Correlates of alcohol and drug use among low-income Hispanic immigrant childbearing women living in the U.S.A.

Abstract

Alcohol and drug use is a widespread and serious problem with deleterious consequences for the health and well-being of childbearing-age women and their children. Little information exists regarding etiological factors for substance use among Hispanic childbearing-age women immigrating to the United States (USA). This research provides a correlational analysis of factors associated with alcohol and drug use. The Social Stress Model for Substance Use Prevention provided the conceptual framework for this cross-sectional, interview-administered survey of 60 low-income predominantly Mexican–American women. The outcome variable was alcohol and drug use (alcohol, cigarettes, marijuana, cocaine and opiates). Independent variables included the major constructs of the model: stress, social support, social influences, personal competencies and community resource utilization patterns. Findings suggested that the levels of drug use were lower among this study sample than in the general USA population regardless of pregnancy status. Bivariate correlations demonstrate that women with higher drug use indices had more lenient attitudes regarding drug use and were more likely to have family and friends that used alcohol and drugs. Although drug use was relatively low among this sample of women, both women who used alcohol themselves and women whose partners used alcohol and drugs reported significantly higher levels of stress, weaker social support and poorer levels of self esteem. Implications for practice and future research are suggested.

Introduction

The use of harmful substances by women of childbearing age may not be a new phenomenon in American life, but the high incidence among low income inner-city women continues to be a serious public health problem. Recent data from the National Pregnancy and Health Survey reveal that 5.5% of pregnant women use some illicit drug (marijuana, cocaine, heroin, etc.), almost 19% use alcohol and 20% smoke cigarettes (Leshner, 1994). In women from the inner-city rates have been found to be three to four times higher (Amaro et al., 1990; Feldman et al., 1992). A multitude of reasons can account for this finding, which is linked to problems in pregnancy outcome, infant status and development (Pettiti and Coleman, 1990; Lindenberg et al., 1991; Bateman et al., 1993; Lindenberg and Keith, 1993; Racine et al., 1993).

Recognized as an even greater concern among inner-city poor is their vulnerability to AIDS, characterizing them as a subgroup at highest risk. Hispanics represent approximately 10.6% of the population (Census, 1997), but comprise 19% of AIDS cases (CDC, 1997) acquired predominantly through drug and related sexual risk behaviors. The use of drugs has also led to other dangerous consequences, resulting in family violence, child abuse and neglect and childhood illness (Canino, 1994; Williams-Petersen et al., 1994; Rouse et al., 1995).

The devastating effects of substance abuse among young women have strong implications for introducing prevention strategies, particularly since this group will become the parenting role model for future generations. Among those living in poverty, their exposure to substance use is often accompanied by poor physical and mental health. In low-income urban settings, the conditions appear more tenuous. At present, inadequate information exists regarding the risk and protective factors among low-income Hispanic childbearing-age women, especially among the newer immigrants (DHHS, 1993).

This paper reports findings from a small cross-sectional survey intended to identify risk and protective factors associated with drug use behavior among low-income Hispanic childbearing age women. Understanding those risks and protective factors will help to develop culturally and socially relevant interventions to prevent and reduce substance abuse among these women in the transition to adult roles and responsibilities.

Several theoretical models have been proposed to explain etiological and intervention approaches to drug use/abuse (Fishbein and Azjen, 1975; Jessor and Jessor, 1977; Garmezy and Masten, 1986; OSAP, 1988; Rhodes and Jason, 1988b; US Prevention Task Force, 1989; Leukefeld and Bukoski, 1991). Although each one emphasizes different factors, all view alcohol and other drug use as stemming from the interaction of multiple personality, family, environmental and behavioral factors.

In the present study, the Social Stress Model for Substance Use Prevention (see Fig. 1) was used to provide direction (Rhodes and Jason, 1988a). This model was chosen because it emphasizes both risk and protective factors. According to the model, the relationship between stressors (risks) and substance use is modified by protective factors such as social support, social influence, personal and social competence and community resources. The protective variables are viewed as interacting to modify the impact of stress on risk-taking behaviors. This conceptual model guided the selection of the measures utilized in this pilot study.