Everyday Discrimination and Substance Use Disorders: A Latent Profile Analysis with African Americans and Caribbean Blacks

Background and Purpose: A major source of health-related stress stems from perceived discrimination (Whitbeck, Hoyt, McMorris, Chen, & Stubben, 2001), the effects of which are comparable to other major stressors such as death of a loved one, divorce, or job loss (Kessler, Mickelson, & Williams, 1999). Evidence suggests a powerful link exists between perceived discrimination and alcohol and illicit use disorders among African Americans and Caribbean Blacks (Gibbons, Gerrard, Cleveland, Willis, & Brody, 2004; Seaton, Caldwell, Sellers, & Jackson, 2008). Although an increasing amount of research has examined the effects of discrimination on mental and physical health, much of this research has conceptualized discrimination as a continuous construct. However, emerging research has suggested that discrimination may manifest as a multifaceted, multidimensional phenomenon (Jones, 1997). The purpose of this study was to model the heterogeneity of perceived everyday-discrimination experiences among African American and Caribbean Blacks and identify differences in the prevalence of substance use outcomes (alcohol-use disorder and illicit drug-use disorder) among the identified subgroups. To our knowledge, this is the first study to identify classes of everyday discrimination and the first to compare prevalence of substance-use disorders across latent subgroups of African Americans and Black Caribbeans distinguished by experiences of everyday discrimination.

Method: The study uses a sample of African American and Caribbean Black respondents between 18 and 65 years (N = 4,462) from the National Survey of American Life. We used latent profile analysis in Latent GOLD® 4.5 to identify and validate latent subgroups of perceived discrimination, and multinomial regression analyses in Stata 13.1SE to examine the relationship between discrimination subgroups and substance-use disorders.

Results: Results yielded a four class solution. Classes consisted of Low Discrimination (17.28%), Disrespect and Condescension (16.94%), General Discrimination (50.03%), and Chronic Discrimination (14.75%). Findings show significant differences exist between the Low Discrimination and General Discrimination classes for alcohol-use disorder and illicit drug-use disorder. Significant differences also exist between the Low Discrimination and Chronic Discrimination classes for both substance-use disorders examined. Compared with the Chronic Discrimination class, members of the other classes were significantly less likely to meet criteria for alcohol-use disorder and illicit drug-use disorder. Findings suggest elevated levels of discrimination increase risk for substance-use disorders.

Conclusions and Implications: The current study’s findings suggest that experiences of perceived discrimination are heterogeneous among African Americans and Caribbean Blacks. Consistent with previous research, our findings suggest that greater frequency of discrimination is a source of increased risk for substance-use disorders. Moreover and importantly, the results suggest the prevalence of substance-use disorders is a function of the type and frequency of discrimination that individuals experience. In particular, when occurring in isolation from other experiences of discrimination, it appears that discrimination perceived as disrespect and condescension does not alone increase risk for illicit drug-use disorder. Rather, it seems it is the ongoing experience of multiple types and frequencies of discrimination, including disrespect, condescension, hostile, and character-based discrimination, which places individuals at greater risk for substance-use disorder.