effects via regression analyses, adjusting for age and socioeconomic indicators. Next, National Center for Health Statistics data (for 47,184 NH Black or White adults [26 +] who died of cocaine-involved overdose between 2015 and 2019) were used to calculate cocaine-involved overdose mortality rates by race and sex across age and educational levels. RESULTS: Several potential overdose vulnerabilities were disproportionately observed among NH Black adults who reported past-year cocaine use: poor/fair overall health; cocaine use disorder; more days of cocaine use yearly; hypertension (for women); and arrests (for men). Adjusting for age and socioeconomic indicators attenuated or eliminated many of these racial differences, although predicted days of cocaine use per year (for men) and cocaine use disorder (for women) remained higher in NH Black than White adults. Cocaine-involved overdose mortality rates were highest in the lowest educational strata of both races; nonetheless, Black/White disparities were observed even at the highest level of education, especially for adults ages 50 + . CONCLUSION: Age and socioeconomic characteristics may account for some, yet not all, of Black/White disparities in vulnerability to cocaine-involved overdose.

Trends in substance use and prevention education involvement among U.S. adolescents receiving public assistance: new evidence.

PURPOSE: The present study aimed to examine the substance use prevention education involvement in different social settings among adolescents receiving public assistance-cash or food voucher-for low household income (heretofore, "PA program enrollees") and preventive effects of each prevention educational setting on current substance use. METHODS: Using data from a nationally-representative sample of PA program enrollees from the 2002-2017 National Survey on Drug Use and Health, we estimated the prevalence of substance use prevention education involvement in home, school, and neighborhood settings and the associations between involvement in each educational setting and current alcohol/illicit drug use. RESULTS: Compared to nonenrollees, PA program enrollees reported significantly lower rates of involvement in all prevention education settings, including parent-child conversations (54.6% vs. 60.1%) and neighborhood prevention resources (71.3% vs. 79.3%). All educational setting were associated with lower odds of current substance use, with the largest effects found for parent-child conversations (AOR = 0.821 [P < .001] for alcohol use; AOR = 0.817 [P < .001] for illicit drug use). CONCLUSIONS: To reduce the elevated risk of illicit drug use among PA program enrollees, special attention needs to be paid to promote parent-child conversation about substance use and increase access to prevention education in regular classes and preventive messages outside schools.

Cultural Stress Theory in the Context of Family Crisis Migration: Implications for Behavioral Health with Illustrations from the Adelante Boricua Study.

On September 20, 2017, Hurricane Maria made landfall in Puerto Rico as a Category 4 hurricane with sustained winds of 155 miles per hour and torrential rains that ravaged the United States territory. In the midst of the crisis, several hundred thousand Maria survivors boarded humanitarian flights and cruise ships, seeking refuge on the United States mainland. More than three years later, tens of thousands of post-Maria migrants remain on the mainland as long-term emigres. In this article, we lay the theoretical/conceptual groundwork for researchers and practitioners interested in understanding the experiences of post-Maria migrants. Specifically, we aim to assist readers in thinking deeply about: [1] why many Puerto Ricans relocated, [2] the experiences of post-Maria migrants en movimiento, and [3] how such experiences shape their lives, behavior, and well-being. In understanding the experiences of post-Maria migrants, several theories/constructs emerge as especially salient. These include "push and pull" models, cultural stress theory and its transnational variants, the concept of crisis migration, and models of cumulative risk. We provide a succinct overview of each of these theories/constructs and describe the broad perspectives that serve as a foundational or orienting paradigm for our work (i.e., the life course perspective, the strengths perspective, and an ecodevelopmental framework). Finally, we provide illustrations of how these theories/concepts apply to emerging data from the Adelante Boricua study, an ongoing research project with post-Maria migrant youth and their parents, supported by funding from the National Institute on Minority Health and Health Disparities.

Substance Misuse Profiles of Women in Families Receiving Temporary Assistance for Needy Families (TANF) Benefits: Findings from a National Sample.

OBJECTIVE: Women in families receiving Temporary Assistance for Needy Families (TANF) cash assistance are twice as likely to have a substance use disorder (SUD) than their non-TANF counterparts in the past year. However, evidence is limited about substance misuse patterns and comorbid mental health problems among women in TANF families. METHOD: Data from the 2015-2018 National Survey on Drug Use and Health were used to examine the prevalence of substance misuse and use disorders among women age 18 or older in TANF families. We used latent class analysis to identify subgroups of distinctive substance misuse behaviors and tested the associations between SUD/serious psychological distress (SPD) and the group classification. RESULTS: Despite higher odds of having an SUD in all substance categories than their non-TANF counterparts, more than 84% of the women in TANF families were considered to have low substance misuse risks. Of the three identified at-risk groups, the polysubstance and the prescription pain reliever and alcohol misuse groups reported higher risks of having an SUD and SPD than the low-risk group. Individuals at risk of marijuana and alcohol misuse, represented by young, Black mothers, reported the lowest rates of treatment receipt despite having past-year SUD, SPD, or both. CONCLUSIONS: Although special attention needs to be paid to integrated care for those at risk of multiple substance misuse, additional efforts are required to increase substance abuse and mental health treatment among women at risk of marijuana and alcohol misuse.

