Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT 06511, USA.
Departments of Psychology and Sociology, University of Central Florida, 4297 Andromeda Loop N., Orlando, FL 32816, USA.
Addict Behav. 2021 Mar;114:106711. doi: 10.1016/j.addbeh.2020.106711. Epub 2020 Oct 15.
Racial discrimination has consistently been linked to elevated alcohol use and smoking in Black adults, but the independent contributions of everyday and major experiences of discrimination have rarely been investigated. The present study aimed to identify variation in magnitude of the links between each type of racial discrimination with current frequency of alcohol use and regular smoking by demographic characteristics and family history of problem drinking/regular smoking in Black adults in the U.S.
Data were drawn from 4462 adults (29.40% Afro Caribbean, 70.60% African American; 63.20% female) in a nationally representative sample of Black Americans. Logistic regression analyses were conducted to predict current frequency of alcohol use and regular smoking using the Everyday Discrimination Scale (EDS) and Major Experiences of Discrimination Scale (MEDS), testing for interactions with demographic characteristics and family history.
In the alcohol model, an EDS by education level interaction was observed: OR = 1.04 (CI:1.02-1.07) for < high school; OR = 0.95 (CI:0.92-0.98) for ≥ high school. MEDS was independently associated with alcohol use (OR = 1.11, CI:1.04-1.18). In the smoking model, EDS was associated with elevated risk (OR = 1.03, CI:1.01-1.04) and a MEDS by age cohort interaction was observed: OR = 1.24 (CI:1.11-1.38) for <age 45; OR = 1.07 (CI:0.97-1.19) for ages 45-65.
Everyday and major experiences of racial discrimination contribute independently to both alcohol use and regular smoking in Black adults, with some variation by education level and age. Differentiating everyday from major experiences of discrimination in studies of mechanisms linking racial discrimination to substance use will enhance their informativeness for intervention development.
种族歧视一直与黑人群体中较高的酒精使用和吸烟率有关，但日常和重大歧视经历的独立贡献很少被研究。本研究旨在确定美国黑人群体中，每种类型的种族歧视与当前饮酒频率和定期吸烟之间的关联程度因人口统计学特征和酗酒/定期吸烟家族史而有所不同。
数据来自美国黑人群体中具有全国代表性的 4462 名成年人（29.40%加勒比裔黑人，70.60%非裔美国人；63.20%女性）。使用日常歧视量表（EDS）和重大歧视经历量表（MEDS），通过逻辑回归分析预测当前饮酒频率和定期吸烟，检验与人口统计学特征和家族史的交互作用。
在饮酒模型中，观察到 EDS 与教育水平的交互作用：<高中的 OR=1.04（CI：1.02-1.07）；≥高中的 OR=0.95（CI：0.92-0.98）。MEDS 与饮酒独立相关（OR=1.11，CI：1.04-1.18）。在吸烟模型中，EDS 与较高的风险相关（OR=1.03，CI：1.01-1.04），并且观察到 MEDS 与年龄队列的交互作用：<45 岁的 OR=1.24（CI：1.11-1.38）；45-65 岁的 OR=1.07（CI：0.97-1.19）。
日常和重大的种族歧视经历独立地导致黑人群体中酒精使用和定期吸烟增加，其程度因教育水平和年龄而异。在研究将种族歧视与物质使用联系起来的机制时，区分日常歧视和重大歧视经历将提高它们对干预措施发展的信息量。
