Short CommunicationAdult social roles and alcohol use among American Indians
Introduction
Research demonstrates that American Indians (AIs) experience a disproportionate share of alcohol-related problems. AI adolescents have the highest prevalence of DSM-IV substance use disorders (Wu, Woody, Yang, Pan, & Blazer, 2011) and AI adults are more likely than any other racial or ethnic group to experience alcohol-related injuries (Keyes, Liu, & Cerda, 2011). Furthermore, substance use disorders among AIs escalate during adolescence and young adulthood (Whitbeck et al., 2014), emphasizing the importance of understanding factors that may shape changes in alcohol consumption during this period.
A useful model for understanding changes in AI alcohol consumption is the life course perspective. This perspective points to the myriad of life transitions (e.g., higher education, marriage, and parenthood) clustered during early adulthood that may shape alcohol use. Although the transition to adult social roles has been linked to alcohol use (Bachman et al., 1997, Staff et al., 2014, Staff et al., 2010) associations vary by race (Akins et al., 2013, Paschall et al., 2005), illustrating the importance of examining the impact of adult social roles on changes in alcohol use among AIs. Furthermore, although AIs are a culturally diverse group, they have a shared traumatic history which can cause stress or grief (Walters, Simoni, & Evans-Campbell, 2002) with implications for alcohol consumption. Thus, it is important to explore within-group predictors of alcohol use among this population.
Prior studies suggest that alcohol use among AIs is linked to social roles. Studies have found that married AIs are more likely to stop using alcohol (Stone, Whitbeck, Chen, Johnson, & Olson, 2006) or be in remission from alcohol dependence (Gilder, Lau, Corey, & Ehlers, 2008) than those who are never-married or divorced. However, some studies have found no association between AI marriage and alcohol use (Akins et al., 2013) and others have shown associations only at the bivariate level (Ward & Ridolfo, 2011). Parenthood may also be protective. For instance, Quintero (2000) examined problem drinking among Navajo men and found that parenthood was frequently cited as a primary catalyst for reducing alcohol consumption. Other adult statuses may also influence substance use among AIs. One recent study found that the association of education and employment with substance use differed for AIs and Whites: Among AIs, education and employment were both associated with a lower likelihood of “bender drinking” (Akins et al., 2013).
These studies provide preliminary evidence about the association between adult social roles and alcohol use among AIs, while also revealing important gaps. For instance, most of these studies used cross-sectional designs or focused on community-based reservation samples, despite the fact that only about 22% of AIs live on reservations (Norris, Vines, & Hoeffel, 2012). The current study addresses these gaps in the literature by examining whether transitions into adult social roles (i.e., cohabitation, marriage, parenthood, full-time work, and enrollment in higher education) are associated with changes in alcohol use among AIs included in a nationally representative sample. We utilize a multi-level modeling strategy to disentangle how social roles and substance use are associated at the within- and between-person level. By design, the within-person estimates control for stable individual differences between people (Raudenbush & Bryk, 2002), thus reducing concerns related to selection.
Section snippets
Data and sample
We utilized the restricted-use National Longitudinal Study of Adolescent Health (Add Health) data (Harris, 2009), a nationally representative sample of adolescents (in grades 7–12 at Wave 1) who were initially surveyed in 1994/1995 and re-interviewed in 1996 (W2), 2001–2002 (W3), and 2007–2008 (W4). Data for this study came primarily from the in-home survey, in which information about substance use was collected using a self-administered questionnaire. Our sample was comprised of individuals
Results
Results demonstrated that adult social roles were linked to alcohol use among AIs at the within- and between-person levels. In interpreting these models, it is important to note that between-person associations indicate whether average alcohol use differs for people who ever occupied a particular social role compared to those who never occupied that role. In contrast, within-person associations indicate the extent to which individuals have different alcohol use when they occupy a social role
Discussion
Given the high rates of alcohol misuse and alcohol-related problems among AIs, the current study sought to explore whether family, work, and school roles protected against alcohol use among this population. Although significant associations were documented at the between- and within-person level, we focus our attention on discussing the latter as they are less likely biased due to selection factors. Below, we apply a life course developmental perspective to inform our interpretation of the
Role of funding sources
Financial assistance for this study was provided by NIDA Grant 1R01DA034466-01. The design and content of this study are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
Contributors
Author A conceptualized the study, conducted statistical analyses, and wrote the first draft of the manuscript. Authors B and C provided input regarding the conceptualization of the study and made revisions to the manuscript. All authors contributed to and have approved the final manuscript.
