Alcohol use and binge drinking among Hispanic/Latino subculture youth, and the differences in the affect of acculturation Hal Johnson, MPH Florida Substance Abuse Program Office and the FSU Florida Center for Prevention Research June 4, 2012 Council of State and Territorial Epidemiologists Omaha, Nebraska
Background Risky behaviors vary among different races/ethnicities Hispanic ethnicity is a growing portion of the US population Many programs/interventions have been developed to reduce risky behaviors, including underage drinking, among Hispanic youth.
Background However, most of these programs don t distinguish between Hispanic subcultures Spanish, Mexican, Puerto Rican, Central American and other Hispanic cultures, while sharing some aspects, are different Examining differences between these subcultures in the US is challenging for several reasons
Background Challenges Immigration patterns - limited diversity of Hispanic subcultures in most areas Underage drinking limited age range means limited population Few databases include information on ethnicity at a level lower than Hispanic
Florida Youth Substance Abuse Survey Annually since 2000 Even years County level (~60,000) Odd years State level (~8,000) Grades 6 through 12 Based on Communities That Care Survey
Florida Youth Substance Abuse Survey How do you describe yourself? (You can choose one answer, or more than one) American Indian/Native American or Alaska Native Asian Black/African American Spanish/Hispanic/Latino Native Hawaiian or other Pacific Islander White/Caucasian Other
Florida Youth Substance Abuse Survey Which one of these ethnic groups BEST describes you? (Choose only one answer) Central American (Guatemalan, Nicaraguan, Honduran, for example) Cuban or Cuban American Dominican Mexican or Mexican American Puerto Rican Other Hispanic, Latino or Spanish origin Haitian West Indian or Caribbean None of these
Florida Youth Substance Abuse Survey Consistent differences by race/ethnicity Whites use at the highest rate Black youth use at lowest rate Hispanic youth use at a slightly lower rate than non-hispanic Whites Similar results from other school based surveys such as Monitoring the Future
Florida Youth Substance Abuse Survey
Florida Youth Substance Abuse Survey Binge Drinking by 6th - 12th graders in Florida, 2010 20.0% 16.6% 15.1% 9.7% 0.0% White Black Hispanic
Hispanic Youth Population Trend * Source: Florida Office of Economic and Demographic Research (Age 10-17)
Florida youth Ethnicity (FYSAS)
Hispanic Subcultures among Florida youth (FYSAS)
Data Considerations Use even year data Exclude 2000 Changes made in race/ethnic variables Compare each year for variations Combine years Weight to adjust for sample size
Population Proportion Across Years
Combined Dataset Ethnicities Hispanic Hispanic Non-Hispanic Total N Total N 2002 2002 10,467 62,934 10,467 2004 12,140 48,205 52,467 60,345 62,934 2004 2006 12,684 43,668 56,352 12,140 2008 20,343 70,351 48,205 90,694 60,345 2006 2010 16,563 56,234 72,797 12,684 43,668 Combined 72,197 270,925 343,122 56,352 2008 20,343 70,351 90,694 2010 16,563 56,234 72,797 Combined 72,197 270,925 343,122
Past-30-day Alcohol Use
Binge Drinking
Odds Ratios Past-30-day alcohol use 99% C.I. OR Lower Upper Central American.792.749.838 * Cuban.919.877.962 * Dominican.825.758.897 * Mexican.865.817.917 * Puerto Rican.871.832.912 * Other Hispanic 1.039.995 1.086 Binge Drinking 99% C.I. OR Lower Upper Central American.797.742.857 * Cuban.829.782.879 * Dominican.854.768.948 * Mexican 1.021.952 1.095 Puerto Rican.838.791.889 * Other Hispanic.981.929 1.036 * p <.001 Reference Group: Non-Hispanic White Control Variables: Age Gender Mother s education Father s education
Acculturation Coatsworth and Maldonado-Molina. J Community Psychol. 2005. 33(2).
Acculturation Acculturation has been implicated as a risk factor for substance use and other unhealthy behaviors 1990 to 2000 Hispanic Population Growth* 50% increase in # American-born Hispanics 81% increase in # born in other countries In 2000, 40% of all Hispanics and 54% of southern US Hispanics were foreign born* *Saenz, R. www2.asanet.org/public/saenz_brief.ppt
Acculturation Length of time in the US related to less acculturation Language spoken at home is reasonable proxy for length of time in US and acculturation FYSAS has one question on language spoken at home
Acculturation FYSAS question: What is the language you use most often at home? English Spanish Another Language
Language Spoken at Home Frequency Percent English Spanish English Spanish Central American 10830 2254 82.8 17.2 Cuban 5807 3402 63.1 36.9 Dominican 2078 1333 60.9 39.1 Mexican 6946 7966 46.6 53.4 Puerto Rican 10807 4720 69.6 30.4 Other Hispanic 6446 5894 52.2 47.8 ALL HISPANIC 42914 25569 62.7 37.3
Past-30-day Use and Binge Drinking by Language Spoken at Home All Hispanic Youth
Odds Ratios Language Spoken at Home ALL HISPANIC YOUTH 99% C.I. OR Lower Upper Past-30-day Alcohol.917.881.956 * Binge Drinking.975.926 1.026 *p<.001 OR Group: Speak Spanish at Home Reference Group: Speak English at Home Control Variables: Age Gender Mother s education Father s education
Past-30-Day Alcohol Use by Language Spoken at Home
Binge Drinking by Language Spoken at Home
Odds Ratios Language Spoken at Home Past-30-day alcohol use 99% C.I. OR Lower Upper Central American.934.833 1.047 Cuban.855.783.933 * Dominican 1.016.859 1.203 Mexican.760.680.851 * Puerto Rican.898.816.988 ** Other Hispanic.948.871 1.032 Binge Drinking 99% C.I. OR Lower Upper Central American.791.681.919 * Cuban.942.841 1.055 Dominican.976.789 1.207 Mexican.869.759.995 ** Puerto Rican 1.001.886 1.130 Other Hispanic 1.039.934 1.155 *p<.001 **P<.01 OR Group: Speak Spanish at Home Reference Group: Speak English at Home Control Variables: Age Gender Mother s education Father s education
Summary All Hispanic youth in Florida drink and binge drink at a rate between NH-Whites and NH- Blacks But there are differences among the Hispanic subcultures Central American youth less likely to drink or binge than others Other Hispanic youth more likely to drink or binge than others Mexican youth more likely to binge than others
Summary Hispanics speaking Spanish at home less likely to report past-30-day use, but not binge drinking Subculture differences: Cuban, Mexican and Puerto Rican youth show past-30-day acculturation affect Central American and Mexican youth show binge drinking acculturation affect No other significant differences
Conclusions FYSAS provides an excellent opportunity to investigate AOD use and other risky behavior among Hispanic subpopulations Large and growing Hispanic youth population More diverse Hispanic population than most states Annual youth survey with large N and useful ethnicity and acculturation questions
Conclusions Hispanic youth are not homogeneous There are differences in alcohol use and binge drinking among subcultures There are differences in the affect of acculturation on likelihood to drink or binge drink Taking subculture into account can add to the effectiveness of targeted prevention programs