The association between racial and socioeconomic discrimination and two stages of alcohol use in blacks.

Background: This study aimed to characterize the associations of racial and socioeconomic discrimination with timing of alcohol initiation and progression from initiation to problem drinking in Black youth.

Methods: Data were drawn from a high-risk family study of alcohol use disorder. Mothers and their offspring (N = 806; M = 17.87, SD = 3.91; 50% female) were assessed via telephone interview. Cox proportional hazards regression analyses were used to examine associations between discrimination and timing of first drink and progression from first drink to problem drinking in two separate models. Predictor variables were considered in a step-wise fashion, starting with offspring racial and socioeconomic discrimination, then adding (2) maternal racial and/or socioeconomic discrimination experiences; (3) religious service attendance and social support as potential moderators; and (4) psychiatric and psychosocial risk factors and other substance use.

Results: Offspring racial discrimination (HR: 2.01, CI: 1.17-3.46 ≤ age 13) and maternal experiences of discrimination (HR: 0.79, CI: 0.67-0.93) were associated with timing of initiation in the unadjusted model only; offspring socioeconomic discrimination predicted timing of initiation among female offspring, even after adjusting for all covariates (HR: 1.49, CI: 1.14-1.93). Socioeconomic discrimination predicted a quicker transition from first use to problem drinking exclusively in the unadjusted model (HR: 1.70, CI: 1.12-2.58 ≤ age 18). No moderating effects of religious service attendance or social support were observed for either alcohol outcome.

Conclusions: Findings suggest socioeconomic discrimination is a robust risk factor for initiating alcohol use in young Black female youth and should be considered in the development of targeted prevention programs.