Alcohol and Development in Youth : Minority Youth

by National Institute of Health

(Page 5 of 5)

Data from a recent nationwide survey reveal that about three-fourths of White, American Indian, and Hispanic high school seniors used alcohol in the past year. More than 6 percent of American Indian and 5 percent of Mexican and Cuban American seniors report daily drinking, compared with 1 percent to 3.8 percent for all other groups. The limited data on Hispanic and American Indian adults suggest that, among those who drink, there is a tendency toward high average intake per drinking day. Youth survey data suggest that some students establish a pattern of heavy drinking by their senior year of high school. About 60 percent of African American and about 57 percent of Asian American high school seniors report having used alcohol in the past 12 months, and about 32.5 percent in both groups report having used it in the past 30 days. However, there appears to be a "cross-over" effect for African Americans. That is, even though they use less alcohol as youths than their non-Hispanic White counterparts, rates of heavy and problem drinking among African American adults, especially males, are higher than for non-Hispanic Whites.

Studies of race and ethnicity should be conducted with sufficiently large and diverse samples to allow investigators to assess variations in drinking by national origin or tribal affiliation, acculturation, immigration status, and language. Significant variation exists among Hispanics and among American Indians. Recent evidence indicates that members of some American Indian groups are more likely to abstain than are people in the general U.S. population. Like their Mexican American counterparts, American Indian drinkers, however, consume more alcohol per drinking occasion. In addition, although Asian Americans often are considered the "model minority," with low rates of alcohol use, most current literature does not include data from rapidly growing at-risk Asian groups such as Southeast Asians, Koreans, and Filipinos, or groups believed to have higher rates of alcohol use, such as Native Hawaiians and other Pacific Islanders.

Although there is clear evidence of genetic variability in alcohol metabolism, we have yet to fully understand the interplay of genetic and environmental variables. For example, the inability to metabolize alcohol efficiently, deemed a protective factor in a subset of the Asian population because of the unpleasant effects of drinking, often results in facial flushing. Highlighting the complexity of the interplay between genetic and environmental variables is the observation that Asian American drinking often increases with level of acculturation in spite of the flushing response.

Risk and Protection

Although almost all U.S. youth grow up in a culture permeated by alcohol, they are not uniformly at risk for alcohol consumption or its consequences. Much research has addressed the risk and protective factors associated with youth drinking. These factors include but are not limited to family history and genetic vulnerability, comorbid conditions and their developmental antecedents, sociodemographic characteristics, social stressors such as poverty and lack of social support, family characteristics, alcohol availability, temperament, and other individual factors. Some of the most consistently documented epidemiologic findings regarding the association of alcohol consumption and other factors are presented in the following brief overview.

Data from general population surveys of youth, as well as data from smaller, more localized studies, consistently indicate that rates of drinking and alcohol-related problems are highest among White and American Indian or Alaska Native youth, followed by Hispanic youth, African Americans, and Asians. Likewise, studies uniformly indicate that alcohol consumption generally increases as a person's age increases. Prevalence rates of drinking for boys and girls are similar in the younger age groups; among older adolescents, however, more boys than girls engage in frequent and heavy drinking, and boys show higher rates of drinking problems. Other common findings are a strong association between conduct problems and earlier alcohol consumption, and youth with a family history of alcohol problems are at much greater risk both for problem use and later alcohol use disorders. Studies also show that underage drinkers generally possess more than one risk factor and exhibit clusters of problem behaviors.

The scientific literature on risk and protective factors for underage drinking reveals important conceptual as well as methodological issues. For example, many such risk factors have been identified solely on the basis of their association with drinking and its consequences. This association is not sufficient evidence, however, to prove that something actually increases risk for, or protection from, underage drinking. Some scientists, therefore, advocate a stricter definition of risk/protective factors. The term "risk factor," for example, would apply only to variables for which there is a statistically significant link to the onset of adolescent alcohol use as well as evidence that any such variable was present prior to the onset of drinking. Furthermore, "alcohol consumption" encompasses not just one but numerous phenomena. Finally, it is important to be aware that many of the risk factors predicting early drinking are not drinking variables but instead are more nonspecific characteristics, such as externalizing and internalizing problems, that are identifiable much earlier than the first drinking experience but represent high-risk pathways into earlier use. We therefore need to more precisely define those risk/protective factors that apply to the initiation of drinking, to the escalation of drinking, to risky drinking, and to other aspects of consumption.

About the Author

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