Substance Use Profiles of Urban American Indian Adolescents: A Latent Class Analysis

ABSTRACT

A growing majority of American Indian adolescents now live in cities and are at high risk of early and problematic substance use and its negative health effects. Objective: This study used latent class analysis to empirically derive heterogeneous patterns of substance use among urban American Indian adolescents, examined demographic correlates of the resulting latent classes, and tested for differences among the latent classes in other risk behavior and prosocial outcomes. Method: The study employed a representative sample of 8th, 10th, and 12th grade American Indian adolescents (n = 2,407) in public or charter schools in metropolitan areas of Arizona in 2012. Latent class analysis examined eight types of last 30 day substance use. Results: Four latent classes emerged: a large group of “nonusers” (69%); a substantial minority using alcohol, tobacco, and/or marijuana [ATM] (17%); a smaller group of polysubstance users consuming, alcohol, tobacco, marijuana, other illicit drugs, and prescription or OTC drugs in combination (6%); and a “not alcohol” group reporting combinations of tobacco, marijuana, and prescription drug use, but rarely alcohol use (4%). The latent classes varied by age and grade level, but not by other demographic characteristics, and aligned in highly consistent patterns on other non-substance use outcomes. Polysubstance users reported the most problematic and nonusers the least problematic outcomes, with ATM and “not alcohol” users in the middle. Conclusions: Urban AI adolescent substance use occurs in three somewhat distinctive patterns of combinations of recent alcohol and drug consumption, covarying in systematic ways with other problematic risk behaviors and attitudes.

KEYWORDS:

• Substance use
• urban
• American Indian
• adolescents
• latent class

Acknowledgments

We thank the American Indian Steering Group at the Southwest Interdisciplinary Research Center for their guidance in the development of this study and interpretations of results.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

Data collection and analysis for this study was supported by the National Institute on Minority Health and Health Disparities [NIH/NIMHD] (awards P20-MD002316 and R01-MD006110). The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health.

Additional information

Notes on contributors

Stephen S. Kulis

Stephen S. Kulis (Ph.D., Columbia University) is Cowden Distinguished Professor of Sociology in the Sanford School of Social and Family Dynamics at Arizona State University (ASU), and Director of Research at the Southwest Interdisciplinary Research Center at ASU, a Center of Excellence for health disparities research funded by the National Institute on Minority Health and Health Disparities of the National Institutes of Health. His research focuses on cultural processes in health disparities, such as the role of gender and ethnic identity in youth drug use and prevention interventions; cultural adaptation of prevention programs for ethnic minority youth; contextual neighborhood and school level influences on youth substance use; gender and racial inequities in professional careers, and the organizational sources of ethnic and gender discrimination. He currently leads parallel NIMHD-funded studies in collaboration with urban American Indian communities in Arizona, including cultural adaptations of evidence-based prevention programs for adolescents and parents, and tests of the interplay of contextual factors at the peer, family and community level that influence urban American Indian adolescent behavior.

Justin Jager

Justin Jager (Ph.D., University of Michigan) is an Assistant Professor within the T. Denny Sanford School of Social and Family Dynamics at Arizona State University. His research focuses on how person-context interactions inform development across adolescence and the transition to adulthood. He pays particular attention to (1) contextual transitions associated with early adulthood and their impact on functioning, and (2) the dual impact of distal/adolescent and proximal/early adulthood factors on subsequent adjustment. His more recent work also focuses on the family system and documents, through the latent modeling of dyadic and triadic data, agreement and disagreement among family members regarding family functioning and family relationships.

Stephanie L. Ayers

Stephanie L. Ayers (Ph.D., Arizona State University) is the Associate Director of Research for the Southwest Interdisciplinary Research and Research Faculty in the School of Social Work at Arizona State University. She focuses on substance use prevention research with an emphasis on Latino and American Indian families. Her research explores how family, peer, school, and neighborhood factors exert risk and protective factors on adolescent substance use. Additionally, she has a specialization in medical sociology with an emphasis on minority health disparities particularly in the area of health care utilization.

Husain Lateef

Husain Lateef is a doctoral student in the School of Social Work at Arizona State University (ASU), and a second year graduate associate at the Southwest Interdisciplinary Research Center at ASU. His research interest are focused in promoting positive youth development for urban African American adolescents, African centered social work practice, and Afrocentric construct measurement. Husain Lateef received his MSW degree from the University of Michigan in 2013 and has post MSW experience working with African American culturally grounded youth programs in Phoenix, AZ, and Atlanta, GA.

Elizabeth Kiehne

Elizabeth Kiehne is a doctoral student in the School of Social Work at Arizona State University and a Graduate Research Associate at the Southwest Interdisciplinary Research Center at ASU, a Center of Excellence for health disparities research funded by the National Institute on Minority Health and Health Disparities of the National Institutes of Health. Her research focuses on the ways in which socio-political contexts impact immigrant populations in the host country, particularly for undocumented Latino immigrants in the United States. As part of the socio-political climate, she is interested in intergroup relations and how and why natives form their attitudes toward immigrant populations. Elizabeth is attentive to factors that can be promoted to mitigate negative sentiments and, thus, discrimination.