Substance Use among Economically Disadvantaged African American Older Adults; Objective and Subjective Socioeconomic Status

Abstract

Purpose. This study investigated the effects of objective and subjective socioeconomic status (SES) indicators on two health behaviors, cigarette smoking and alcohol drinking, among African American older adults. Methods. This community-based study recruited 619 economically disadvantaged African American older adults (age ≥ 65 years) residing in South Los Angeles. Structured face-to-face interviews were conducted to collect data. Data on demographic factors (age and gender), subjective SES (financial difficulties), objective SES (educational attainment), living arrangement, marital status, healthcare access (insurance), and health (number of chronic medical conditions, self-rated health, sick days, depression, and chronic pain) and health behaviors (cigarette smoking and alcohol drinking) were collected from participants. Logistic regressions were used to analyze the data. Results. High financial difficulties were associated with higher odds of smoking cigarettes and drinking alcohol, independent of covariates. Educational attainment did not correlate with our outcomes. Similar patterns emerged for cigarette smoking and alcohol drinking. Conclusion. Subjective SES indicators such as financial difficulties may be more relevant than objective SES indicators such as educational attainment to health risk behaviors such as cigarette smoking and alcohol drinking among African American older adults in economically constrain urban environments. Smoking and drinking may serve as coping mechanisms with financial difficulty, especially among African American older adults. In line with the minorities’ diminished returns (MDR) theory, and probably due to discrimination against racial minorities, educational attainment has a smaller protective effect among economically disadvantaged African American individuals against health risk behaviors.

Smoking Status and Well-Being of Underserved African American Older Adults

“…A recent study that analyzed this sample of older African American adults residing in South Los Angeles found that even though men smoked more than women, depressive symptoms had a stronger effect on women [4]. Current smoking use among this group is also associated with higher financial difficulties [2] and higher odds of drinking/binge drinking [3]. Smoking is a major modifiable risk factor for multiple illnesses, specifically, chronic respiratory conditions, among older African American adults living in these impoverished urban environments [54].…”

“…African American intermittent smokers have a higher dependence, history of daily smoking, and smoke more cigarettes per day compared with Whites [70]. Within some minority populations, unhealthy behaviors, such as smoking and drinking, may act as coping behaviors for SES-related factors, such as financial difficulty [2].…”

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

“…Given the nature of the data collection, we defined our medication data collection as comprehensive. Data were gathered between 2015 and 2018 [10,[38][39][40][41][42][43].…”

“…Although all of LA County is experiencing an increase in homelessness, this is a more severe challenge in the poorest areas where AA individuals are more likely to lose their homes due to an inability to pay mortgage, rent, or property tax. Given poverty is concentrated in SPA6, homelessness has increased in this section of LA County [39].…”

Substance Abuse and Public Health: A Multilevel Perspective and Multiple Responses

“…In this special issue, Lo et al [31] explored how far using illicit drugs, smoking cigarettes and drinking alcohol predicted sexual misconduct among Macau youths, while simultaneously adjusting for the effects of susceptibility to peer influence and school attachment/commitment. Assari et al [32] attempted to assess the impact of subjective and objective socioeconomic status on the cigarette smoking and alcohol use of older African Americans by controlling the effects of pertinent covariates, which included demographic factors (age and gender), living arrangement and family type, health insurance status, chronic medical conditions, self-rated health, sick days, depression and chronic pain. Muller et al [33] investigated changes in exercise and nicotine use among 1464 Norwegian prison inmates by classifying them into harmful and non-harmful substance use pre-incarceration groups, according to the Drug Use Disorders Identification Test (DUDIT) and the Alcohol Use Disorders Identification Test (AUDIT), both of which are commonly used by healthcare practitioners and researchers to assess the severity of illicit drug and intoxicant use.…”