Alcohol use and binge drinking
among Hispanic/Latino
subculture youth, and the
differences in the affect of
acculturation
Hal Johnson, MPH
Florida Substance Abuse Program Office and the
FSU Florida Center for Prevention Research
June 4, 2012
Council of State and Territorial Epidemiologists
Omaha, Nebraska
Background
• Risky behaviors vary among different
races/ethnicities
• Hispanic ethnicity is a growing portion of
the US population
• Many programs/interventions have been
developed to reduce risky behaviors,
including underage drinking, among
Hispanic youth.
Background
• However, most of these programs don’t
distinguish between Hispanic subcultures
• Spanish, Mexican, Puerto Rican, Central
American and other Hispanic cultures,
while sharing some aspects, are different
• Examining differences between these
subcultures in the US is challenging for
several reasons
Background
• Challenges
– Immigration patterns - limited diversity of
Hispanic subcultures in most areas
– Underage drinking – limited age range means
limited population
– Few databases include information on
ethnicity at a level lower than “Hispanic”
Florida Youth Substance Abuse
Survey
• Annually since 2000
– Even years – County level (~60,000)
– Odd years – State level (~8,000)
• Grades 6 through 12
• Based on Communities That Care Survey
Florida Youth Substance Abuse
Survey
How do you describe yourself? (You can
choose one answer, or more than one)
American Indian/Native American or Alaska
Native
Asian
Black/African American
Spanish/Hispanic/Latino
Native Hawaiian or other Pacific Islander
White/Caucasian
Other
Florida Youth Substance Abuse
Survey
Which one of these ethnic groups BEST
describes you? (Choose only one answer)
Central American (Guatemalan, Nicaraguan,
Honduran, for example)
Cuban or Cuban American
Dominican
Mexican or Mexican American
Puerto Rican
Other Hispanic, Latino or Spanish origin
Haitian
West Indian or Caribbean
None of these
Florida Youth Substance Abuse
Survey
• Consistent differences by race/ethnicity
– Whites use at the highest rate
– Black youth use at lowest rate
– Hispanic youth use at a slightly lower rate
than non-Hispanic Whites
• Similar results from other school based
surveys such as Monitoring the Future
Florida Youth Substance Abuse
Survey
Florida Youth Substance Abuse
Survey
Binge Drinking by 6th - 12th graders
in Florida, 2010
20.0%
16.6%
15.1%
9.7%
0.0%
White
Black
Hispanic
Hispanic Youth Population Trend
* Source: Florida Office of Economic and Demographic Research (Age 10-17)
Florida youth Ethnicity (FYSAS)
Hispanic Subcultures among
Florida youth (FYSAS)
Data Considerations
• Use even year data
• Exclude 2000
– Changes made in race/ethnic variables
• Compare each year for variations
• Combine years
• Weight to adjust for sample size
Population Proportion Across
Years
Combined Dataset Ethnicities
2002
2004
2006
2008
2010
Combined
HispanicHispanic Non-Hispanic
Non-Hispanic
Total N
10,467
2002
52,467
10,467
52,467 62,934
12,140
60,345
2004
48,205
12,684
56,352
2006
43,668
12,140
48,205
20,343
90,694
2008
70,351
16,563
72,797
2010
56,234
12,684
43,668
Combined
72,197
270,925
343,122
20,343
70,351
16,563
56,234
72,197
270,925
Total N
62,934
60,345
56,352
90,694
72,797
343,122
Past-30-day Alcohol Use
Binge Drinking
Odds Ratios
Past-30-day alcohol use
OR
Central American
.792
Cuban
.919
Dominican
.825
Mexican
.865
Puerto Rican
.871
Other Hispanic
1.039
99% C.I.
Lower
Upper
.749
.838
.877
.962
.758
.897
.817
.917
.832
.912
.995
1.086
Binge Drinking
99% C.I.
