Discrimination and Substance Use: A Test with Adolescents in Hawaii

Introduction: Racial/ethnic discrimination has been linked to health disparities in mainland U.S. studies and substance use has been suggested as a part of the pathway. Most prior research on discrimination has been conducted with African-Americans, but relatively little research has been conducted with other populations. The Hawaiian Islands constitutes a setting of a particular interest because epidemiologic studies have shown health disparities for Native Hawaiians and Filipinos. However, the behavioral basis for these disparities is not well understood.

Method: This study examined pathways in the relationship between perceived racial/ethnic discrimination and substance use (tobacco, alcohol, and marijuana) in a multiethnic sample of adolescents (N = 2,659, M_age= 12.6 years) that included Asian-Americans (31% of the sample), Filipinos (25%), and Native Hawaiians (20%), and Caucasians (16%). A school-based survey included measures of discrimination and substance use as well as measures of six possible mediators (school involvement, affect, smoking/alcohol expectancies, rebelliousness, social competence, and self-esteem).

Results: A structural equation modeling analysis showed mediation through more anger, rebelliousness, and substance expectancies and less school involvement; the mediators had indirect effects to adolescent substance use through affiliation with peer users as well as direct effects to substance use. Multiple-group analysis showed significant paths from discrimination to the mediators that were similar for Asian-Americans, Filipinos, and Native Hawaiian/Pacific Islanders but not for Caucasians.

Conclusions: Discrimination affects several different ethnic groups and does so from relatively early ages. Processes underlying the effect of discrimination on substance use were similar for three of the ethnic groups studied. The finding of an effect for discrimination at a relatively young age is noteworthy, particularly so because none of the ethnic groups studied constitute a numerical majority in Hawai‘i. However, all major ethnic groups reported experiencing racial/ethnic discrimination to some extent. These findings suggest a basis for early interventions to reduce discriminatory experiences and strengthen problem-focused coping and academic competence. Intervention components to decrease anger and substance use as coping strategies may also be warranted.