Conflict of interest
All authors declare that they have no conflict of interest.
Acknowledgments
This research uses data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris, and funded by a grant P01-HD31921 from the National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R. Rindfuss and Barbara Entwisle for their assistance in the original design for the National Longitudinal Study of Adolescent Health.
References (21)
“The lizard in the green bottle”: “Aging out” of problem drinking among Navajo men
Social Science & Medicine
(2000)- et al.
Patterns and correlates of adult American Indian substance use
Journal of Drug Issues
(2013) - et al.
- et al.
Heavy episodic alcohol use in emerging adulthood: The role of early risk factors and young adult social roles
Journal of Drug Issues
(2010) - et al.
Factors associated with remission from alcohol dependence in an American Indian community group
The American Journal of Psychiatry
(2008) The National Longitudinal Study of Adolescent Health (Add Health)
Waves I & II, 1994–1996; Wave III, 2001–2002; Wave IV, 2007–2009 [machine-readable data file and documentation]
(2009)- et al.
Persons as contexts: Evaluating between-person and within-person effects in longitudinal analysis
Research in Human Development
(2009) - et al.
The role of race/ethnicity in alcohol-attributable injury in the United States
Epidemiologic Reviews
(2011) - et al.
Job satisfaction, job reward characteristics, and employees' problem drinking behaviors
Work and Occupations
(1996) - et al.
Alcohol and employment in the transition to adulthood
Journal of Health and Social Behavior
(2000)
Cited by (12)
American Indian income and father involvement with children in urban cities
2017, Children and Youth Services ReviewCitation Excerpt :Continued effects of historical trauma have impacted the likelihood of decreased father involvement or father absences in Native American homes (Brave Heart, Chase, Elkins, & Altschul, 2011; White, Godfrey, & Moccasin, 2006). Some of the difficulties American Indian families continue to face include high rates of child abuse (Cross, Earle, & Simmons, 2000), substance abuse (Green, Eitle, & Eitle, 2014; Kawamoto, 2001), and suicide rates of American Indian youth that are one and a half times those of the national average (Center for Disease Control, 2015). Efforts to improve parenting patterns including fathering behaviors among American Indian families have been initiated by American Indian tribes in response to the loss of many parenting role models (Kawamoto, 2001; Shears, Bubar, & Hall, 2011).
Hidden Suicides of the Indigenous People of the Brazilian Amazon: Gender, Alcohol and Familial Clustering
2019, Revista Colombiana de PsiquiatriaCitation Excerpt :Among the Tikuna group alcohol consumption creates the opportunity not only for arguments, accusations and fighting followed by death, but it is also associated to idea that “it gives courage” to commit the act of suicide, mainly among the younger members. The alcohol consumption seems to be an important associated factor for suicide in other indigenous groups, mainly during the transitional period from late adolescence until young.27,28 Another important aspect reported in this study is the occurrence of familial clustering of suicide.
Social disparities in alcohol consumption among Canadian emerging adults
2023, Health Promotion and Chronic Disease Prevention in CanadaLanguage Ability Accounts for Ethnic Difference in Mathematics Achievement
2022, Frontiers in PsychologyAging and Health of American Indians and Alaska Natives: Contributions from the Native Investigator Development Program
2021, Journal of Aging and HealthAssociations of Binge Drinking With Vascular Brain Injury and Atrophy in Older American Indians: The Strong Heart Study
2021, Journal of Aging and Health