Perceptions of Discrimination and Stress Among Latina Adults with Risky Alcohol Use

Background

Discrimination has been associated with negative mental and behavioral health outcomes for Latinx, including alcohol misuse. This may be exacerbated for Latinas, who often have multiple disadvantaged statuses that may contribute to cumulative stress and risky alcohol use. Moreover, Latinas are at higher risk of psychological distress than Latino men. Few studies have examined discrimination among Latina adults with risky drinking behavior. Drawing from minority stress theory, which incorporates minority identity as a factor in negative health behaviors, this study explored perceptions of discrimination and their role in psychological distress and alcohol use among diverse Latina adults with risky alcohol use.

Methods

Participants (N= 40) were part of a mixed-methods study examining sociocultural factors associated with risky alcohol use (> 3 drinks per day or > 7 drinks per week on average) among Latina adults. Using purposive sampling, semistructured interviews were conducted with Latinas in their preferred language (n= 20 Spanish; n= 20 English) who met criteria for risky alcohol use in the previous 90 days, determined using the Timeline Follow-back method. Participants described their perceptions and experiences related to discrimination, psychological distress, and alcohol use. They completed the Everyday Discrimination and the Perceived Discrimination scales, which measure routine experiences of unfair treatment and incidents of unfair treatment due to race and ethnicity, respectively. Qualitative data were analyzed using thematic analysis, which consisted of comparing codes across and within participant transcripts. Memo writing was used throughout the analysis process to document decisions regarding theme development.

Results

Spanish-speaking Latinas (M= 36, SD= 5.71) were significantly older than English-speaking Latinas (M= 29, SD= 4.78; p< .001); no other demographic differences were found. No significant differences were found in everyday discrimination, perceived discrimination, or quantity of alcohol consumed by language group. Qualitative analysis revealed that perceptions of discrimination focused on the vicarious impact of anti-immigrant policy and rhetoric (“Uncertainty of not knowing what is going to happen to us as Hispanics in this country”) and its contribution to psychological distress. Other participants mentioned feeling no control over anti-immigrant policy and rhetoric and therefore, used avoidance as a coping mechanism (“If I allow myself to get involved, it is very stressful”). Colorism (“We are Whitexicans ... we go unnoticed”) in self-perception and behaviors by others was another stress-related factor. Qualitative data indicated differences between language groups related to within-group discrimination (“There is a lack of unity. ... Why are you trying to knock down other Latinos?”), which was salient among Spanish-speaking participants, whereas gender-related discrimination (“If it’s a woman, it would be, ‘She’s drinking a lot!’”) was more prominent among English-speaking participants.

Implications

Findings underscore the detrimental role of discrimination on Latinas with risky alcohol use. Collectively, these experiences were associated with distress, regardless of preferred language. This highlights the relevance of examining risky alcohol use behavior using a multifaceted approach that considers discrimination as a contributing factor to distress for Latinas. Such insight can guide community-based interventions and treatment priorities for this underserved group.