Perceived Race-Ethnic Discrimination, Major Depressive Disorder, and Alcohol Use Disorder Among US-Born and Immigrant Minorities

Background and Purpose: Perceived race-ethnic discrimination may explain differential rates of Major Depressive Disorder [MDD] and Alcohol Use Disorder [AUD] that exist within minority populations in the United States. While many studies have established a relationship between symptoms of depression and discrimination, few have done so by examining depression using DSM diagnostic criteria and fewer still have examined the relationship between discrimination and AUD. Finally, most studies of discrimination have compared race-ethnic groups to White Americans only. This study expanded upon what is known about the negative sequelae of discrimination while uniquely comparing race-ethnic groups across both US-born and immigrant populations.

Methods: This dissertation study used data from Wave II of The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and included Black, Hispanic, Asian, and Native American respondents who were US-born [n = 10,044], and Black, Hispanic, and Asian respondents who were immigrants [n = 4,435].  Thus, the total sample was 14,479.   Odds ratios were used to study associations between MDD and AUD and perceived race-ethnic discrimination among race-ethnic groups both US-born and immigrant. Moderation analysis was also conducted to test the interaction between immigrant and US-born individuals who perceive discrimination and its affect on the outcomes.

Results: Important differences between US-born and immigrant minorities in the United States are observed. Immigrants are significantly more likely to experience MDD and AUD than their US-born counterparts [ORs = .79 –.43]. Patterns are similar for AUD with odds ratios almost mirroring those of MDD. Further, a consistent pattern emerges indicating the deleterious nature of perceived race-ethnic discrimination for both groups.  MDD is about two times [OR = 1.99; p = 0.001] more likely among US-born and immigrant minorities who experience discrimination than for those who do not experience discrimination.  Similarly, minorities who experience discrimination are also almost two times more likely to experience AUD that those who do not [OR = 1.88; p = 0.001].

Conclusion and Implications: The findings address important questions related to social work practice and policy. Social workers and other provides are reminded of the profound impact discrimination has on mental health outcomes. In particular, these findings allow for social workers to gain a deeper understanding of how discrimination impacts particular groups and as such can modify existing programs and develop interventions that can be specifically tailored to the unique needs of minorities, both US-born and immigrants. Moreover, while policies exist that target certain types of discrimination and federal statues enable the prosecution of hate crimes, these policies are not always upheld. These results have further elucidated the negative impact of discrimination among minorities.  This in turn, may make it more likely that prosecution of hate crimes will occur. Further research is needed to explore cultural factors that may explain these differences across US-born and immigrant minority populations.