The Hispanic cultural value of familism emphasizes the interdependency of family members (Cuellar, Arnold, & Gonzalez, 1995). This can increase children’s self-efficacy, but also undermine parental authority and place excessive stress on children, and it can boost youth’s risk of involvement in problem behaviors such as substance use (Portes & Rumbaut, 2001; Szapocznik et al., 2007; Titzmann, 2012). Other risk and protective factors for Hispanics, unique to immigrant and/or minority groups, are described in the next section. Empirically, most of the risk and protective factors for substance use identified among Hispanics are similar to those identified among other ethnic groups, including peer influences, parental monitoring, and bonding with prosocial mentors and institutions (summarized by Szapocznik et al., 2007).
After appropriately weighted, respondents are a representative sample of the Hispanic civilian non-institutionalized population aged 18 and older in these sites. A recent update indicates that Hispanics already are 14.4% of the population (U.S. Census Bureau, 2005), and will be about 25% of the U.S. population in 2050 (Falcon et al., 2001; U.S. Census Bureau, 2004). Hispanics constituted 12.5% of the U.S. population in the 2000 Census (U.S. Census Bureau, 2000). The federal government also treats different types of beverages differently for taxes purposes. U.S. Hispanics come from many countries in Latin America, which can lead to different beverage preferences in the U.S. Studies show that despite being more likely to need substance abuse treatment, Hispanic Americans have less access to substance abuse treatment and must wait longer to access such services when compared to non-Hispanics.6-7
Curiously, although beer is responsible for most binge drinking episodes, liquor drinkers are the ones most likely to binge. Individuals with at least some college education and those with higher income also seem consistently more likely to drink wine, beer, and liquor than those with less than a high school education and those with lower income. While there are no major differences in beverage choice across Hispanic national groups, research examining other drinking-related areas (e.g., types of problems) have reported considerable differences across national groups.
- Mexican men have greater alcohol use and dependence compared to Central and South American men, while Cubans men consume the least amount of alcohol of all the Latino subgroups (De La Rosa et al. 2020; Castañeda et al. 2019; NIAAA, 2019).
- Over the past 25 years, beer and spirits consumption have increased and wine consumption has decreased in Central and South American nations (Pan American Health Organization, 2007).
- This is in contrast to most studies that are done in a wait-list setting or using national transplant databases as these studies have some component of inherent referral and selection bias.Unfortunately, the same traits that improve generalizability bring limitations to our study.
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- Conversely, messages can posit that a reduction in alcohol-misuse can lead to gain of efficiency at work, which in turn may increase the income that a man can provide his family.
- The Hispanic population in the Chicago is similar to other major US cities in that it is 80% Mexican which is also the largest Hispanic subgroup in the US in general.39 Thus although we feel that our Hispanic cohort is relatively uniform our dataset is not granular enough to verify our cohort’s heritage to this level.
- In a cross-sectional analysis of the ninth grade data (Okamoto et al., 2009), adolescents who perceived more discrimination were at increased risk of using tobacco, alcohol, marijuana, and inhalants.
Alcohol Use Disorder (AUD) in the United States: Age Groups and Demographic Characteristics
Spirits come in second place with a recorded consumption of a little less than 2 liters per person, and wine is third with a recorded consumption of less than 1 liter per person. For example, in Guatemala, Nicaragua, Costa Rica, and Peru spirits consumption comes first, followed by beer (Babor et al., 2003; World Health Organization, 2004). In South America, Chile and Argentina are also known for their higher consumption of wine compared to other countries in that continent (World Health Organization, 2004).
Alcohol control policies such as taxation and control of sales availability should apply equally to wine, beer, and liquor. It collected comprehensive information on alcohol consumption from representative samples of Hispanic national groups in five large metropolitan areas in the U.S. However, at an individual level, liquor drinkers are more likely to binge than beer drinkers. These contrasting results can be explained by the fact that there are more beer drinkers than liquor drinkers, which then generates more beer-related binge events than liquor-related events. Those with higher education may have better jobs, more social opportunities to drink, and perhaps more liberal views towards alcohol consumption.
These results do not confirm stereotypical views suggesting that Hispanics of Caribbean origin drink mostly liquor in the form of rum. Altogether, comparison of these results with those for the U.S. population (e.g., Dawson, 1993; Rogers and Greenfield, 1999) indicates that in regard to beverage preference, U.S. Compared to those who were employed full- or part-time, retirees and homemakers were about half as likely to participate in binge drinking. Liquor comes in second place for Puerto Ricans, while among Cuban Americans, Mexican Americans and South/Central Americans differences between wine and liquor are not large. About two fifths of them binged on beer and about a third binged on liquor at least once a month or more often.
