Race‐Ethnicity,Union Status,and Change in Body Mass Index in Young Adulthood

This study used data from three waves of the National Longitudinal Study of Adolescent to Adult Health and fixed effects regression to consider whether associations between change in union status and change in body mass index (BMI) were moderated by race‐ethnicity. The results indicated that intimate unions were differentially associated with gains in BMI along racial‐ethnic lines, especially for women. When compared with White women, marriage was associated with larger increases in BMI for Black, Hispanic, and Multiracial women, and cohabitation was associated with larger increases for Black and Hispanic women. In contrast, marriage and cohabitation were associated with less weight gain for Asian when compared with White women. Among men, racial‐ethnic differences in the relationship between union status and BMI were similarly patterned but less pronounced. The results suggest that marital status further exacerbates racial‐ethnic disparities in BMI from adolescence to young adulthood.     

Concurrent binge drinking and current tobacco use and its social and health correlates among adults in Laos

ABSTRACT

The aim of this study was to examine sociodemographic and health correlates of concurrent binge drinking and tobacco use in a national adult population in Laos. A cross-sectional study based on a stratified cluster random sampling was conducted in 2013. The total sample included 2,543 individuals 18–64 years. Questionnaire interview, blood pressure, and anthropometric measurements, and biochemistry tests were conducted. Results indicate that 18.6% (38.3% in men and 5.2% in women) of the participants had engaged in concurrent current tobacco use and past month binge drinking, 15.2% in current tobacco use only and 28.4% in past month binge drinking only. Among current tobacco users, 42.2% engaged in frequent heavy drinking (3 or more times/month), and among past month heavy alcohol users, 55.8% were daily current tobacco users. In adjusted analysis, being 35 to 49 years old, lower education, having normal weight, and moderate or high physical activity were associated with concurrent current tobacco use and past month heavy drinking. Current tobacco use alone increased with age and decreased with education and heavy drinking alone decreased with age and increased with education. Findings suggest sociodemographic and health factors are important for public health interventions in addressing concurrent tobacco and alcohol use.     

Changes in Diverse Sexual and Contraceptive Behaviors Across College

Researchers have made repeated calls for a better understanding of normative sexuality development during adolescence and young adulthood. We examined how the occurrence of seven penetrative, nonpenetrative, and contraceptive behaviors changed longitudinally across seven waves, and how individual (gender) and contextual (romantic relationship status) factors related to these changes in a sample of college students (N = 730, M age = 18.4 at Semester 1; 51% female; 26% Hispanic/Latino American, 22% Black/African American, 30% Asian American/Pacific Islander, 45% White/European American). Across college, reported kissing, touching, performing and receiving oral sex, and penetrative sex rates increased, and contraception use (any type) and condom use (in particular) rates decreased, demonstrating changes with age independent of young adults’ romantic relationship experiences. Rates of all sexual behaviors were higher, and of contraception use lower, when students were in serious romantic relationships. Contraception use decreased more for men than for women, particularly in semesters men were not in serious relationships. Condom use decreased for men, and for women in semesters they were in serious relationships. Findings demonstrate normative trends in sexuality development, as well as suggesting the value of enhanced sexual health promotion programming, with a particular focus on contraceptive behaviors, across college.     

Racial/ethnic disparities in prior mental health service use among incarcerated adolescents

Research on racial and ethnic disparities in mental health and substance abuse service use among incarcerated youth in the U.S. is inconclusive. This cross-sectional study adds to our understanding of racial and ethnic disparities by examining the prior use of mental health and substance abuse services among incarcerated juveniles. Guided by Andersen's behavioral model of health service utilization, a series of logistic regression analyses were conducted on a non-probability sample of 13–19 year-old youth in two residential facilities for juvenile offenders in Western Pennsylvania (N = 181). Black and Hispanic youth were less likely than White youth to have used mental health and substance abuse services, even when controlling for predisposing, enabling, and need factors. Additional analyses revealed that these differences did not hold across all service types, specifically with regards to outpatient service use. Significant differences did exist, however, in the prior use of inpatient mental health and substance abuse services. This suggests that White youth are often funneled into the mental health system, while youth of color enter the justice system. Implications for racial/ethnic disproportionality in service use and justice system involvement are discussed.     

