Examining the Relationship Between Intersectional Discrimination and Substance Use Disorders by Race/Ethnicity and Gender

Objectives: The present study aims to assess the relationship between substance use disorders (SUD) and intersectional discrimination, the intersection of racial/ethnic discrimination, and gender discrimination. Further, this study aims to determine if the relationship between SUD and discrimination varies by race/ethnicity and gender. Method: This cross-sectional study analyzes data from a diverse sample of American Indian, Asian, Black, Latinx, and White adult respondents (N = 34,547) from Wave 2 of the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions. Multinomial logistic regression was used to test the association between intersectional discrimination and SUD. Intersectional discrimination was assessed using an interaction term between racial/ethnic discrimination and gender discrimination. Alcohol use disorders (AUD) only and alcohol plus drug use disorders (SUD) were assessed separately. Analyses were stratified by race/ethnicity and gender. Results: Overall, intersectional discrimination was associated with increased predicted probabilities of SUD relative to those with no discrimination and was more often associated with SUD than AUD. Intersectional discrimination was associated with increased predicted probabilities of AUD and SUD among women, Black, Latinx, and White adults. Intersectional discrimination was associated with increased predicted probabilities of SUD but not AUD among men, American Indian, and Asian adults. Conclusions: Intersectional discrimination consistently elevated AUD and/or SUD across subgroups defined by gender or race/ethnicity; however, effects were variable across gender, race/ethnicity, and disorder. Findings demonstrate the negative health implications of intersectional discrimination for men and women and American Indian, Asian, Black, Latinx, and White adults. Study findings have implications for the development of policies and interventions that are centered around intersectionality.Public Significance StatementDespite strong evidence for the relationship between intersectional discrimination and SUD, relatively few studies have empirically assessed this relationship. Results of this study suggest that intersecting social positions may increase one's risk of SUD in complex ways, particularly through intersectional discrimination.

Automated summary

This study aims to assess the relationship between substance use disorders (SUD) and intersectional discrimination, specifically the intersection of racial/ethnic discrimination and gender discrimination. The results show that intersectional discrimination is associated with an increased probability of SUD, particularly among women and certain racial/ethnic groups. These findings have important implications for policy development and interventions that address intersectionality.