Elsevier

Addictive Behaviors

Volume 36, Issue 4, April 2011, Pages 381-388
Addictive Behaviors

Drinking and driving among immigrant and US-born Hispanic young adults: Results from a longitudinal and nationally representative study

https://doi.org/10.1016/j.addbeh.2010.12.017Get rights and content

Abstract

Objective

To evaluate the risk factors associated with the initiation of driving under the influence (DUI) among Hispanics in a longitudinal and nationally-representative sample of adolescents and young adults. Specifically, this study tests the effect of demographic variables, individual-level risk factors, and eco-processes (e.g., peer drug use, parental involvement) during adolescence on DUI among Hispanic young adults.

Methods

Data were derived from 1734 Hispanic adolescents surveyed for the National Longitudinal Study of Adolescent Health (Add Health). Survey logistic regression procedures were used to examine the effects of nativity status on DUI initiation, to evaluate the independent effect of each risk factor (demographic, individual-level, and eco-processes), and to identify whether and to what extent these factors are associated with the initiation of DUI.

Results

The overall prevalence of DUI initiation was 18.3%. Differences were observed in the rates of DUI initiation by nativity status: first-generation immigrants reported the lowest rates of DUI initiation (15.4%) when compared with second-generation US-born Hispanic youth (17.4%) and third-generation and beyond US-born Hispanic youth (21.5%). US-born Hispanic youth were also more likely to report higher frequency of alcohol use (t = 3.46, p = 0.001) and marijuana use (t = 2.34, p = 0.021) compared to immigrant adolescents. After adjusting for a number of risk factors, men (OR = 2.86), marijuana users (OR = 1.98), and those who reported feeling safe in their neighborhoods (OR = 2.02) were at an increased risk DUI initiation.

Conclusions

Findings provide support for the “immigrant paradox”: immigrant youth reported lower rates of DUI initiation and other high-risk behaviors when compared with US-born Hispanic youth.

Research Highlights

► Rate of DUI initiation differed by nativity status. ► Immigrant youth reported lower rates of DUI behaviors. ► Significant differences were observed among several risk factors by nativity status. ► US-born Hispanic youth engaged in more risky behaviors compared to immigrant youth.

Introduction

In the United States, driving under the influence (DUI) of alcohol is a major public health problem. On average, someone is killed in an alcohol-impaired driving crash every 45 min, and in 2008 (latest figures available), DUI fatalities accounted for 32% of all traffic deaths (National Highway Traffic Safety Administration, 2009). Across all racial/ethnic groups, motor vehicle crashes are the leading cause of death for persons ages 4 to 34 (National Highway Traffic Safety Administration, 2006). Hispanics, however, are over-represented in DUI deaths (National Highway Traffic Safety Administration, 2006, Roudsari et al., 2009). This health disparity is especially alarming given that Hispanics represent the largest and fastest growing minority population in the United States; and by 2050, it is projected that Hispanics will comprise nearly 30% of the US population (U.S. Census Bureau, 2008). Due to the growing population of Hispanic youth, reducing behavioral health risks (such as impaired driving), is of considerable public health importance.

When compared to White and African-American drivers, Hispanics are at increased risk of alcohol-impaired driving (Shults et al., 2009, Voas et al., 1998, Walker et al., 2003). Hispanic adolescents viewed DUI as less hazardous (Ginsburg et al., 2008) and were nearly twice as likely to ride with drivers who had been drinking compared to whites (Walker et al., 2003). Moreover, Hispanic drivers tended to report higher rates of legal alcohol intoxication, speeding, and invalid driver's licenses (Harper, Marine, Garrett, Lezotte, & Lowenstein, 2000). Overall, Hispanics reported believing that a larger number of drinks would be necessary to affect their driving ability when compared with other ethnic groups (Bergdahl, 2007, Caetano and Clark, 2000).

Efforts to understand the prevalence and etiology of DUI among Hispanics are challenged by the heterogeneity within the Hispanic population. US-born Hispanics are approximately three times more likely to drink and drive than Hispanics who were born in other countries but live in the United States (Caetano & Clark, 2000). Several studies have shown that US-born Hispanics report more encounters with the police when driving, increased alcohol abuse and dependence, and higher rates of DUI than their immigrant counterparts (Caetano and Clark, 2000, Caetano et al., 2008b). Previous studies are also consistent with a growing body of literature describing the “immigrant paradox” (Vega, Rodriguez, & Gruskin, 2009), or the tendency for foreign-born Hispanics, who would be expected to show poorer signs of health due to immigration and lifestyle disruptions, to report more favorable health indicators than US-born Hispanics. Potential explanations for the “immigrant paradox” include the deterioration of cultural and Hispanic family values, attitudes, behaviors (Prado et al., 2008, Schwartz et al., 2010, Szapocznik et al., 2007), and increased exposure to substances in the United States than in the immigrant host country (Vega, Gil, & Kolody, 2002). Another explanation for the “immigrant paradox” holds that ecological determinants such as school, peer, and family processes may operate differently for US-born and foreign-born youth (Prado, Huang, et al., 2009, Prado, Schwartz, et al., 2009, Vega et al., 2009).