Studies have examined the associations between alcohol use and caballerismo with mixed findings. Researchers posit that Latino men are socialized to adhere to the gender role machismo, which is typically considered to be a bi-dimensional construct. Applied to traditional Latino gender norms, evidence suggests that Latino men are encouraged to engage in alcohol use, while Latina women are discouraged from this kind of behavior (Perrotte, Martin, & Piña-Watson 2020; Perrotte & Zamboanga 2019; Schwartz et al. 2014; Zamboaga et al. 2014). Traditional gender norms have been found to substantially impact health behavior’s among Latino men (Arcienega et al. 2008; Nuñez et al. 2020; Perrotte & Zamboanga 2019).
Exploring Structural, Sociocultural, and Individual Barriers to Alcohol Abuse Treatment Among Hispanic Men
Present study findings highlight the need to consider socioeconomic status-related structural barriers to health for Hispanic men, specifically regarding work- and income-related constraints that keep men from seeking treatment. There was a generalized sentiment, however, that only people with extreme drinking problems or those with underlying behavioral health issues need to seek help. Participants mentioned that most men will reach out to their closest drinking companions for advice when problems with alcohol abuse arise. The men discussed that because alcohol use is not perceived to be a problem, that treatment is not perceived as necessary until they face grave consequences of their alcohol abuse, such as serious health problems, loss of family, or driving under the influence (DUI) convictions. Participants explained that high-risk drinking is seen as a phase of youth, and an inescapable habit for Hispanic men.
Little is known, however, about how aforementioned individual and sociocultural factors interact with an individual’s social context (i.e., neighborhood disadvantage, differential access to care, economic resources) to influence treatment seeking behaviors among Hispanic males. Although stereotypical in nature, research suggests that some Hispanic men may closely adhere to masculine ideologies (i.e., machismo) that exaggerate hyper-masculine behavior and can be detrimental to health (Arciniega et al., 2008; Torres, Solberg, & Carlstrom, 2002). There is a persistent lack of knowledge about the mechanisms by which adherence to Hispanic gender-bound cultural norms influence treatment-related behaviors in this group (Kissinger et al., 2013; NSDUH, 2012; Ojeda & Liang, 2014; Vega, Alderete, Kolody, & Aguilar-Gaxiola, 1998). Consequently, some Hispanic men might face disproportionate challenges when undergoing conventional alcohol abuse treatment.
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After approval by the Northwestern University Institutional Review Board, cirrhosis patients were identified and included if they were ≥18 years of age and had one of three cirrhosis Ninth Revision of International Classification of Diseases and Health Related Problems (ICD-9) codes (571.2, 571.5, or 571.6) similar to previous studies.23–25 Our study population included, 3,279 (16%) Hispanics, 9,150 (45%) NHW, 4,432 (22%) African Americans, 529 (3%) Asians and 2,731 (14%) comprised other races/ethnic groups. We used multivariable Cox regression to assess whether this ‘Hispanic paradox’ applies to patients with liver cirrhosis using a retrospective cohort of 20,121 patients in a Chicago-wide electronic health record database.
Moderation Analyses
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- Stigma related to participation in peer to peer support and church-based treatment programs was frequently cited.
- Race and ethnicity were abstracted from the medical record from the earliest encounter with a participating healthcare institution.
- Those with higher education may have better jobs, more social opportunities to drink, and perhaps more liberal views towards alcohol consumption.
- About two fifths of them binged on beer and about a third binged on liquor at least once a month or more often.
- Differences in the mean number of drinks of beer across Cuban American, Mexican American, and South/Central American women are not large.
- Moreover, one study found that women who chose to complete a survey in English were twice as likely to drink alcohol than those who chose the Spanish version.
This status categorized respondents based what is angel dust side effects, use, and risks on the combination of beverages (wine, beer, and liquor) they reported drinking in the past 12 months. The objective of this paper is to examine alcoholic beverage preference – wine, beer, and liquor – across Hispanic national groups in the U.S. Dawson (1993) reported that differences in beverage preferences between men (beer mostly) and women (wine and liquor) explain differences in alcohol consumption between genders. Recent years have seen the development of interventions aiming to reduce heavy alcohol consumption in the general population, and recent evidence suggests that attending to cultural factors may enhance treatment effects among Latino men.
