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

Int J Environ Res Public Health. 2019 May 23;16(10):1826. doi: 10.3390/ijerph16101826.

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.

Keywords: African Americans; Blacks; drinking; educational attainment; financial difficulty; older adults; smoking; socioeconomic position; socioeconomic status.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / ethnology
  • Alcohol Drinking / psychology*
  • Black or African American / psychology*
  • Black or African American / statistics & numerical data
  • Cigarette Smoking / ethnology
  • Cigarette Smoking / psychology*
  • Female
  • Health Behavior / ethnology*
  • Humans
  • Logistic Models
  • Los Angeles / ethnology
  • Male
  • Social Class*
  • Vulnerable Populations / psychology*
  • Vulnerable Populations / statistics & numerical data