Studies have also shown differences in rates of DUI by country of origin. For instance, Mexican-Americans have the second highest alcohol-related fatality rate (after Native Americans) among all four types of road users: drivers, passengers, pedestrians, and cyclists (Voas, Tippetts, & Fisher, 2000). Mexican-American men also have reported higher driving while intoxicated (DWI) arrests than any other ethnic/racial groups (R. B. Voas et al., 2000). When compared to whites, Mexican-Americans were also more likely to consider DUI less problematic and were more likely to believe that they would not be arrested for DUI (Cherpitel & Tam, 2000). In a recent study, Caetano, Ramisetty-Mikler, and Rodriguez (2008a) found that Mexican-Americans and South Americans, men, young drivers, those with less than high school education, those with higher income and higher alcohol consumption were more likely to report DUI and had more DUI arrests (Caetano, Ramisetty-Mikler, & Rodriguez, 2008a).

With the exception of the Hispanic American Baseline Alcohol Study (HABLAS) study (Caetano et al., 2008a, Caetano et al., 2008b, Caetano et al., 2008, Caetano et al., 2009), no studies to our knowledge have used a nationally representative sample of Hispanic youth to examine factors associated with risk of DUI. Furthermore, studies conducted to examine the “immigrant paradox” have sampled from specific regions within the United States because different segments of the Hispanic population have settled in different parts of the country (Paez & Suaez, 2002). Thus, using a nationally representative sample of Hispanics to examine the risk factors associated with DUI might help explain why US-born Hispanics report higher rates of DUI compared to their immigrant Hispanic counterparts.

The current study is a significant contribution to literature because it uses a longitudinal and nationally-representative sample of Hispanic adolescents and young adults to investigate DUI initiation among Hispanics by nativity status and country of origin. Specifically, the current study examines the role of demographic variables (e.g., gender, nativity status, and country of origin) on DUI and uses longitudinal data to examine the effects of ecological processes (e.g., parent, peers, and school) on DUI initiation, after controlling for the individual-level risk factors (e.g., drug use and other related behaviors).

We addressed two research questions: (1) Are there any differences in the prevalence of DUI among Hispanic youth by nativity status? and (2) What risk factors are associated with DUI initiation? We organized the risk and protective factors into three levels: demographics, ecological processes, and individual-level risk factors. Demographic factors include gender, age, generation status (1st generation immigrant, 2nd generation US-born, and 3rd and beyond generation US-born), and country of origin. Ecological factors include parental involvement, school connectedness, and peer drug use; and individual-level factors include drug use, delinquency, and other related risk factors.

Several general theoretical frameworks provide support for the study of risk factors associated with DUI behaviors. Expanding on social learning theory (Akers, 1985), the problem-behavior theory (Jessor, 1991, Jessor et al., 1995) provided a framework to the study of risk factors associated with adolescent problem behaviors (alcohol and illicit drug use, delinquency, and drunk-driving), health-related behaviors (e.g., unhealthy eating and tobacco use) and school behaviors (e.g., truancy, dropout, and drug use at school). In addition, Hawkins and colleagues provided a framework to identify conditions that increase or decrease the probability of children and adolescents manifesting behavioral problems (Hawkins, Catalano, & Miller, 1992). Szapocznik and colleagues also proposed an eco-developmental model of risk and protection for understanding contextual factors within various domains for children and adolescents: family, peer, school and neighborhood (Prado, Huang, et al., 2009, Prado, Schwartz, et al., 2009, Szapocznik and Coatsworth, 1999). Thus, reviews of these theories suggest that it is important to account for various contextual factors, including individual, family, peer, neighborhood, and cultural influences on DUI in order to more completely understand DUI etiology. To our knowledge, this is the first study to investigate the effects of risk factors during adolescence on the initiation of DUI among Hispanic young adults using nationally representative, longitudinal data.

Section snippets

Research design

Analyses were performed using the National Longitudinal Study of Adolescent Health dataset (Add Health), a longitudinal school-based survey of health-related behaviors among adolescents beginning in grades 7–12 and continuing into adulthood. The Add Health study was designed to explore the causes of various health-related behaviors, emphasizing social and contextual influences. Wave I included students interviewed between April and December 1995, Wave II included the same subjects interviewed

Differences in risk factors by nativity status

There were significant differences observed among several risk factors by nativity status. Overall, US-born Hispanic youth engaged in more risky behaviors when compared with immigrant youth. For instance, when compared to immigrant adolescents, US-born Hispanic youth were more likely to report higher frequency of alcohol use (t = 3.46, p = 0.001), marijuana use (t = 2.34, p = 0.021), and reported having a larger number of peers who use alcohol (t = 2.01, p = 0.047) and marijuana (t = 2.89, p = 0.005). In

Discussion

The purpose of the current study was to examine the effects of demographics, individual and eco-processes (e.g., drug use, peer drug use involvement, and school connectedness) on initiation of DUI behaviors between US-born and immigrant Hispanic young adults. Findings suggest that 2nd generation US-born Hispanic youth and 3rd generation and beyond US-born Hispanic youth were more likely to engage in DUI when compared to immigrant Hispanic youth, even after accounting for demographic variables.

Role of Funding Source

Funding of this study was provided by NIAAA Grant K01-AA017480. NIAAA had no role in study design, collection, analysis or interpretation of data, writing the manuscript, or the decision to submit the paper for publication.

Contributors

Dr. Maldonado-Molina and Ms. Reingle designed the study and conducted statistical analysis. Dr. Maldonado-Molina wrote the first draft of the manuscript and all authors contributed to and have approved the final manuscript.

Conflict of Interest

All authors declare that they have no conflicts of interests.

Acknowledgments

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for

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