Abstract
Background: While socioeconomic status (SES) indicators such as educational attainment are among the major drivers of health behaviors such as substance use, the protective effects of these indicators may differ across ethnic groups. Built on the Marginalization related Diminished Returns (MDRs) phenomenon that refers to weaker health effects of SES indicators for marginalized and minoritized groups (vs. non-Latino White people), we conducted this study with two aims: First to test the association between educational attainment and time spent on substance/drug use, and second, to test for ethnic variation in this association. Methods: This cross-sectional study used the American Time Use Survey (ATUS 2019) data. Participants included 7380 individuals who were either Latino or non-Latino White. We tested for associations between time spent on substance/drug use and a continuous measure of educational attainment using linear regression. Age and sex were control variables. We used logistic regression for sensitivity analysis using any time spent on substance/drug as the outcome. Results: Overall, high educational attainment showed an inverse association with time spent on substance/drug use overall. We also documented a statistical interaction between ethnicity and educational attainment such that associations between educational attainment and time spent on substance/drug use was weaker in Latino vs. non-Latino White individuals. We could replicate the results using logistic regression for any time spent on substance/drug as the outcome. Conclusion: We observe that SES indicators such as educational attainment may have a differential protective effect against time spent on substance/drug use for diverse ethnic groups. In contrast to non-Latino White individuals, Latino individuals reported spending similar amounts of time on substance/drug use across the full SES spectrum. This finding is in line with the MDRs framework and may be attributable to the effects of structural racism, social stratification, and marginalization impacting ethnic minorities in the United States.
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