Socio-Cultural Factors Associated with Heavy Drinking Among U.S.-Born and Foreign-Born Filipino-American

Despite the growing number of Asian-Americans in the U.S., understanding of problem drinking pattern in this population is severely understudied. Researchers suggest that the patterns of heavy drinking widely differ based on various ethnic backgrounds within Asian-Americans and are related to a range of socio-cultural factors, including racial discrimination. This study reports on the effect of racial discrimination and other risk and protective factors for heavy drinking among U.S.-born and foreign-born Filipino-Americans. Two hypotheses were tested for the present study: 1) U.S. born Filipino-Americans and Filipino immigrants will differ in the characteristics and prevalence of heavy drinking; 2) U.S. born Filipino-Americans and Filipino immigrants do not share the same protective or risk factors, including discrimination for heavy drinking.

Data from the 1998-1999 Filipino American Community Epidemiological Survey (FACES) was used to test the study hypotheses. FACES used stratified probability sampling technique to recruit Filipino-Americans residing in San Francisco and Honolulu. A total of 2,285 interviews were completed (78% response rate). The present study included those respondents who reported yes to drinking in their lifetime, yielding a final analytic sample of 1,443. Appropriate weights were applied to reflect the complex sampling technique. Taylor series linearization method was used for correct estimation of standard errors in the presence of stratification. The interactive logit regression results confirmed the presence of significant interaction by nativity status, which gave statistical rationale to run separate analyses by nativity status. Two-step logistic regression analyses were performed to test the study hypotheses. In the first step, the heavy drinking was regressed on everyday discrimination while controlling for sociodemographic factors (age, gender, education, employment status, marital status, and location of residence). In the second step, sociocultural factors (overall health status, any mood disorder, emotional support, religiosity, and psychological distress) were added to the first step.

The results showed that U.S. born and foreign-born Filipino-Americans substantially differed in age, gender, employment status, marital status, location of residence, mood disorders, religiosity, and psychological distress, as well as prevalence of heavy drinking. Stratified logistic regression revealed that risk and protective factors for heavy drinking differed for Filipino-Americans based on their nativity status. The everyday discrimination was a significant risk factor, while location of residence and religiosity were significant protective factors of heavy drinking for U.S. born Filipino-Americans. On the contrary, being male and less everyday discrimination, was a significant risk factor of heavy drinking for foreign-born Filipino-Americans

Nativity status significantly and differentially predicted the risk and protective factors of heavy drinking among Filipino-Americans living in SF and Honolulu in the present study. While sociocultural factors, including location of residence and religious participation were protective factors and everyday discrimination a risk factor of heavy drinking for U.S.-born Filipino-Americans, only being a male was a risk factor of heavy drinking among Filipino immigrants. In light of the present findings, health professionals should tailor independently to U.S. born and foreign born Filipino-Americans when considering preventive and intervening strategies to curb the heavy drinking among this population.