Regional Concerns for Underage Drinking: Risks of Race & Ethnicity

Regional Concerns for Underage Drinking: Risks of Race & Ethnicity Presented by Delia Saldaña, Ph.D. University of Texas Health Science Center Department of Psychiatry June 21, 2006

Target Population SAFB Bexar County Texas U.S. Population 1.3 million 20.9 million 293.7 million Hispanic 89% 74% 32% 13% Caucasian Not Hispanic African American 3% 24% 52% 69% 6% 14% 12% 12% Asian 0% 18% 2% 2% American Indian 0% 2% 2% 9%

Texas Youth (Age 0-17) Population Projection: 2000-2040 6,000,000 anglo black hispanic 5,000,000 4,000,000 3,000,000 2,000,000 1,000,000 0 Source: TxHHSC/State Data Center YEAR 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039

100% STATEWIDE Risks for Students in Grades 7-12 Trends in Lifetime Use 80% 60% 40% 20% 0% 76% 81% 76%74%73%72%71%71% 68% Alcohol Tobacco Any Illicit Drug Marijuana Inhalants 1988 1990 1992 1994 1996 1998 2000 2002 2004 2004 Texas School Survey G7-12 (Prelim)

STATEWIDE Risks for Students in Grades 7-12 Trends in Past-Month Use 50% 40% 30% 20% Alcohol Tobacco Any Illicit Drug Marijuana Inhalants 10% 0% 1988 1990 1992 1994 1996 1998 2000 2002 2004 2004 Texas School Survey G7-12 (Prelim)

Regional Realities Texas is the drunkest state in the nation Texas has the largest number of alcohol related fatalities in the U.S Region 6 (Houston) has higher than average rates of alcohol use Region 7 (Austin) leads the state in marijuana use In 2000, Region 8 (San Antonio) had the highest rate of cocaine abuse Racial & ethnic risk for substance abuse varies 2003 National Survey on Drug Use & Health 2004 Texas Survey of Substance Use among Adults Behavioral Risk Factor Surveillance Survey

STATEWIDE Students Report Lifetime Use Tobacco, Alcohol, Inhalants, and Illicit Drugs 80% 70% 72% 66% 66% 60% 50% 40% 30% 20% 10% 0% 45% 39% 37% 30% 29% 30% 20% 16% 12% Tobacco Alcohol Inhalants Any Illicit Drug Anglos Hispanics African Americans 2004 Texas School Survey G7-12 (Prelim)

80% STATEWIDE Students Report Past-Month Use Tobacco, Alcohol, Inhalants, and Illicit Drugs 70% 60% 50% 40% 30% 20% 10% 20% 9% 19% 36% 33% 27% 6% 5% 8% 17% 14% 12% 0% Tobacco Alcohol Inhalants Any Illicit Drug Anglos Hispanics African Americans 2004 Texas School Survey G7-12 (Prelim)

Local Realities Texas has the largest number of alcohol related fatalities in the U.S Bexar is 1 of the 13 counties with highest rates of alcoholrelated traffic fatalities Over the past 3 years, 84% of tickets have been for DWI In 2006, 47% of crashes were alcohol-related Hispanics also have highest prevalence on most drugs San Antonio is the drunkest city nationwide Hispanics drink more than Anglos or African Americans Bexar County Sheriff s Office Texas DSHS Epi Workgroup

Priority Problem Areas: Driving & Alcohol Age is a risk factor Drivers age 35-54 had highest number involved in fatalities 29% were alcoholrelated Highest rate of intoxication is among young adults age 21-29 % of intoxicated drivers varies by age % Youth are growing in Bexar County

Binge Drinking Highest rate of intoxication is among young adults age 21-29 Their peers not in college consumed less (35%) 40% of college students report consuming 5+ drinks at least once in the past 2 weeks SAFB data suggests high drinking rate starts in middle school Binge drinking was lower but still worrisome among high school students (31%) Number of underage drunk drivers involved in fatalities is higher (31.4%) than state average (29.3%)