Trends and Correlates of Youth Violence-Prevention Program Participation, 2002-2016.

INTRODUCTION: Adolescent participation in violence-prevention programming is critical in addressing the nation's elevated rates of youth fighting and violence. However, little is known about the secular trends and correlates of violence-prevention program participation in the U.S. Using national data, the authors examined the year-by-year trends and correlates of participation among American adolescents over a 15-year span. METHODS: National trend data (2002-2016) were analyzed on non-Hispanic black/African American (n=35,216), Hispanic (n=45,780), and non-Hispanic white (n=153,087) youth aged 12-17years from the National Survey on Drug Use and Health in 2018. Consistent with the Centers for Disease Control and Prevention's trend analysis guidelines, the authors conducted logistic regression analyses with survey year specified as an independent variable and youth violence-prevention program participation specified as the dependent variable, while controlling for sociodemographic factors and other key correlates. RESULTS: Youth participation in violence-prevention programs decreased significantly from 16.7% in 2002 to 11.7% in 2016, a 29% relative decrease in participation. A significant declining trend in participation over time was found across all sociodemographic subgroups examined and among youth reporting the use of violence and no use of violence in the past year. Participation among black/African American youth was significantly greater than Hispanic youth who, in turn, had significantlyhigher participation rates than white youth. CONCLUSIONS: Youth participation in violence-prevention programming has decreased in recent years, with particularly large declines observed among younger adolescents (aged 12-14 years), youth in higher-income households, and youth reporting no past-year use of violence.

Trends and correlates of perceived access to heroin among young adults in the United States, 2002-2016.

BACKGROUND: We are at a unique moment in United States (US) history as heroin overdose rates are higher than at any time in recent memory. Based on prior research and the developmental risks faced by young adults (ages 18-25), we examine the trends and correlates of perceived access to heroin among this group over a 15-year period. METHODS: We analyzed national trend data from the National Survey on Drug Use and Health (2002-2016) on young adults' (N = 247,679; ages 18-25) perceived access to heroin. We conducted logistic regression analyses with survey year specified as an independent variable and heroin access specified as the dependent variable while controlling for sociodemographic factors. RESULTS: A majority of respondents reported that it would be difficult or impossible to obtain heroin, if desired. Young adult reports that it would be "probably impossible" to access heroin increased significantly from 31% in 2002 to 41% in 2016. The upward trend in the perceived lack of access was most robust among African Americans and Hispanics as well as those reporting no past-year substance use or drug/criminal justice system involvement. CONCLUSIONS: In the midst of a very serious opioid epidemic, the present study found that most young adults in the US consider that it would be "probably impossible" to obtain heroin. This trend was observed across young adulthood and across gender, racial/ethnic, and family income differences. However, we found that these trends are largely driven by those at relatively low risk of drug misuse and deviant behaviors generally.

A Social Work Approach to Policy: Implications for Population Health.

The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health.

Trends in Fighting and Violence Among Adolescents in the United States, 2002-2014.

OBJECTIVES: To examine trends in and correlates of fighting and violence among youths from the 3 largest racial/ethnic groups in the United States. METHODS: We derived race/ethnicity-specific prevalence estimates for fighting, group fighting, and attacks with intent to harm from the National Survey on Drug Use and Health, a population-based study of youths aged 12 to 17 years. RESULTS: The prevalence of youth fighting and violence decreased significantly in all racial/ethnic groups over the study period (2002-2014), dropping from a high of 33.6% in 2003 to a low of 23.7% in 2014, reflecting a 29% decrease in the relative proportion of young people involved in these behaviors. However, there was also a clear severity gradient in which year-by-year point estimates for fighting and violence were consistently highest among non-Hispanic African American youths, followed by Hispanic and then non-Hispanic White youths. CONCLUSIONS: Although fighting and violence are on the decline among young people in general and across racial/ethnic subgroups, there is a stable pattern of disparities in youth involvement in these behaviors.

Adverse Childhood Experiences Among Immigrants to the United States.

