Profiles of Social Disadvantage and Alcohol Use Disorder Criteria Among Asian Americans and Pacific Islanders

Background and Purpose: Alcohol use disorder (AUD) has been the most prevalent form of substance use disorder in the United States. While much is known about the relationship between social disadvantage and AUD, this relationship is poorly understood in Asian Americans and Pacific Islander (AAPI) populations. The study explored the patterns of social disadvantage and their associations with the AUD criteria in this population.

Methods: This study used data from the National Epidemiologic Survey of Alcohol and Related Conditions-III on AAPIs’ (N = 1,340) social disadvantage and AUD criteria. Social disadvantage in the study includes three socioeconomic variables (i.e., educational attainment, income, and employment status), childhood poverty, racial discrimination, and adverse childhood experiences (ACEs). A three-step latent class analysis (LCA) using the Bolck, Croon, and Hagenaars (BCH) method was conducted to examine the heterogeneity within response patterns to items that describe social disadvantage among AAPIs. In addition, the relationship between classes and the AUD criteria was examined.

Results: Three classes were identified: Class 1 labeled “High Adversity” (9.5%), Class 2 labeled “High Discrimination” (10.1%), and Class 3 labeled Low Disadvantage (80.4%). The High Adversity group reported the higher probabilities of U.S.-born and the number of AUD criteria than those in the High Discrimination group. The High Adversity group also showed the greater probabilities of U.S.-born and the number of AUD criteria as well as a lower probability of mental functioning compared to the Low Disadvantage group. Moreover, the High Discrimination group reported a lower probability of mental functioning than the Low Disadvantage group. Results from the multiple regression analyses showed the regression effect of class membership and covariates on the AUD criteria: Class 1 and Class 2 were positively associated with AUD criteria, controlling for demographic and functioning characteristics (B = 1.314, SE = .30, p < .001, and B = .577, SE = .29, p = .043, respectively).

Conclusions and Implications: The results suggest that AAPIs in groups with high adversity and racial discrimination are more susceptible to AUD than those with low disadvantage. The findings suggest that social work practitioners should provide a trauma-informed perspective to clients who have experienced childhood adversity or who report perceived discrimination to reduce their risk of alcohol-related disorders. Latent class models demonstrate how disadvantage is distributed unequally across classes and illustrate its associations with the AUD criteria. Further studies are also needed to better understand social disadvantage and its negative consequences in AAPI populations.