Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue New Haven, CT, 06511, United States.
Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue New Haven, CT, 06511, United States; Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, 63110, United States.
Drug Alcohol Depend. 2019 Jun 1;199:129-135. doi: 10.1016/j.drugalcdep.2019.02.026. Epub 2019 Apr 23.
This study aimed to characterize the associations of racial and socioeconomic discrimination with timing of alcohol initiation and progression from initiation to problem drinking in Black youth.
Data were drawn from a high-risk family study of alcohol use disorder. Mothers and their offspring (N = 806; M = 17.87, SD = 3.91; 50% female) were assessed via telephone interview. Cox proportional hazards regression analyses were used to examine associations between discrimination and timing of first drink and progression from first drink to problem drinking in two separate models. Predictor variables were considered in a step-wise fashion, starting with offspring racial and socioeconomic discrimination, then adding (2) maternal racial and/or socioeconomic discrimination experiences; (3) religious service attendance and social support as potential moderators; and (4) psychiatric and psychosocial risk factors and other substance use.
Offspring racial discrimination (HR: 2.01, CI: 1.17-3.46 ≤ age 13) and maternal experiences of discrimination (HR: 0.79, CI: 0.67-0.93) were associated with timing of initiation in the unadjusted model only; offspring socioeconomic discrimination predicted timing of initiation among female offspring, even after adjusting for all covariates (HR: 1.49, CI: 1.14-1.93). Socioeconomic discrimination predicted a quicker transition from first use to problem drinking exclusively in the unadjusted model (HR: 1.70, CI: 1.12-2.58 ≤ age 18). No moderating effects of religious service attendance or social support were observed for either alcohol outcome.
Findings suggest socioeconomic discrimination is a robust risk factor for initiating alcohol use in young Black female youth and should be considered in the development of targeted prevention programs.
本研究旨在描述种族和社会经济歧视与黑人青少年饮酒起始时间以及从起始饮酒到出现问题饮酒的进展之间的关系。
数据来自于一项关于酒精使用障碍的高危家庭研究。通过电话访谈对母亲及其子女(N=806;M=17.87,SD=3.91;50%为女性)进行评估。使用 Cox 比例风险回归分析来检验歧视与首次饮酒时间以及从首次饮酒到出现问题饮酒的进展之间的关联,在两个单独的模型中分别进行。预测变量以逐步的方式考虑,首先是子女的种族和社会经济歧视,然后加入(2)母亲的种族和/或社会经济歧视经历;(3)宗教服务参与度和社会支持作为潜在的调节因素;以及(4)精神疾病和心理社会风险因素和其他物质使用情况。
在未调整的模型中,子女的种族歧视(HR:2.01,CI:1.17-3.46≤13 岁)和母亲的歧视经历(HR:0.79,CI:0.67-0.93)仅与起始时间有关;在调整了所有协变量后,子女的社会经济歧视预测了女性子女的起始时间(HR:1.49,CI:1.14-1.93)。社会经济歧视仅在未调整的模型中预测了从首次使用到出现问题饮酒的更快过渡(HR:1.70,CI:1.12-2.58≤18 岁)。宗教服务参与度或社会支持没有观察到对任何一个饮酒结果的调节作用。
研究结果表明,社会经济歧视是黑人年轻女性青少年开始饮酒的一个强有力的风险因素,应该在制定有针对性的预防计划时加以考虑。