Temporal Relationship of Sex Risk Behaviors and Substance Use Severity Among Men in Substance Use Treatment

Sex risk behaviors and substance use are intertwined. Many men continue to engage in high-risk sexual behaviors even when enrolled in substance use disorder (SUD) treatment. We hypothesized that changes in sex risk behaviors would coincide with changes in drug/alcohol use severity among men in SUD treatment. During an HIV risk-reduction trial, men in methadone maintenance and outpatient drug-free treatment (N = 359) completed assessments at baseline and six months after. We assessed changes in sex risk and substance use severity, using the Addiction Severity Index–Lite (ASI-Lite), controlling for treatment condition. In multinomial logistic regressions, decreased alcohol severity was significantly associated with decreases in reported sex partners, and increased alcohol severity was significantly associated with increases in reported sex partners. Increasing drug use severity was significantly associated with maintaining and initiating sex with a high-risk partner, while decreasing alcohol use severity was significantly associated with discontinuing sex under the influence. However, changes in drug/alcohol use severity were not associated with changes in unprotected sex. Substance use reductions may decrease HIV risk behaviors among male substance users. Our findings highlight the importance of integrating interventions in SUD treatment settings that address the intersection of sex risk behaviors and substance use.     

Factors Associated with Drug Treatment Entry Patterns Among Hispanic Women Injection Drug Users Seeking Treatment

SUMMARY

This paper examines patterns of drug treatment entry and factors that are associated with these patterns among 1,849 Hispanic women injection drug users (IDUs). The data analyzed originates from a statewide drug-treatment database covering seven years, 1996–2002. Through the use of logistic regression analyses, the study identified significant differences in predisposing, need and enabling factors in the use of detoxification only, residential treatment, or methadone maintenance. Compared to other Hispanics, Puerto Rican women were 40 percent less likely to use only detoxification services and one and a half times more likely to use methadone maintenance. Having health insurance was an especially important factor associated with methadone treatment utilization. Two of the most important factors associated with residential treatment use were history of mental health services utilization and involvement with the criminal justice system. This article discusses specific social work practice implications including the need for social work practitioners to promote services such as residential treatment, to be trained in treatment of co-occurring mental health disorders, especially among women in residential treatment, and the need to establish close linkages with the mental health and criminal justice systems.     

Man Up,Man Down: Race–Ethnicity and the Hierarchy of Men in Female‐Dominated Work

Scholars have largely overlooked the significance of race and socioeconomic status in determining which men traverse gender boundaries into female‐dominated, typically devalued, work. Examining the gender composition of the jobs that racial minority men occupy provides critical insights into mechanisms of broader racial disparities in the labor market—in addition to stalled occupational desegregation trends between men and women. Using nationally representative data from the three‐year American Community Survey (2010–2012), we examine racial/ethnic and educational differences in which men occupy gender‐typed jobs. We find that racial minority men are more likely than white men to occupy female‐dominated jobs at all levels of education—except highly educated Asian/Pacific Islander men—and that these patterns are more pronounced at lower levels of education. These findings have implications for broader occupational inequality patterns among men as well as between men and women.     

Physical activity among ethnically diverse college students

The authors compared physical activity patterns among 874 Asian, 332 African, 1,101 White, and 529 Hispanic American college students aged 18 to 25 years. According to self-report responses, 46.7% of the sample did not engage in vigorous physical activity and 16.7% were physically inactive. Among women, ethnic-specific rates of physical inactivity were Asian, 28.1%; African, 23.5%; White, 17.4%; and Hispanic, 20.3%. For men, rates of inactivity were Asian 11.7%; African, 7.7%; White, 12.0%; and Hispanic, 13.8. Weight-training activity, youthful physical activity, and TV viewing accounted for a significant portion of the variance in physical activity levels (13.1% for women and 14.8% for men). The results of this study support the need for physical activity interventions for college students, particularly minorities.     

Race-ethnicity and medical services for infertility: stratified reproduction in a population-based sample of U.S. women

Evidence of group differences in reproductive control and access to reproductive health care suggests the continued existence of "stratified reproduction" in the United States. Women of color are overrepresented among people with infertility but are underrepresented among those who receive medical services. The authors employ path analysis to uncover mechanisms accounting for these differences among black, Hispanic, Asian, and non-Hispanic white women using a probability-based sample of 2,162 U.S. women. Black and Hispanic women are less likely to receive services than other women. The enabling conditions of income, education, and private insurance partially mediate the relationship between race-ethnicity and receipt of services but do not fully account for the association at all levels of service. For black and Hispanic women, social cues, enabling conditions, and predisposing conditions contribute to disparities in receipt of services. Most of the association between race-ethnicity and service receipt is indirect rather than direct.     

