Pre- and Post-Immigration Correlates of Alcohol Misuse among Young Adult Recent Latino Immigrants: An Ecodevelopmental Approach
Abstract
:1. Introduction
1.1. Alcohol Misuse among Latino Immigrants in the United States
1.2. Research Aims
1.3. Theoretical Framework
1.4. Social-Ecological Factors and Alcohol Misuse among Latino Immigrants
1.4.1. Microsystemic Factors
1.4.2. Mesosystemic Factors
1.4.3. Macrosystemic Factors
2. Materials and Methods
2.1. Study Design
2.2. Measures
2.2.1. Microsystem Measures
2.2.2. Mesosystem Measures
2.2.3. Macrosystem Measures
2.3. Statistical Analysis
2.4. Ethical Aspects for Human Subject Research
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Sample Item/Description | Categories | ||
---|---|---|---|
Microsystem | |||
Age | T1 | How old are you? | Recoded binary as ≥25 or ≤25 |
Gender | T1 | What is your gender? | Binary: (0) Male or (1) Female |
Marital Status | T2 | What is your current marital status? 5 categories (i.e., married, single, divorce, widowed) | Recoded as binary (0) Single or (1) Married/Partnered |
Education | T2 | What is the highest grade you completed in school? | 5-point Likert scale ranging from (1) Less than high school to (5) Graduate/Professional Studies |
Employment | T2 | Are you currently employed? | Binary: (1) yes or (0) no |
Income | T2 | Total income in past 3 months | In total US dollars |
Birth country | T1 | Where were you born? (List of 17 possible Latin American countries provided) | Recoded as (1) Cuban, (2) South American or (3) Central American |
Documentation status | T2 | Which of the following best describes your current immigrant status? (List of 10 options (i.e., permanent resident, temporary resident, work visa, students visa, undocumented) | Recoded as binary (0) Undocumented or (1) Documented |
Alcohol misuse | T1 | AUDIT (Alcohol Use Disorders Identification Test). 10 items, Likert Scale. Sample item: In the past 12 months “How often do you have 5 or more drinks on one occasion?” Sum score recoded to cut-off of ≥ 8 indicating alcohol misuse | Recoded binary as ≥8 = (1) alcohol misuse or ≤8 = (0) no alcohol misuse |
Family history of substance use problems | T1 | Effect of substance use on the family members was assessed by determining health, law, or work problems related to the substance use in the father, mother, grandfather, and grandmother. | FHSUP+ = one or more family members with a history of substance use problems. FHSUP− = no family history of substance use problems. |
Mesosystem | |||
Medical Outcomes Study Social Support Scale | T2 | 19 items on a 5-point Likert-type scale (1 = none of the time to 5 = all of the time) Sample item: “How often do you have someone you can count on to listen to you when you need to talk?” | Sum of all items calculated for total scale score. |
Came to the U.S. alone | T1 | “Did you come to the United States alone, with your family or/and with friends?” | (0) Alone (1) With family or with friends |
Macrosystem | |||
Acculturative stress | T2 | Hispanic Stress Index-Immigration Stress Subscale: 18 items ask whether a stressor occurred (1) yes or (0) no. Follow up appraisal item rates how stressful the experience was on a 5-point Likert-type scale ranging from (1 = not at all to 5 = extremely). Sample item: “Because my poor English, it has been difficult for me to deal with day to day situations.” | Sum of frequency score and appraisal score. |
Reason for immigration | T1 | “Please rank in order of importance the reasons you immigrated to the United States ‘1 being the most important and ‘3′ being the least.” | Recoded as (1) Economic versus (0) non-economic as primary reason for immigration |
