ASSOCIATIONS BETWEEN RACE-BASED DISCRIMINATION AND PAST 30-DAY SUBSTANCE USE AMONG PREDOMINANTLY BLACK YOUTH RESIDING IN URBAN NEIGHBORHOODS

• Published in: Journal of adolescent health Vol. 68; no. 2S; p. S8
• Main Authors: Stokes, Lynissa R, Culyba, Alison J, Hill, Amber L, Dwarakanath, Namita, Pollard, Jordan, Miller, Elizabeth L, Hill, Ashley V
• Format: Journal Article
• Language: English
• Published: New York Elsevier BV 01-02-2021
• Subjects: Adolescents; African Americans; Alcohol use; Children & youth; Coping; Coping strategies; Discrimination; Drug use; Ethnicity; Females; Health behavior; Health education; Health status; Heterosexuality; Intervention; Job training; Males; Manhood; Marijuana; Medical personnel; Neighborhoods; Police; Prevention programs; Public health; Race; Racial discrimination; Racism; Security; Sex crimes; Sexual violence; Smoking; Stress; Substance abuse; Teenagers; Youth
• ISSN: 1054-139X; 1879-1972

Purpose: Experiences of race-based discrimination among Black and other minority youth may influence substance use behaviors, leading to adverse health and social outcomes. We examined associations between race-based discrimination and substance use among a predominantly Black sample of youth. Methods: Adolescents aged 13 to 19 were recruited through youth-serving community agencies in Pittsburgh, PA from 2017-2019 to participate in one of two cluster-randomized trials comparing gender-transformative, community-based sexual violence prevention programs (Manhood 2.0 and Sisterhood 2.0) to job readiness training. Participants provided demographic information, completed a questionnaire about experiences with ten different discriminatory situations, and reported the frequency of past 30-day cigarette, alcohol, and marijuana use, which was then dichotomized to "use'V'non-use." Logistic regression models were adjusted for age, race/ethnicity, suspension history, and intervention status. Results: Manhood 2.0 data are presented first. Average participant age was 15.5 (SD - 1.6) and 15.2 (SD = 1.5). Most participants self-identified as Black/African American (71.6% and 61%) and heterosexual (79.5% and 61.5%). Most youth reported experiencing at least one race-based discriminatory encounter (82.1% and 82.9%). Being accused of something they didn't do was reported by 63.6% and 66.7% of youth. Male and female youth reported similar rates of past 30-day alcohol (21.8% and 22.2%) and marijuana use (34.1% and 41.9%). A higher proportion of male (23.4%) compared to female youth (13.4%) reported past 30-day cigarette use. For males, overall discrimination was unrelated to past 30-day substance use. Being watched by a security guard was associated with greater odds of alcohol (adjusted odds ratio [AOR]=1.56;95% CI:1.02-2.39) and marijuana use (AOR= 1.62;95% CI:l.ll-2.36). Witnessing a family member or friend being mistreated was associated with greater odds of alcohol use (AOR=1.73;95% CI: 1.10-2.70). Unfair police treatment was associated with increased odds of cigarette (AOR=2.04;95% CI:1.34-3.11), alcohol (AOR, 1.81; 95% CI, 1.18 - 2.79), and marijuana use (AOR=2.17;95% CI:1.49-3.18). For females, overall discrimination was associated with greater odds of past 30-day marijuana use (AOR=l.ll ;95% CI:1.00-1.24). Being watched by a security guard was associated with greater odds of alcohol use (AOR=2.33;95% CI: 1.05-5.13). Unfair police treatment was associated with greater odds of cigarette (AOR=3.70;95% CI:1.38-9.88), alcohol (AOR=3.04;95% CI:1.35-6.85), and marijuana use (AOR-3.20;95% CI: 1.55-6.62). Conclusions: Discriminatory experiences are common among youth of color in the U.S., and substance use may represent one coping strategy for stress induced by discrimination. Adolescent health professionals should consider assessing race-based discriminatory experiences and associated stress among youth of color who engage in substance use. Community-level and public health interventions designed to combat racism experienced by youth are needed.