Comparing Offers and Take‐ups of Employee Health Insurance across Race,Gender, and Decade*

How often do U.S. employees receive health insurance offers from employers? When offered, how often do they take up their employer‐based health insurance? This article uses the 1992 and 2002 waves of the National Study of the Changing Workforce (NSCW) to investigate changes in access to (offers) and employees electing to accept, take, or purchase their employers’ health insurance plans (take‐ups) among wage and salaried workers. Although much research has studied employee health benefits, little has examined the intersection of gender and race regarding both offers and take‐ups of such benefits. Logistic regression results indicate that offers and take‐ups of personal health benefits declined from 1992 to 2002, net of salient controls. Further analyses demonstrate that these declines did not affect all workers identically. Offers declined somewhat for both women and men among whites and African Americans, but declined more among Hispanic women and men. Among other ethnoracial groups, offers declined the most among men, but increased among comparable women. Take‐ups declined among white men and Hispanic workers. However, white and African American women's take‐ups did not change and among African American men take‐ups increased. We discuss the need to examine gender and race simultaneously and urge researchers to more closely examine changes in health benefit offers and take‐ups.     

Cohabitation and U.S. Adult Mortality: An Examination by Gender and Race

This study is the first to explore the relationship between cohabitation and U.S. adult mortality using a nationally representative sample. Using data from the National Health Interview Survey‐Longitudinal Mortality Follow‐up files 1997–2004 (N = 193,851), the authors found that divorced, widowed, and never‐married White men had higher mortality rates than cohabiting White men, and never‐married Black men had higher mortality rates than cohabiting Black men. In contrast, the mortality rates of nonmarried White and Black women were not different from those of their cohabiting counterparts. The results also revealed that mortality rates of married White men and women were lower than their cohabiting counterparts and that these mortality differences tended to decrease with age. The authors found no significant mortality differences when they compared married Black men or women to their cohabiting counterparts. The identified mortality differences were partially—but not fully—explained by income, psychological, or health behavior differences across groups.     

The use of mental health care,psychotropic drugs and social services by divorced people: does informal support matter?

This study compares the mental health care, psychotropic drugs and social service use of divorced people (re-partnered or single) with that of married people. This paper questions whether the availability of informal support facilitates or substitutes for formal care seeking. Data from the Divorce in Flanders survey of 2009–2010 are used. Logistic regression analyses are performed separately for women (N = 3450) and men (N = 3020). Greater use of mental health care, psychotropic drugs and social services by single divorced men is explained by their higher need for care, while divorced women (especially single divorced) more frequently contact a general practitioner (GP), a psychiatrist, or a psychologist, regardless of their mental health, socio-economic background and informal support. Women who have support from non-family members are more inclined to use social services and to contact a GP, while support from family members is only positively related to GP consultations. With regard to men, informal support from non-family members positively influences each type of formal care seeking. Our results suggest that non-family members (and only among women, family members as well) can provide help and advice about seeking professional mental health care and social services, but they do not have an influence on psychotropic drug use.     

More from Louis Baxter on doctors taking MAT

The question of whether or not doctors and other health care professionals on medication‐assisted treatment (MAT) are safe to practice medicine has been debated for the last few years since the advent of Food and Drug Administration (FDA)–approved MAT for opioid use disorder (OUD). The newly approved medications have been primarily buprenorphine formulations for OUD, naltrexone formulations for OUD and alcohol use disorder (AUD), and, most recently, an alpha 2‐adrenergic medication that specifically targets amelioration of opioid‐withdrawal symptoms from OUD (lofexidine). Quite frankly, the question of safety about medications to treat substance use disorder (SUD) has been asked since the development of methadone for OUD treatment more than 30 years ago.     

Premarital cohabitation and marital disruption among white,black, and Mexican American women

We use data from the 1995 National Survey of Family Growth (N = 4,547) to investigate racial and ethnic differences in risk factors for marital disruption, with a particular emphasis on premarital cohabitation. We find that the nature and strength of the estimated effects of several risk factors for disruption differ across groups. In particular, premarital cohabitation is positively associated with subsequent marital disruption among non‐Hispanic White women but not among non‐Hispanic Black or Mexican American women. Little of the observed gaps between groups in levels of disruption, however, appears to be attributable to differences in premarital cohabitation. In addition to improving our understanding of marital disruption, this research contributes to a growing literature emphasizing heterogeneity across groups in the meaning and function of cohabitation.     