English proficiency | T2 | How well do you speak/understand English? | 4-point Likert scale (1) Understand/speak a little to (4) Understand/speak very well |
Pre-immigration neighborhood crime level | T1 | “In the neighborhood in which you grew up or lived prior to coming to the US, how would you characterize the crime level? | 3-point Likert scale (1) Low (2) Medium (3) High |
Family History of Substance Use Problems (FHSUP) | |||
---|---|---|---|
Variables | a FHSUP− | a FHSUP+ | p-Value |
(n = 239) | (n = 235) | ||
% | % | ||
Age (years) | 0.237 | ||
≤25 | 37.2 | 42.6 | |
>25 | 62.8 | 57.4 | |
Gender | 0.262 | ||
Female | 48.5 | 43.4 | |
Male | 51.5 | 56.6 | |
Marital status | 0.737 | ||
Married/partnered | 37.7 | 36.2 | |
Single | 62.3 | 63.8 | |
English proficiency | 0.065 | ||
Speak/Understand a little | 27.8 | 33.6 | |
Understand fairly well | 48.5 | 37.9 | |
Speak English well or very well | 23.6 | 28.5 | |
Education | 0.021 | ||
Less than high school or high school diploma | 43.1 | 55.3 | |
Some training/college after high school | 39.7 | 28.9 | |
Bachelor’s degree or advanced education | 17.2 | 15.7 | |
Employment | 0.198 | ||
No | 15.5 | 20.0 | |
Yes | 84.5 | 80.0 | |
Birth country/region | <0.001 | ||
Cuba | 57.6 | 28.1 | |
South America | 26.7 | 30.7 | |
Central America | 15.7 | 41.1 | |
Immigration reason | 0.003 | ||
Economic reasons | 51.9 | 65.5 | |
Not economic reasons | 48.1 | 34.5 | |
Documentation status | <0.001 | ||
Documented | 84.1 | 60.0 | |
Undocumented | 15.9 | 40.0 | |
Pre-immigration neighborhood crime level | <0.001 | ||
Low | 52.7 | 34.9 | |
Medium | 34.7 | 32.3 | |
High | 12.6 | 32.8 | |
Immigrated to the US alone | 0.017 | ||
Yes | 43.1 | 54.0 | |
No | 56.9 | 46.0 | |
Pre-immigration alcohol misuse | <0.001 | ||
Yes | 18.8 | 43.0 | |
No | 81.2 | 57.0 | |
Mean (b SD) | Mean (b SD) | p-value | |
Income (total in past 3 months) | 7294 (5117) | 8011 (6289) | 0.174 |
Acculturative stress | 5.2 (3.9) | 6.9 (5.0) | <0.001 |
Social support scale total score | 4.2 (0.9) | 3.9 (1.0) | <0.001 |
Alcohol Misuse | |||||
---|---|---|---|---|---|
Variables | No (n = 376) | % | Yes (n = 98) | % | p-Value |
Family history of substance use problems | 0.010 | ||||
No | 201 | 84.1 | 38 | 15.9 | |
Yes | 175 | 74.5 | 60 | 25.5 | |
Age (years) | 0.656 | ||||
≤25 | 148 | 78.3 | 41 | 21.7 | |
>25 | 228 | 80.0 | 57 | 20.0 | |
Gender | <0.001 | ||||
Female | 195 | 89.4 | 23 | 10.6 | |
Male | 181 | 70.7 | 75 | 29.3 | |
Marital status | 0.055 | ||||
Married/partnered | 147 | 84.0 | 28 | 16.0 | |
Single | 229 | 76.6 | 70 | 23.4 | |
English proficiency | 0.956 | ||||
Speak/Understand a little | 114 | 78.6 | 31 | 21.4 | |
Understand fairly well | 163 | 79.9 | 41 | 20.1 | |
Speak English well or very well | 98 | 79.7 | 25 | 20.3 | |
Education | 0.088 | ||||
High school diploma or less | 182 | 78.1 | 51 | 21.9 | |
Some training/college after high school | 125 | 76.7 | 38 | 23.3 | |
Bachelor’s degree or greater | 69 | 88.5 | 9 | 11.5 | |
Employment | 0.281 | ||||
No | 63 | 75.0 | 21 | 25.0 | |
Yes | 313 | 80.3 | 77 | 19.7 | |
Birth country/region | 0.160 | ||||
Cuba | 167 | 83.1 | 34 | 16.9 | |
South America | 103 | 76.9 | 31 | 23.1 | |
Central America | 99 | 75.0 | 33 | 25.0 | |
Immigration reason | 0.015 | ||||
Economic reasons | 210 | 75.5 | 68 | 24.5 | |
Not economic reasons | 166 | 84.7 | 30 | 15.3 | |
Documentation status | 0.348 | ||||
Documented | 275 | 80.4 | 67 | 19.6 | |
Undocumented | 101 | 76.5 | 31 | 23.5 | |
Pre-immigration neighborhood crime level | 0.227 | ||||
Low | 172 | 82.7 | 36 | 17.3 | |
