Silmi Kazi Priyanka, Castillo Victoria, Segura Nallely, Cervantes Nayeli Carrillo, Perez Yailene, Valenzuela Aubrey, Pugh Erika A, Unger Jennifer B, Gonzalez Marybel R
Department of Psychiatry and Behavioral Health, College of Medicine, Ohio State University, Columbus, OH, United States.
Department of Psychology, University of California San Diego, San Diego, CA, United States.
Front Psychiatry. 2025 Aug 7;16:1568462. doi: 10.3389/fpsyt.2025.1568462. eCollection 2025.
Alcohol and tobacco use (ATU) have been persistent public health concerns among youth in the United States (U.S.), including Hispanic youth who represent 25% of all American youth. While the psychosocial factors associated with ATU among Hispanic adolescents have been investigated for decades, the social environments for youth have undergone considerable change over time. The aim of this scoping review was to examine how social determinants of health (SDOH) influence ATU among Hispanic adolescents and to assess the extent to which mental health variables are integrated into these studies.
We conducted a systematic, reproducible search on PubMed, PsycInfo, and Scopus for empirical research articles published that examined the SDOH of ATU among Hispanic/Latino/a/x adolescents in the U.S. We retrieved and screened 1467 titles and abstracts that yielded 241 articles for full review, of which 63 articles met final criteria for inclusion in the final synthesis. We categorized the SDOH by domains of behavioral, physical/built environment, socio-cultural, health care, and by levels for individual, interpersonal, school, community, and societal factors.
Most studies focused on socio-cultural domains within individual and interpersonal levels. Less studies examined societal and healthcare domains. Along with the influence of individual and interpersonal determinants (e.g., generational status, Hispanic values, acculturation stress, family and peers), community level factors (e.g., neighborhood level factors such as neighborhood exposure to ATU and neighborhood ethnic concentration) emerged as key structural predictors of ATU. Ethnic discrimination was also identified as a societal level predictor that influenced ATU, with potential association of mental health as mediators, moderators, or co-occurring outcomes. About one-third of the studies investigated the influence of SDOH on ATU along with mental health related variables like depression, anxiety, and stress.
SDOH at the societal level and in the health care domain were identified as understudied among Hispanic adolescents. Future research is needed on these broader societal and structural determinants, including access to healthcare services and the integration of substance use prevention within these services, to intervene early in adolescence and reduce ATU related health consequences among Hispanic adults in the U.S.
在美国，酒精和烟草使用（ATU）一直是青少年群体中长期存在的公共卫生问题，其中包括占美国青少年总数25%的西班牙裔青少年。尽管几十年来一直在研究西班牙裔青少年中与ATU相关的心理社会因素，但青少年的社会环境随着时间的推移发生了相当大的变化。本范围综述的目的是研究健康的社会决定因素（SDOH）如何影响西班牙裔青少年的ATU，并评估心理健康变量在这些研究中的整合程度。
我们在PubMed、PsycInfo和Scopus上进行了系统的、可重复的搜索，以查找已发表的实证研究文章，这些文章研究了美国西班牙裔/拉丁裔青少年中ATU的SDOH。我们检索并筛选了1467个标题和摘要，从中选出241篇文章进行全文审查，其中63篇文章符合最终纳入综合分析的标准。我们根据行为、物理/建筑环境、社会文化、医疗保健等领域以及个人、人际、学校、社区和社会因素等层面来对SDOH进行分类。
大多数研究集中在个人和人际层面的社会文化领域。较少有研究考察社会和医疗保健领域。除了个人和人际决定因素（如代际地位、西班牙裔价值观、文化适应压力、家庭和同伴）的影响外，社区层面的因素（如邻里层面的因素，如邻里接触ATU的情况和邻里的种族集中度）成为ATU的关键结构预测因素。种族歧视也被确定为影响ATU的社会层面预测因素，心理健康有可能作为中介、调节因素或同时出现的结果与之相关联。约三分之一的研究考察了SDOH对ATU的影响以及与抑郁、焦虑和压力等心理健康相关变量的关系。
在西班牙裔青少年中，社会层面和医疗保健领域的SDOH被确定为研究不足的方面。未来需要对这些更广泛的社会和结构决定因素进行研究，包括获得医疗保健服务的情况以及在这些服务中纳入物质使用预防措施，以便在青春期早期进行干预，减少美国西班牙裔成年人中与ATU相关的健康后果。
