Applying a social determinants of health framework, this review brings attention to evidence from social sciences and neuroscience on the role of selected social factors in individual and population-level vulnerability to substance use and substance use disorders (SUDs). The understanding that social vulnerability to substance use and SUDs is multifaceted and occurs across different levels of influence (individual, interpersonal, community, and societal) is underscored. We propose that socially based stressors play a critical role in creating vulnerability to substance use and SUDs, and as such, deserve greater empirical attention to further understand how they "get under the skin." Current knowledge from social sciences and neuroscience on the relationships among vulnerability to substance use resulting from stressors, exposure to socially toxic childhood environments, and racism and discrimination are summarized and discussed, as are implications for future research, practice, and policy. Specifically, we propose using a top-down approach to the examination of known, yet often unexplored, relationships between vulnerability to substance use and SUDs, related inequities, and potential differential effects across demographic groups. Finally, research gaps and promising areas of research, practice, and policy focused on ameliorating social vulnerabilities associated with substance use and SUDs across the lifespan are presented. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.
1 August 2018 in Developmental Cognitive Neuroscience
Neurodevelopmental maturation takes place in a social environment in addition to a neurobiological one. Characterization of social environmental factors that influence this process is therefore an essential component in developing an accurate model of adolescent brain and neurocognitive development, as well as susceptibility to change with the use of marijuana and other drugs. The creation of the Culture and Environment (CE) measurement component of the ABCD protocol was guided by this understanding. Three areas were identified by the CE Work Group as central to this process: influences relating to CE Group membership, influences created by the proximal social environment, influences stemming from social interactions. Eleven measures assess these influences, and by time of publication, will have been administered to well over 7,000 9-10 year-old children and one of their parents. Our report presents baseline data on psychometric characteristics (mean, standard deviation, range, skewness, coefficient alpha) of all measures within the battery. Effectiveness of the battery in differentiating 9-10 year olds who were classified as at higher and lower risk for marijuana use in adolescence was also evaluated. Psychometric characteristics on all measures were good to excellent; higher vs. lower risk contrasts were significant in areas where risk differentiation would be anticipated.
Religious institutions can be a source of support for recent Latino immigrants struggling to adjust to a new culture. For undocumented immigrants, who are often marginalized from other formal institutions, they may symbolize a place of refuge and hope through supportive social networks that mitigate common challenges such as social isolation and other forms of immigration stress. This cross-sectional study examined the impact of religious social capital and social support on immigration stress among documented and undocumented recent Latino immigrants (N = 408). Religious social capital was associated with higher levels of social support, while social support was protective against immigration stress. Social support mediated associations between religious social capital and immigration stress, but only among undocumented immigrants. Findings suggest religious social capital may be a particularly useful resource for undocumented immigrants, aiding in the provision of social support and in decreasing levels of immigration stress. Future research directions and implications for culturally tailored service delivery are presented.
(1) The study aim was to assess disparities in non-retention in HIV care and non-viral suppression among non-Hispanic Black Caribbean immigrants living with HIV in Florida. (2) We analyzed cases involving individuals, aged ≥13, who met CDC HIV case definition during 2000–2014. Chi square test was used to evaluate differences in non-retention and non-viral suppression by country of origin/race/ethnicity. Multilevel logistic regressions with three referent groups [US-born Blacks, Hispanics, and non-Hispanic Whites (NHWs)] were used to estimate adjusted odds ratios (aOR). (3) Caribbean-born Blacks were less likely to be retained in care or be virally suppressed than US-born Blacks, Hispanics, and NHWs. Bahamians, Haitians, and Trinidadians and Tobagonians had increased odds of non-retention (aOR 3.13, 95% confidence interval [CI] 2.40 –4.10; aOR 1.52, 95% CI 1.40–1.66; aOR 2.30, 95% CI 1.38–3.83), and non-viral suppression (aOR 3.23, 95% CI 2.48–4.21; aOR 1.82, 95% CI 1.68–1.98; aOR 1.76, 95% CI 1.06–2.90) compared with NHWs. (4) Caribbean-born Blacks living with HIV infection are less likely than other racial/ethnic groups to be retained in care and/or achieve viral suppression. Further research is urgently needed to determine social, cultural, and biological factors that contribute to this disparity.
3 July 2015 in Journal of Ethnic & Cultural Diversity in Social Work
Family relationships can serve as an important source of support during the acculturation process; yet, how the stress related to acculturation, or acculturative stress, may impact family functioning across time is not clear. Participants (N = 479) between the ages of 18 and 34 were recruited using respondent-driven sampling methodology. Findings suggest family cohesion decreased over time; however, it decreased less for those reporting more acculturative stress. The implication is that for those Latino immigrants who struggle to adapt to their new host culture, family remains a source of support more so than for those who do not struggle as much.
1 December 2014 in Psychology of Addictive Behaviors
The escalation of alcohol use among some Latino immigrant groups as their time in the United States increases has been well documented. Yet, little is known about the alcohol use behaviors of Latino immigrants before immigration. This prospective longitudinal study examines pre- to postimmigration alcohol use trajectories among a cohort of recent Latino immigrants. Retrospective preimmigration data were collected at baseline from a sample of 455 Cuban, South American, and Central American Latinos ages 18-34 who immigrated to the United States less than 1 year prior. Two follow-up assessments (12 months apart) reported on their postimmigration alcohol use in the past 90 days. We hypothesized (a) overall declines in pre- to postimmigration alcohol among recent Latino immigrants and (b) gender/documentation specific effects, with higher rates of alcohol use among males and undocumented participants compared to their female and documented counterparts. Growth curve analyses revealed males had higher levels of preimmigration alcohol use with steeper declines in postimmigration alcohol use compared to females. Declines in alcohol use frequency were observed for documented, but not undocumented males. No changes in pre- to postimmigration alcohol use were found for documented or undocumented females. This study contributes to the limited knowledge of pre- to postimmigration alcohol use patterns among Latinos in the United States. Future research is needed to identify social determinants associated with the alcohol use trajectories of recent Latino immigrants, as it may inform prediction, prevention, and treatment of problem-drinking behaviors among the largest and fastest growing ethnic minority in the United States.