Acculturation, Acculturative Stress, Religiosity, and Social Support, and Alcohol Use Among Asian Immigrants

Purpose: Although Asian Americans are the fastest-growing ethnic minority and suffer the same adverse health and social consequences of alcohol use as do other ethnic groups (Fong & Tsang, 2007), research on alcohol use within this group is scant. According to acculturative stress model, alcohol use can be seen as one manifestation of stress accompanying the process of acculturation to the mainstream society (Bhattacharya, 2005; D' Avanzo et al., 1994). Studies that reported acculturation as a risk factor for use of alcohol often assume that the relationship is based on the stress of acculturation, rather than assessing acculturative stress directly and empirically (Caetano et al., 2007). A few studies on the effects of acculturation on alcohol use have actually measured acculturative stress. The purpose of this study is to examine both acculturation and acculturative stress as risk factors and social support and religiosity as protective factors in relation to use of alcohol.

Methods: This study was a secondary analysis of data from the National Latino and Asian Americans Study (NLAAS), which collected information from a nationally representative sample of individuals of Asian descent who were 18 years of age or older residing in the United States. This current study used Asian American immigrants born outside the U.S. The total unweighted sample size was 1,639 for a population of 5,932,403. Alcohol use, the dependent variable, was defined as abstaining, non-risky drinking, and risky drinking. Acculturation was measured by English-language proficiency (á=0.96) and acculturative stressors were assessed by family cultural conflict (á=0.75), and discrimination (á=0.98). Protective factors included religiosity, family cohesion (á=0.93), and friend support (á=0.85). Socio-demographic variables included age, gender, income, education, religion affiliation, and marital status. Ordered logistic regression for complex surveys was conducted using Stata 10.

Results: Ordered logistic regression results showed that after controlling for socio-demographic variables, English-language proficiency, discrimination, family conflict, and religiosity were significantly related to alcohol use. Asian immigrants who reported higher level of acculturation (OR=1.11, 95% CI [.05, 1.18]), discrimination (OR=1.03, 95% CI [1.00, 1.06]), and family cultural conflict (OR=1.17, 95% CI [1.09, 1.26]) were more likely to be risky-drinkers, holding all other variables constant. The odds of being a risky drinker were associated with decreased odds of high religiosity (OR=0.40, 95% CI [0.25, 0.65]), holding all other variables constant. However, more support from friends was associated with increased likelihood of being a risky drinker (OR=1.11, 95% CI [1.02, 1.21]), holding all other variables constant. Family cohesion was not significantly associated with alcohol use.

Implications: The results suggest that acculturation is a risk factor for alcohol use so the retention of their own cultural values and norms may be important for continued well-being of immigrants. Social workers need to help Asian immigrants develop constructive coping skills to deal with acculturative stress including discrimination and family cultural conflict. This study found friend support provides a negative effect on alcohol use, thus social workers carefully assess social support. Further, Social workers advocate implementing policies to reduce racial discrimination, oppression, and prejudices.