Discrimination and Substance Use Among Older Adults: The Role of Racial/Ethnic Identity

Background and Purpose: Perceived discrimination has negative impacts on mental and physical health and can lead to risky coping behaviors, such as substance use. Various studies have examined the preventative and risk factors of substance abuse, and some have found that a strong cultural/ethnic identity moderates the effects of perceived discrimination on substance abuse among adolescents. However, despite the projected growth both in racial/ethnic diversity and rates of substance use among older adults, no study to date has examined the protective and risk factors as they relate to racial/ethnic identity and substance use among this population. To address this gap in the literature, our study draws from the Perceived Unfairness Model (Jack & Kubzansky, 2006), which posits that an individual’s perception of unfairness over a prolonged period can result in the development of a disease (i.e., substance abuse). This relationship can potentially be moderated by an individual’s sense of self and group membership. In accordance with this model and previous empirical literature, we hypothesize that: 1) stronger racial/ethnic identity will be associated with lower substance use among minority older adults, but not White older adults; and 2) higher racial/ethnic identity will decrease the negative impact of perceived discrimination on substance use for minority older adults but not for White older adults.

Methods: Date for this study are from the 2012-2013 National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III), a cross-sectional survey based on a nationally representative sample of noninstitutionalized U.S. residents 18 years and older. Our analytic sample of 10,418 consisted of adults aged 55 and older who reported their race/ethnicity as Black, White, or Latinx. We conducted binary logistic regression analyses to model the association between racial/ethnic identity, perceived racial discrimination, and past 12-month substance use among older adults, adding control variables to models hierarchically. We then tested a series of models that included interactions between racial/ethnic identity, perceived discrimination, and race/ethnicity.

Results: Our study shows that higher cultural identity is associated with lower odds of substance use, but this association does not differ according to race/ethnicity. However, a three-way interaction between racial/ethnic identity, perceived discrimination, and race/ethnicity revealed that compared to Whites, for Latinx older adults in the U.S., stronger racial/ethnic identity significantly reduced the negative effect of perceived discrimination on substance use.

Conclusions and Implications: This is the first study to explore the moderating role of racial/ethnic identity on the association between perceived discrimination and substance abuse among older adults across racial/ethnic groups. Results from this study show that among Latinx older adults, higher cultural identity buffers some of the negative impact of discrimination on substance use. This calls attention to the need to create culturally sensitive community programs that empower Latinx communities to access supportive resources. In the context of today’s political climate, the increased rates of anti-Latinx sentiments need to be addressed at the community level through welcoming and protection policies that promote safety and trust among this population. Longitudinal studies are needed to understand the role of race/ethnic identity among minority older adults across the life-course.