Lower
Upper
.742
.857
.782
.879
.768
.948
.952
1.095
.791
.889
.929
1.036
* p < .001
Central American
Cuban
Dominican
Mexican
Puerto Rican
Other Hispanic
OR
.797
.829
.854
1.021
.838
.981
*
*
*
*
*
*
*
*
*
Reference Group:
Non-Hispanic White
Control Variables:
Age
Gender
Mother’s education
Father’s education
Acculturation
Coatsworth and Maldonado-Molina. J Community Psychol. 2005. 33(2).
Acculturation
• Acculturation has been implicated as a risk
factor for substance use and other
unhealthy behaviors
• 1990 to 2000 Hispanic Population Growth*
– 50% increase in # American-born Hispanics
– 81% increase in # born in other countries
• In 2000, 40% of all Hispanics and 54% of
southern US Hispanics were foreign born*
*Saenz, R. www2.asanet.org/public/saenz_brief.ppt
Acculturation
• Length of time in the US related to less
acculturation
• Language spoken at home is reasonable
proxy for length of time in US and
acculturation
• FYSAS has one question on language
spoken at home
Acculturation
FYSAS question:
What is the language you use most
often at home?
English
Spanish
Another Language
Language Spoken at Home
Central American
Cuban
Dominican
Mexican
Puerto Rican
Other Hispanic
ALL HISPANIC
Frequency
English Spanish
10830
2254
5807
3402
2078
1333
6946
7966
10807
4720
6446
5894
42914
25569
Percent
English Spanish
82.8
17.2
63.1
36.9
60.9
39.1
46.6
53.4
69.6
30.4
52.2
47.8
62.7
37.3
Past-30-day Use and Binge
Drinking by Language Spoken at
Home – All Hispanic Youth
Odds Ratios – Language Spoken
at Home
ALL HISPANIC YOUTH
Past-30-day Alcohol
Binge Drinking
99% C.I.
OR
Lower Upper
.917
.881
.956 *
.975
.926
1.026
*p<.001
OR Group:
Speak Spanish at Home
Reference Group:
Speak English at Home
Control Variables:
Age
Gender
Mother’s education
Father’s education
Past-30-Day Alcohol Use by
Language Spoken at Home
Binge Drinking by Language
Spoken at Home
Odds Ratios – Language Spoken
at Home
Past-30-day alcohol use
OR
Central American
.934
Cuban
.855
Dominican
1.016
Mexican
.760
Puerto Rican
.898
Other Hispanic
.948
Binge Drinking
Central American
Cuban
Dominican
Mexican
Puerto Rican
Other Hispanic
OR
.791
.942
.976
.869
1.001
1.039
99% C.I.
Lower
Upper
.833
1.047
.783
.933
.859
1.203
.680
.851
.816
.988
.871
1.032
OR Group:
Speak Spanish at Home
*
*
**
99% C.I.
Lower
Upper
.681
.919 *
.841
1.055
.789
1.207
.759
.995 **
.886
1.130
.934
1.155
*p<.001 **P<.01
Reference Group:
Speak English at Home
Control Variables:
Age
Gender
Mother’s education
Father’s education
Summary
• All Hispanic youth in Florida drink and binge
•
drink at a rate between NH-Whites and NHBlacks
But there are differences among the Hispanic
subcultures
– Central American youth less likely to drink or binge
than others
– “Other Hispanic” youth more likely to drink or binge
than others
– Mexican youth more likely to binge than others
Summary
• Hispanics speaking Spanish at home less
likely to report past-30-day use, but not
binge drinking
• Subculture differences:
– Cuban, Mexican and Puerto Rican youth show
past-30-day acculturation affect
– Central American and Mexican youth show
binge drinking acculturation affect
– No other significant differences
Conclusions
• FYSAS provides an excellent opportunity
to investigate AOD use and other risky
behavior among Hispanic subpopulations
– Large and growing Hispanic youth population
– More diverse Hispanic population than most
states
– Annual youth survey with large N and useful
ethnicity and acculturation questions
Conclusions
• Hispanic youth are not homogeneous
– There are differences in alcohol use and binge
drinking among subcultures
– There are differences in the affect of
acculturation on likelihood to drink or binge
drink
• Taking subculture into account can add to
the effectiveness of targeted prevention
programs