A growing number of studies have examined the "immigrant paradox" with respect to health behaviors in the United States. However, little research attention has been afforded to the study of adverse childhood experiences (ACE; neglect, physical and sexual abuse, and witnessing violence) among immigrants in the United States. The present study, using Waves I and II data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), aims to address these gaps by comparing forms of ACE of first- and second-generation immigrants with native-born American adults in the United States. We also examined the latent structure of ACE among immigrants and conducted analyses to assess the psychiatric correlates of identified latent classes. With the exception of neglect, the prevalence of ACE was markedly higher among native-born Americans and second-generation immigrants compared with first-generation immigrants. Four latent classes were identified-limited adverse experience ( n = 3,497), emotional and physical abuse ( n = 1,262), family violence ( n = 358), and global adversity ( n = 246). The latter three classes evinced greater likelihood of being diagnosed with a mood, anxiety, personality, and substance use disorder, and to report violent and non-violent antisocial behavior. Consistent with prior research examining the associations between the immigrant paradox and health outcomes, results suggest that first-generation immigrants to the United States are less likely to have experienced physical and sexual abuse and witness domestic violence. However, likely due to cultural circumstances, first-generation immigrants were more likely to report experiences that are deemed neglectful by Western standards.

Handgun carrying among White youth increasing in the United States: New evidence from the National Survey on Drug Use and Health 2002-2013.

The objective of the present study was to examine trends and correlates of handgun carrying among adolescents ages 12-17 in the United States. Data was derived from the National Survey on Drug Use and Health (NSDUH) involving non-Hispanic White, African American, and Hispanic respondents ages 12-17 (n=197,313) and spanning the years 2002-2013. Logistic regression was used to examine significance of trend year and correlates of previous 12-month handgun carrying. The overall self-reported prevalence of handgun carrying was 3.4%. The prevalence of handgun carrying during 2004-2005 was significantly higher for African-Americans (4.39%) compared to non-Hispanic Whites (3.03%). However, by 2012-2013, non-Hispanic Whites (4.08%) completely diverged and reported carrying handguns significantly more than both African-American (2.96%) and Hispanic (2.82%) youth. Male gender and a number of externalizing behaviors were significant correlates of handgun carrying; however, we also found evidence of differential correlates with regard to such factors as drug selling, parental affirmation, and income by race/ethnicity. To our knowledge, this is the largest study of handgun carrying among youth in the United States. Findings indicate that although at historically low levels handgun carrying is on the rise but only among non-Hispanic Whites. Differential correlates among racial/ethnic groups suggest prevention programming and policies may need modifications depending on group and geographic locale targeted.

Bullying Victimization Among School-Aged Immigrant Youth in the United States.

PURPOSE: Bullying is a serious sociodevelopmental issue associated with a range of short- and long-term problems among youth who are bullied. Although race and ethnicity have been studied, less attention has been paid to examining prevalence and correlates of bullying victimization among immigrant youth. METHODS: Using data from the Health Behavior in School-Aged Children (N = 12,098), we examined prevalence and correlates of bullying victimization among U.S. immigrant youth. RESULTS: After controlling for several demographic variables, findings indicate that immigrant youth are more likely to experience bullying victimization than native-born youth. Furthermore, immigrant youth who experience bullying victimization were more likely to report interpersonal, socioemotional, health, and substance use problems. CONCLUSIONS: Given the greater risk and unique challenges experienced by immigrant youth, prevention and intervention programs may need to be tailored to their specific needs and circumstances. Further research is needed to understand the specific factors and mechanisms involved in bullying victimization among immigrant youth.

Poor sleep and reactive aggression: Results from a national sample of African American adults.

BACKGROUND: We know that poor sleep can have important implications for a variety of health outcomes and some evidence suggests a link between sleep and aggressive behavior. However, few studies have looked at this relationship among African-Americans in the United States. METHODS: Data from the National Survey of American Life (NSAL) and the NSAL Adult Re-Interview were used to examine associations between sleep duration and self-reported quality of sleep on reactive aggression among African American and Caribbean Black respondents between the ages of 18 and 65 (n = 2499). RESULTS: Controlling for an array of sociodemographic and psychiatric factors, sleep was found to be significantly associated with reactive aggression. Specifically, individuals who reported sleeping on average less than 5 h per night were nearly three times more likely to report losing their temper and engaging in a physical fight (AOR = 3.13, 95% CI = 1.22-8.02). Moreover, individuals who reported being "very dissatisfied" with their sleep were more than two times more likely to report losing their temper and engaging in physical fights (AOR = 3.32, 95% CI = 1.50-7.33). Persons reporting everyday discrimination and problems managing stress were more likely to sleep poorly. CONCLUSIONS: The present study is among the first to document an association between poor sleep and reactive violence among African-Americans. Findings suggest that reducing discrimination may lead to improved sleep and subsequently reduce forms of reactive violence.

Religiosity and violence among adolescents in the United States: findings from the national survey on drug use and health 2006-2010.