Racial and Ethnic Differences in Problem Gambling among College Students

The college years are a formative period where the risk for development of problematic gambling is high. Research examining racial and ethnic differences in gambling behaviors has been limited and inconsistent. The aims of this study were to examine racial and ethnic differences in problem gambling among a large sample of college students. Undergraduates (N = 3058) from a large southern university completed an online screening questionnaire which included demographics, gambling frequency, gambling expenditure (i.e. money lost) in the previous 6 months, and the South Oaks Gambling Screen (SOGS). Negative binomial regression results indicated that Asian participants gambled less frequently than participants who were Caucasian or Hispanic/Latino(a), but spent more money than participants who were African-American (AA)/Black or Hispanic/Latino(a). A significantly larger proportion of Asian students met probable pathological gambling criteria (SOGS 5+; 7.8 %) and at-risk gambling criteria (SOGS 3+; 16.3 %)) than Caucasian (5.2; 10.1 %), AA/Black (3.9; 10.2 %), or Hispanic/Latino(a) (3.6; 9.4 %) students. Additionally, a significantly larger proportion of Asian students endorsed problematic gambling indicators such as lying about losses, feeling guilty about gambling, feeling like they had a gambling problem, being criticized for their gambling, feeling like they couldn’t stop gambling, losing time from school or work due to gambling, having a family history of problem gambling, and arguing with close others about their gambling than Caucasian, AA/Black or Hispanic/Latino(a) students. Results suggest that Asian students may be a high-risk sub-group of college gamblers, and that there is a critical need for targeted interventions for this population.     

Gabapentin shows promise for treating early alcohol withdrawal symptoms

Treating alcohol use disorder (AUD) with gabapentin in the early stages of alcohol withdrawal shows promise, according to a randomized clinical trial reported in JAMA Internal Medicine. The study, “Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial,” by Raymond F. Anton, M.D., and colleagues, evaluated gabapentin versus placebo in 145 treatment‐seeking people who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for AUD, 96 of whom were in recent alcohol withdrawal and randomized to treatment after three abstinent days. Daily drinking was recorded, and a heavy drinking blood marker was collected at baseline and monthly. The percentage of individuals with total abstinence and those with no heavy drinking days were compared between treatment groups. The participants had 83% heavy drinking days (four drinks a day for women, five for men) at baseline. More gabapentin‐treated individuals had no heavy drinking days (12 of 44 participants [27%]) compared with placebo (four of 46 participants [9%]), and more total abstinence (eight of 44 [18%]) compared with placebo (two of 46 [4%]). The prestudy high‐alcohol‐withdrawal group had positive gabapentin effects on no heavy drinking days and total abstinence compared with placebo, while within the low‐alcohol‐withdrawal group, there were no significant differences. These findings were similar for other drinking variables, where gabapentin was more efficacious than placebo in the high‐alcohol‐withdrawal group only. Gabapentin caused more dizziness, but this did not affect efficacy.     

The influence of ethnicity, socioeconomic status, and psychological barriers on use of mammography

This study assessed the relative influence of psychological barriers, SES, and ethnic differences in mammography use for a community sample of 586 White, 227 Black, and 150 Hispanic women. Confirmatory factor analyses with latent variables indicated plausible factor structures for all groups on items related to barriers to mammography. Summed indicators of SES, fear of radiation, embarrassment, pain, anxiety, and cost concerns were correlated significantly with mammography use for the pooled group. Separate analyses by ethnicity indicated a substantial relationship between mammography use and cost concerns by White and Black women, and fear of pain by Black and Hispanic women. Use of mammography was associated more highly with SES among Hispanic women. Pooled logistic regression analyses controlling for SES and ethnicity showed that the psychological barriers, especially concern about cost, remained important independent predictors of mammography use. We explore sociocultural explanations for less mammography use by Hispanic women, especially those less acculturated.     

Experience of Forced Sex and Subsequent Sexual,Drug, and Mental Health Outcomes: African American and Hispanic Women in the Southeastern United States

ABSTRACT. Objectives: This cross-sectional study examined African American and Hispanic women's (N = 1,509) self-reports of unwanted forced sex and its association with behavioral and mental health outcomes after the event. Methods: Twenty percent of the women had experienced forced sex (1st occurrence at age 15 years or younger for 10%, 1st occurrence at older than 15 years of age for 10%). Results: Regardless of when forced sex 1st occurred, women were more likely to have engaged in unprotected vaginal and anal sex, to have had multiple unprotected sex partners, to have sexually transmitted infections, to have reported binge drinking and illicit drug use, and to exhibit distress and have received mental health counseling. Conclusions: Forced sex may have wide-ranging behavioral and mental health consequences years later.     

Exploring Adoptive Motherhood: Adoption-Seeking Among Hispanic and Non-Hispanic White Women

Predictors of ever having sought adoption are evaluated for Hispanic and non-Hispanic White women. Analysis of the 2002 National Survey of Family Growth, a nationally representative study of reproductive health of 7,643 women aged 15 to 44 years, is employed. These include Hispanic and non-Hispanic White women aged 18 to 44 who are currently married and cohabiting (n = 3,118) and Hispanic and non-Hispanic White women aged 18 to 44 of all marital statuses (n = 5,236). Being married, older, and attending religious services are significantly associated with having sought adoption among non-Hispanic White women. Nativity status, language spoken, and resources are significantly associated with having sought adoption among Hispanic women.