Alcohol use and binge drinking among

Hispanic/Latino subculture youth, and the differences in

the affect of acculturation

Hal Johnson, MPHFlorida Substance Abuse Program Office and the

FSU Florida Center for Prevention Research

June 4, 2012Council 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 NativeAsianBlack/African AmericanSpanish/Hispanic/LatinoNative Hawaiian or other Pacific IslanderWhite/CaucasianOther

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 AmericanDominicanMexican or Mexican AmericanPuerto RicanOther Hispanic, Latino or Spanish originHaitianWest Indian or CaribbeanNone 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

16.6%

9.7%

15.1%

0.0%

20.0%

White Black Hispanic

Binge Drinking by 6th - 12th graders in Florida, 2010

Florida Youth Substance Abuse Survey

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  Non-Hispanic Total N  

2002 10,467 52,467 62,934  2004 12,140 48,205 60,345  2006 12,684 43,668 56,352  2008 20,343 70,351 90,694  2010 16,563 56,234 72,797  

Combined 72,197 270,925 343,122           

Hispanic  Non-Hispanic Total N2002 10,467 52,467 62,9342004 12,140 48,205 60,3452006 12,684 43,668 56,3522008 20,343 70,351 90,6942010 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 useOR 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 DrinkingOR Lower Upper

Central American .797 .742 .857 *Cuban .829 .782 .879 *Dominican .854 .768 .948 *Mexican 1.021 .952 1.095Puerto Rican .838 .791 .889 *Other Hispanic .981 .929 1.036

* p < .001

99% C.I.

99% C.I.

Reference Group:Non-Hispanic

White

Control Variables:AgeGenderMother’s

educationFather’s education

Acculturation

“Acculturation … is now commonly viewed as a

multidimensional process in which one maintains aspects of their culture of origin while also adopting elements of the new

cultural group.”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?EnglishSpanishAnother Language

Language Spoken at Home

English Spanish English SpanishCentral American 10830 2254 82.8 17.2Cuban  5807 3402 63.1 36.9Dominican 2078 1333 60.9 39.1Mexican  6946 7966 46.6 53.4Puerto Rican 10807 4720 69.6 30.4Other Hispanic  6446 5894 52.2 47.8ALL HISPANIC 42914 25569 62.7 37.3

Frequency Percent

Past-30-day Use and Binge Drinking by Language Spoken at Home – All Hispanic Youth

Odds Ratios – Language Spoken at Home

OR Group:Speak Spanish at

Home

Reference Group:Speak English at

Home

Control Variables:AgeGenderMother’s educationFather’s education

ALL HISPANIC YOUTHOR Lower Upper

Past-30-day Alcohol .917 .881 .956 *Binge Drinking .975 .926 1.026

*p<.001

99% C.I.

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 useOR Lower Upper

Central American .934 .833 1.047Cuban .855 .783 .933 *Dominican 1.016 .859 1.203Mexican .760 .680 .851 *Puerto Rican .898 .816 .988 **Other Hispanic .948 .871 1.032

Binge DrinkingOR Lower Upper

Central American .791 .681 .919 *Cuban .942 .841 1.055Dominican .976 .789 1.207Mexican .869 .759 .995 **Puerto Rican 1.001 .886 1.130Other Hispanic 1.039 .934 1.155

*p<.001 **P<.01

99% C.I.

99% C.I.

OR Group:Speak Spanish at

Home

Reference Group:Speak English at

Home

Control Variables:AgeGenderMother’s educationFather’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