There is a pressing need to develop a more nuanced understanding of the relationships between particular expressions of religiosity and the various manifestations of violence among youth. This study examines these relationships among adolescents in the general population as well as across racial/ethnic, gender, and family income differences. Using a nationally representative sample of adolescents (N = 90,202) from the National Survey on Drug Use and Health (2006-2010), logistic regression is used to examine the relationships between religiosity and violence. Results indicate that multiple components of adolescent religiosity are associated with the decreased likelihood of fighting, group fighting, and, to a lesser extent, violent attacks. A number of noteworthy differences were identified across race/ethnicity, gender, and family income. Findings from this investigation shed light on the relationship between particular facets of religiosity and violence that may be useful for violence prevention organizations seeking to integrate religious components into intervention efforts.

The immigrant paradox: immigrants are less antisocial than native-born Americans.

PURPOSE: Although recent research on crime and violence among immigrants suggests a paradox--where immigrants are more socially disadvantaged yet less likely to commit crime--previous research is limited by issues of generalizability and assessment of the full depth of antisocial behavior. METHODS: We surmount these limitations using data from waves I and II of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and compare immigrants (N = 7,320) from Asia, Africa, Europe, and Latin America to native-born Americans (N = 34,622) with respect to violent and nonviolent forms of antisocial behavior. RESULTS: After controlling for an extensive array of confounds, results indicate that immigrants are significantly less antisocial despite being more likely to have lower levels of income, less education, and reside in urban areas. These findings hold for immigrants from major regions of the world including Africa, Asia, Europe, and Latin America. CONCLUSIONS: This study confirms and extends prior research on crime and antisocial behavior, but suggests that it is premature however to think of immigrants as a policy intervention for treating high crime areas.

Prevalence and correlates of truancy in the US: results from a national sample.

Truancy has been a persistent problem in the United States for more than 100 years. Although truancy is commonly reported as a risk factor for substance use, delinquency, dropout, and a host of other negative outcomes for youth, there has been surprisingly little empirical investigation into understanding the causes and correlates of truancy using large, nationally representative samples. Using the adolescent sample (N = 17,482) of the 2009 National Survey on Drug Use and Health (NSDUH), this study presents the prevalence of truancy and examines individual, school engagement, parental, and behavioral correlates of truancy. Overall, 11% of adolescents between the ages of 12-17 reported skipping school in the past 30 days. Results from multinomial logistic regression models indicate skipping school was robustly associated with an increased probability of reporting externalizing behaviors, less parental involvement, and engagement and lower grades in school. Implications for theory, prevention, and policy are discussed.

Buckle up: non-seat belt use and antisocial behavior in the United States.

OBJECTIVE: To compare persons who report that they never wear a seat belt while driving or as a passenger with those who do in a nationally representative sample in the United States. Our guiding hypothesis is that failure to wear a seat belt is part of an antisocial behavior spectrum. METHODS: Using public-use data from the 2010 National Survey on Drug Use and Health, this study employed binary logistic regression with adjustments for complex survey sampling to assess relationships between never wearing a seat belt and sociodemographic variables, antisocial behaviors, substance abuse and co-occurring problems, and criminal justice system contact. RESULTS: Individuals who do not wear seat belts are younger, more likely to be male, less likely to be African American or Hispanic, have incomes of less than $75,000, and be a high school or college graduate. After controlling for the effects of age, gender, race, income, education, and population density, individuals reporting that they never wear a seat belt while driving or as a passenger are more likely to report using alcohol and drugs (adjusted odds, 1.61-2.56), committing antisocial behaviors including felony offenses (adjusted odds, 2.13-3.57), and possess a dual diagnosis (adjusted odds, 1.62-1.73). CONCLUSIONS: Findings indicate that non-seat belt use is convergent with a spectrum of serious antisocial behavior and comorbid psychological distress. Importantly, results suggest that standard seat belt use policies and campaigns may not be effective for non-seat belt using individuals and a targeted approach may be needed.

Who are truant youth? Examining distinctive profiles of truant youth using latent profile analysis.

The present study explored the heterogeneity of truant youth to provide a more nuanced examination of the nature of adolescent truancy and examine distinct profiles of truant youth as they relate to externalizing behaviors. Latent profile analysis was employed to examine the heterogeneity of truant youth by using a nationally representative sample of 1,646 truant adolescents (49.8 % female) from the 2010 National Survey on Drug Use and Health. Five key indicator variables were utilized to identify latent classes: school engagement, participation in school-based activities, grades, parental academic involvement, and number of school days skipped. Additionally, multinomial regression was employed to examine the relationship between latent truant youth classes and externalizing behaviors. Four classes of truant youth were identified: achievers (28.55 %), moderate students (24.30 %), academically disengaged (40.89 %), and chronic skippers (6.26 %). Additionally, group membership was found to be associated differentially with marijuana use, fighting, theft and selling drugs. Results from the present study suggest that truant youth are not a homogenous group, but rather present with different risk profiles as they relate to key indicators, demographic characteristics and externalizing behaviors. Implications for practice, policy and future research are discussed.