English use/proficiency, ethnic discrimination, and alcohol use disorder in Hispanic immigrants
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ORIGINAL PAPER
English use/proficiency, ethnic discrimination, and alcohol use disorder in Hispanic immigrants Manuel Cano1 Received: 7 October 2019 / Accepted: 3 February 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Acculturation-related measures, often based on language, have traditionally been identified as predictors of drinking outcomes for US Hispanics. However, a sole focus on acculturation may obscure the role of societal factors such as discrimination. The present study evaluated ethnic discrimination as a mediator in the relationship between English use/ proficiency and alcohol use disorder in US Hispanic immigrants. Methods The study examined data from the 2222 self-identified Hispanic immigrant adults in the National Epidemiologic Survey on Alcohol and Related Conditions-III who reported alcohol use within the past year. The study utilized multivariable binomial logistic regression analyses to test relationships between English use/proficiency and perceived ethnic discrimination; English use/proficiency and DSM-5 alcohol use disorder; ethnic discrimination and DSM-5 alcohol use disorder. Statistical mediation examined ethnic discrimination as a mediator in the relationship between English use/proficiency and alcohol use disorder. Results Perceived ethnic discrimination was significantly associated with alcohol use disorder in men (adjusted odds ratio [AOR] 1.99; 95% CI [confidence interval], 1.40–2.83), yet not women (AOR 1.32; 95% CI, 0.71–2.44), in a regression model that also included English use/proficiency. Perceived ethnic discrimination also acted as a partial mediator between English use/proficiency and DSM-5 alcohol use disorder for male, yet not female, Hispanic immigrants. Conclusion Findings show some support for the notion that experiences of ethnic discrimination, which may accompany the process of acculturation, partially explain deteriorating drinking outcomes in Hispanic immigrant men adapting to life in the US. Keywords Acculturation · English use/proficiency · Ethnic discrimination · Hispanic/Latino immigrants · Mediation
Introduction With implications for chronic disease and mortality, alcoholrelated problems represent a threat to population health. For Hispanics in the US, drinking outcomes are often tied to acculturation [1–3], a process which involves reconciling two cultures: a culture of heritage and the culture of the US. Prior literature has shown support for a statisticallysignificant relationship between acculturation measures and a range of drinking outcomes for US Hispanic groups [4–6], especially women, and this relationship has been * Manuel Cano [email protected] 1
Department of Social Work, University of Texas at San Antonio, 501 W. César E. Chávez Blvd., San Antonio, TX 78207, USA
documented with language-based measures, acculturation scales, and demographic variables (e.g., nativity, years lived in the US) utilized as proxies of acculturation. Results from two meta-analyses of acculturation and drinking in US Hisp
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