Medium | 124 | 78.0 | 35 | 22.0 | |
High | 80 | 74.8 | 27 | 25.2 | |
Immigrated to the US alone | 0.091 | ||||
Yes | 175 | 76.1 | 55 | 23.9 | |
No | 201 | 82.4 | 43 | 17.0 | |
Pre-immigration alcohol misuse | <0.001 | ||||
Yes | 79 | 54.1 | 67 | 45.9 | |
No | 297 | 90.5 | 31 | 9.5 | |
Mean | SD a | Mean | SD | p-value | |
Income (total in past 3 months) | 7522.1 | 5725.9 | 8137.8 | 5718.8 | 0.344 |
Acculturative Stress | 5.9 | 4.4 | 6.3 | 5.0 | 0.463 |
Social Support Scale Total Score | 4.1 | 0.9 | 3.8 | 1.0 | 0.009 |
aaOR (95% bCI) | |||
---|---|---|---|
Variable | Model 1 | Model 2 | Model 3 |
Microsystem | Mesosystem | Macrosystem | |
Block 1: Microsystem | |||
Age: >25 years old vs. ≤25 years old | 0.92 (0.53,1.58) | 0.91 (0.53,1.57) | 0.87 (0.50,1.50) |
Gender: Male vs. Female | 1.97 (1.07,3.62) * | 1.93 (1.03,3.59) * | 1.85 (0.98,3.49) |
Marital Status: Single vs. Married/partnered | 1.72 (0.96,3.06) | 1.68 (0.94,3.01) | 1.74 (0.96,3.13) |
Education: | |||
a Some training after H.S. vs H.S. or < | 1.55 (0.83,2.93) | 1.77 (0.92,3.4) | 1.89 (0.96,3.71) |
Bachelor’s degree or > vs. H.S. or < | 0.44 (0.17,1.11) | 0.48 (0.19,1.25) | 0.53 (0.20,1.44) |
Employment: Yes vs. No | 0.64 (0.33,1.23) | 0.59 (0.30,1.16) | 0.60 (0.30,1.21) |
Income (total in past 3 months) | 1.00 (1.00,1.00) | 1.00 (1.00,1.00) | 1.00 (1.00,1.00) |
Birth country: | |||
South America vs. Cuba | 1.25 (0.63,2.49) | 1.09 (0.54,2.2) | 1.01 (0.48,2.13) |
Central America vs. Cuba | 1.1 (0.45,2.68) | 0.99 (0.40,2.43) | 0.94 (0.37,2.38) |
Documented vs. Undocumented status | 1.44 (0.65,3.18) | 1.53 (0.68,3.41) | 1.75 (0.75,4.1) |
Pre-immigration alcohol misuse: Yes vs. No | 7.41 (4.14,13.27) ** | 7.29 (4.06,13.08) ** | 7.35 (4.05,13.34) ** |
b FHSUP+ vs. FHSUP− | 1.17 (0.67,2.06) | 1.16 (0.66,2.03) | 1.15 (0.65,2.05) |
Block 2: Mesosystem | |||
Social support scale total score | 0.78 (0.58,1.05) | 0.77 (0.57,1.03) | |
Came to the U.S. alone | 1.21 (0.70,2.07) | 1.22 (0.71,2.11) | |
Block 3: Macrosystem | |||
Acculturative stress | 1.02 (0.96,1.08) | ||
Reason for immigration: Economic vs. To be with my family | 1.51 (0.83,2.74) | ||
English proficiency: | |||
Understand fairly well vs. Speak/understand a little | 1.18 (0.62,2.25) | ||
Speak English well or very well vs. Speak/understand a little | 1.09 (0.49,2.42) | ||
Pre-immigration neighborhood crime level: | |||
Medium vs. Low | 1.08 (0.58,2.01) | ||
High vs. Low | 1.06 (0.52,2.16) |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Levitt, E.; Ainuz, B.; Pourmoussa, A.; Acuna, J.; De La Rosa, M.; Zevallos, J.; Wang, W.; Rodriguez, P.; Castro, G.; Sanchez, M. Pre- and Post-Immigration Correlates of Alcohol Misuse among Young Adult Recent Latino Immigrants: An Ecodevelopmental Approach. Int. J. Environ. Res. Public Health 2019, 16, 4391. https://doi.org/10.3390/ijerph16224391
Levitt E, Ainuz B, Pourmoussa A, Acuna J, De La Rosa M, Zevallos J, Wang W, Rodriguez P, Castro G, Sanchez M. Pre- and Post-Immigration Correlates of Alcohol Misuse among Young Adult Recent Latino Immigrants: An Ecodevelopmental Approach. International Journal of Environmental Research and Public Health. 2019; 16(22):4391. https://doi.org/10.3390/ijerph16224391
Chicago/Turabian StyleLevitt, Eli, Bar Ainuz, Austin Pourmoussa, Juan Acuna, Mario De La Rosa, Juan Zevallos, Weize Wang, Pura Rodriguez, Grettel Castro, and Mariana Sanchez. 2019. "Pre- and Post-Immigration Correlates of Alcohol Misuse among Young Adult Recent Latino Immigrants: An Ecodevelopmental Approach" International Journal of Environmental Research and Public Health 16, no. 22: 4391. https://doi.org/10.3390/ijerph16224391