Of that number, less than 10% received any addiction treatment from a facility designed to provide it. Between 1992 and 2002, an increasing number of women online aa meetings zoom proof of attendance received alcohol-related citations. Adolescents of Mexican parentage who have lived in the U.S. 11 years or more have significantly higher rates of alcohol abuse than those who have lived in the country for 10 years or less. Women, in particular, tend to consume more alcohol the more they become acculturated. Mexican and South/Central American men who drink, binge drink at a rate of 46.2% and 42.9% respectively.
Other sociodemographic variables
Hispanic men experience disproportionate levels of adverse health consequences of alcohol abuse when compared to NHW men (Caetano, 2003). Specifically, the detrimental effects of alcohol-related problems and potential benefits of maverick sober living treatment should be addressed in order to diminish social stigma of abuse and of treatment. There is need for responsive treatment strategies that comprehensively consider the gendered- and sociocultural-factors that govern treatment seeking and engagement behaviors.
Rogers and Greenfield (1999) showed that beer consumption accounted for most of the alcohol consumed (67%), most of the alcohol consumed by the heaviest drinkers, and most of the alcohol consumed (81%) in hazardous occasions (5 or more drinks). In all countries of the world where alcohol is not prohibited, the alcoholic beverages consumed most often are wine, beer, and liquor. Among men who drink beer, beer drinking constitutes 52% to 72% of total alcohol consumption. Nearly all participants in this sample consumed alcohol with regularity at the time of the study, however, only a fraction of these reported a binge drinking event in the last month, potentially limiting perspectives regarding alcohol abuse and treatment seeking. The purpose of this study was to examine Hispanic male perspectives regarding alcohol abuse treatment-seeking behaviors and the structural, sociocultural, and individual factors that may influence initiation and continued engagement in treatment in this population. Hispanic men, in particular, are at considerably elevated risk of heavy drinking compared to the population at large.
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This is in contrast to most studies that are done in a wait-list setting or using national transplant databases as these studies have some component of inherent referral and selection bias.Unfortunately, the same traits that improve generalizability bring limitations to our study. This finding is surprising in that recent data has suggested that female patients have longer wait times for transplant and potentially higher mortality on the waitlist due to disproportionate MELD score reduction related to lower serum creatinine.36,37 We posit that divergence of our findings from other studies is due to our cohort representing the general population of patients with cirrhosis. An increased risk of death was seen among NHW, African Americans and ‘other’ races compared to Hispanic patients. After exclusion of patients on Coumadin, a sensitivity analysis which included maximal MELD score during the study period with the same variables above did not alter the direction or statistical significance of these relationships. Relative to Hispanics, patients who identified as NHW (aHR 1.26; 95% CI 1.16–1.37), African American (aHR 1.26; 95% CI 1.15–1.39), and ‘other’ (aHR 1.55; 95% CI 1.40–1.71) had an increased risk of death. Of the entire study population, 3,279 (16%) were Hispanics, 9,150 were NHW (45%), 4,432 (22%) were African Americans, 529 (3%) were Asian and 2,731 (14%) were listed as ‘other’.
However, studies also show that Hispanic adults who do drink, tend to drink more heavily than other ethnicities. Only 54.5% of Hispanic adults over the age of 18 had at least one drink in the past year, compared to 70.3% of non-Hispanic white adults. Puerto Ricans account for nearly 10% and the Salvadoran, Cuban, Dominican, Guatemalan, and Colombian communities each have populations over 1 million in the U.S.
Because traditional gender roles for boys emphasize risk-taking, endorsement of these gender roles is not likely to protect boys against substance use. Our analyses suggest several possible ways that changes during acculturation increase or decrease adolescents’ risk of substance use, though researchers need to replicate these pathways and examine others. These findings are consistent with the view that adolescents are at risk when their acculturation differs from their parents’ acculturation. In longitudinal analyses (Unger et al., 2009b), adolescents who reported that the gap in Hispanic acculturation between themselves and their parents widened between ninth and tenth grade had an increased risk of substance use in tenth grade. This suggests that although Hispanic adolescents growing up in the United States are at risk for substance use, this risk can be mitigated by emphasizing enculturation—teaching youth about their cultures of origin and encouraging them to maintain a strong connection with the positive practices and values of those cultures.