Racial and Ethnic Influences on Mental Health and Substance Use Disorders: The Case of Caribbean Blacks

Abstract

The scientific literature supports that differences in socioeconomic status and poor living arrangements influence health outcomes. The fact that the nature of health inequalities differ by their sources raises important questions about causal factors related to substance abuse disorders. Prior studies have generally grouped respondents of African American and Caribbean black ethnicities into one global category of “Black” or African American. This aggregation may obscure important differences in substance use patterns. This study examines in- and out-of country Caribbean Blacks, in comparison to African Americans, at the population and individual levels and how processes of migration might influence substance use disorders. The study is based upon national household probability samples of non-institutionalized African Americans and Blacks from Caribbean countries living in the U.S., conducted between February 2001 and June 2003, with a slightly modified version of the World Mental Health version of the World Health Organization’s Composite International Diagnostic Interview. A total of 3570 African Americans and 1623 Caribbean Blacks, aged 18 and over were interviewed in the United States and an additional 2068 adults in Guyana and 1216 in Jamaica. In this study we found that prevalence of substance disorders vary by national context, with higher rates within the U.S. Rates of substance misuse were lower overall for women, but differ across cohorts by other socio-demographic factors. Nativity and length of time in the U.S. were also associated with mental health disorders. The needs and directions for future research are discussed.