Discrimination and Substance Misuse Among Filipinos in the Philippines

Background and Purpose: Discrimination has been associated with negative health outcomes including the misuse of substances, such as alcohol and cigarette use. People experience discrimination because of numerous factors such as their gender, English language proficiency, accent, and darker skin color. Whereas experiences of discrimination and substance misuse has been examined among the Filipina/o diaspora in the U.S., little is known about how experiences of discrimination among Filipina/os in the Philippines influence their misuse of substances. The U.S. and the Philippines have an enduring relationship as a result of the aftermath of the Philippine-American War in 1902 with the Philippines becoming a U.S. colony for several decades which has led Filipina/os as one of the leading immigrant groups in the U.S. This article aims to understand the association of experiences of discrimination and substance misuse among Filipina/os living in the Philippines.

Methods: Data was analyzed on 1624 Filipina/os using baseline data derived from the Health of the Philippine Emigrants Study (HoPES). The study examines the influence of migration among Filipina/os before and after they arrived in the U.S. The Everyday Discrimination Scale was used to assess perceived experiences of discrimination. Weighted binary logistic and negative binomial regressions were performed to estimate the association of experiences of discrimination on cigarette and alcohol misuse respectively. Interaction effects were performed to investigate the moderating effect between gender and discrimination. A secondary analysis of binge drinking by gender (≥5 for men; ≥4 for womxn) were also performed using weighted binary logistic regressions.

Results: In the fully adjusted models that controlled for sociodemographic characteristics and migrant status, discrimination was independently associated with substance misuse risk behaviors: smoking history (OR=1.28; 95% CI:1.11,1.47) and heavy alcohol misuse (OR=1.45; 95% CI:1.20,1.77). Womxn had lower adjusted odds of each behavior. The interaction between gender and discrimination were significant on several substance misuse risk behaviors: smoking history (OR=1.41; 95% CI: 1.07, 1.84), smoking history of over 100 cigarettes in lifetime (OR=1.42; 95% CI:1.04, 1.95), smoking often (OR=1.56; 95% CI: 1.09, 2.22), and heavy alcohol use (OR=1.88; 95% CI:1.31, 2.69). In gender-stratified models for binge drinking, the association between discrimination and binge drinking (OR=1.89; 95% CI=1.41,2.53) was present for womxn but not for men, suggesting a gender-specific pattern of vulnerability to discrimination.

Conclusions and Implications: Our findings suggest that experiences of discrimination are associated with certain behaviors of substance misuse. The moderating effect of gender on substance misuse, specifically among Filipina womxn, indicate that gender-related discrimination may have influence on substance misuse behaviors. Implications for future studies should consider how discrimination manifests in the Filipina/o population and how it can influence health behaviors. Given the design of the HoPES study, it is imperative to examine how migration to the U.S. and the changing form of discrimination that Filipina womxn might experience can influence their misuse of substances. This study can also inform social work and public health researchers and practitioners in implementing interventions that address and mitigate various forms of discrimination that influence the misuse of substances in this population.