Psychosocial and contextual determinants of alcohol and drug use disorders in the National Latino and Asian American Study.

BACKGROUND: In the U.S., Latino and Asian American immigrants and ethnic minorities may be at increased risk for alcohol and drug use disorders (AUDs/DUDs). The role of psychosocial and contextual characteristics as potential factors underlying this increased risk is unresolved.

METHODS: Participants include 4649 adults from the National Latino and Asian American Study. Logistic regression was used to determine the relationship between acculturation, acculturative stress, neighborhood characteristics, family characteristics, and discrimination and AUDs/DUDs. Models were stratified by age of immigration and ethnicity and controlled for demographic and mental health characteristics.

RESULTS: Overall, 9.6% of Latino and 4.1% of Asian participants met criteria for lifetime AUDs/DUDs. Acculturation, family conflict, and discrimination were positively associated with AUDs/DUDs (odds ratios [ORs] and 95% confidence intervals [95%CIs]: 1.80[1.54-2.09], 1.24[1.12-1.36], and 1.54[1.38-1.73]), while neighborhood safety and family cohesion were protective for AUDs/DUDs (ORs[95%CIs]: 0.75[0.66-0.85] and 0.79[0.69-0.90]). Acculturative stress and neighborhood cohesion were not related to AUDs/DUDs. The relationships between family conflict and family cohesion with AUDs/DUDs were attenuated after accounting for other psychosocial and contextual factors. These relationships were generally consistent across ethnic and age of immigration subgroups.

CONCLUSIONS: Factors such as acculturation, discrimination, and neighborhood safety, are robustly and largely universally related to AUDs/DUDs among first and later generation Latino and Asian immigrants. Further research is required to understand how and why these factors relate to risk of substance misuse, and to identify ways to apply these factors in prevention and intervention efforts.