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Mailman School of Public Health study examines link between racial discrimination and substance use

In one of the first studies to focus on the relationship between racial discrimination and health risk behaviors, researchers at the Columbia University Mailman School of Public Health with colleagues from the Universities of Minnesota, Alabama (Birmingham), and California (San Francisco), and Harvard University found African Americans experiencing racial discrimination were more likely to report current tobacco use or recent alcohol consumption and lifetime use of marijuana and cocaine.

Although racial discrimination was far less common in Whites (38%) than in African Americans (89%), the researchers assessed whether parallel associations exist in Whites and found similar associations with smoking, alcohol, and lifetime use of marijuana and cocaine as they did in African Americans. Thus, substance use may be an unhealthy coping response to perceived unfair treatment for some individuals regardless of their race/ethnicity. However, it is worth noting that racial discrimination may be a different phenomenon for African Americans than it is for Whites, and thus, lead to very different consequences, said Luisa N. Borrell, DDS, PhD, of the Mailman School of Public Healths Department of Epidemiology and principal investigator of the study.

African Americans experiencing racial discrimination also reported having more education, higher income, and a stronger social network than those reporting no racial discrimination. In contrast to African Americans, Whites reporting racial discrimination reported less education and lower income than did those who reported none. Similar to African Americans, Whites reporting any discrimination were more likely to report less control of their life, more anger, less emotional support, and more negative interactions than did their counterparts reporting none.

We found that African Americans reporting discrimination in three or more domains in both years had higher levels of education and income than did those who reported experiencing less or no discrimination, said Dr. Borrell. Possibly, African Americans with a higher socioeconomic position report more discrimination because they are more exposed to situations in which they are discriminated, or they may be more aware of subtle forms of discrimination, noted Dr. Borrell.

According to the findings, in contrast, Whites with a low socioeconomic position may be more likely to be exposed to environments in which they are the minority and, therefore, be more likely to feel discriminated.

Among the strengths of the study are its population-based nature, the focus on young to middle-aged adults, the wide ranges of educational attainment and income, the information on illicit substance use, and socioeconomic position indicators. It is possible that use of a recreational drug helps to cope with life stress resulting from perceived unfair treatment because of ones race/ethnicity, observed Dr. Borrell. Our findings that current use of marijuana was not related to discrimination and that risk of being a former smoker was increased suggest that, by early middle age (average age, 40 years), people may have found other ways to cope. However, the finding of an excess of current smoking in this population, suggest that this addictive habit may be long lasting, even when alternative coping behaviors are adopted.

Source of the data was the CARDIA study, a prospective study of cardiovascular risk among young adults. 3,330 persons aged 1830 years examined at baseline (1985-1986) and re-examined again seven (1992-1993) and 15 years (2000-2001) later in the (CARDIA) Study were included in this study.


Contact: Stephanie Berger
Columbia University's Mailman School of Public Health

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