Students Use of Alcohol and Related Problems Differ by Ethnicity 40% 35% 30% 25% 33% 27% 36% 25% 27% Anglos African Americans Hispanics 20% 15% 10% 5% 12% 16% 5% 15% 9% 8% 11% 0% Past-Month Binge Alcohol Drinking Use (5+ drinks at Driving one time) While Drunk Attending Class While Drunk * * Including students in grades 9-12 only. 2004 Texas School Survey G7-12 (Prelim)

Students Use of Illicit Drugs and Related Problems Differ by Ethnicity 20% 16% 12% Anglos African Americans 16.8% Hispanics 15.6% 13.9% 13.2% 12.0% 12.5% 11.3% 11.8% 8% 4% 7.0% 7.4% 6.0% 6.4% 0% Past-Month Illicit Heavy Drug Drug Use Use (Daily/Weekly) Driving While High Attending on Drugs Class While High * * Including students in grades 9-12 only. 2004 Texas School Survey G7-12 (Prelim)

So What s the Good News?

Risk and Protective Factors Related to Substance Use (Youth s Beliefs, Norms, and Values) Perceived Availability of Substances Perceived Danger (Risk) of Substances Perceived Parental Attitudes Parental Attendance at School Events Perceived Peer Use, Values, and Behaviors Perceived Environmental Safety Participation in Extracurricular Activities 2002 Texas School Survey G7-12

Students Must Receive More Information 1.0 0.8 0.6 0.4 0.8680 0.8080 0.7910 0.7480 70% 60% 0.6500 0.6650 50% 0.60600.5951 40% 30% 3.5% Others 22.9% 8.5% Hispanics African Americans 0.2 20% 10% 24.6% Anglos 0% 0 1990 1992 1994 1996 1998 2000 2002 2004 Info reported from any school source 2004 Texas School Survey G7-12 (Prelim)

Messages Count 100% 80% 73% 60% 61% 66% 40% Alcohol Very/Somewhat Easy to Obtain Very Dangerous to Use Disapproved of by Their Parents 42% 58% 45% 80% 81% 76% 20% 0% Perceived Availability Perceived of Alcohol Danger Perceived of Using Parental Alcohol Disapproval of Drinking Anglos Hispanics African Americans 2004 Texas School Survey G7-12 (Prelim)

Education Works 60 40 20 0 Pre 6th Post Pre 7th Post Pre 8th Post Alcohol Getting Drunk Tobacco Impacting Attitudes throughout Middle School Impacting Attitudes from Fall to Spring 40 20 0 Pre 6th Post Pre 7th Post Pre 8th Post Alcohol Tobacco Marijuana

Community Awareness SAFB SIG Results 25 20 15 10 5 0 Sense of Community Mobilization 2004 Capacity Readiness for - Action 2005

Establishing a Pipeline Reduce Binge Drinking Reduce Alcohol-related Traffic Fatalities Establish community and academic coalition partnership Begin education in 4 middle schools Continue with education in 2 high schools Expand undergraduate education to 5 private universities Create mentoring opportunities for high risk youth Increase college student awareness of substance abuse impact Inform empowerment research based on community needs

Closing Comments The perception of using substances as well as their use and consequences vary by race and culture. Culturally competent approaches must address needs that differ regionally & locally. Beyond individual personal beliefs, parents and family also play an important role. Prevention planning should address cultural competence in family structure and identity, family dynamics, and parenting styles. Tools for bridging the gap between teachers/educators (schools) and non-english-speaking family members/ students are in need to transmit prevention messages. Professional practitioners and evaluators must respect and respond to the cultural diversity of communities and persons served; and maximizing linguistically appropriate staff will be a plus.

Regional Policy Forum 2006 Delia Saldaña, Ph.D. University of Texas Health Science Center saldana@uthscsa.edu (210) 567-5466