- Gil, A; Vega, W
- Few areas of Latino health are as profoundly affected by changes in human behavior as drug abuse (Volkow 2006). Drug use is socially acquired behavior. Societies and the subcultures that compose them vary widely in their degree of toleration or outright condemnation of those who consume or become addicted to illicit drugs (Vega et al. 2002). Examining the differences between subgroups of Latinos with different personal and extra-personal characteristics provides insights about factors that protect against or promote illicit drug use (Vega and Gil 1998). In keeping with the goal of this book, this chapter places special emphasis on the impact of structural factors on the development of illicit drug use among Latino males. As noted in the conference announcement for the 2007 College of Problems of Drug Dependence, "There is accumulating evidence that the antecedents, consequences, and mechanisms of drug abuse and dependence are not identical in males and females and sex/gender may be an important variable in treatment and prevention outcomes." Research about the health gradient has documented how social inequality reduces personal resistance to many health problems and social pathologies. Recent research has shown that subordination to inferior social status and discrimination are both linked to various forms of organic anomalies and disease, including immune system dysfunction and cardiovascular disease. Michael Marmot, one of the foremost investigators of inequality and disease, has noted, "It is not the social position in the hierarchy per se that is the culprit, but what position in the hierarchy means for what one can do in a given society: the degree of autonomy and social participation" (Marmot 2004, 2005, 2006). Other researchers (Williams and Jackson 2005; Kawachi, Daniels, and Robinson 2005; Krieger, Chen, and Ebel 1997) have concluded that it is time to move our aim from individual risk factors, which typifies the medical model logic of focusing on individuals, and instead shift our focus to the effects of the social structure and unequal distribution of wealth on all-cause morbidity and mortality and public policies that can alter the status quo. This chapter will address both individual and structural risk factors with the explicit assumption that structural factors can create a propensity toward experiencing risk factors that systematically produce inferior health for the least affluent sectors of the population (Link and Phelan 1995). The chapter proceeds by presenting four levels of information: (1) a review of factors that have been identified as affecting Latino drug use; (2) variations in intraethnic and interethnic prevalence levels of drug use and related factors; (3) trajectories of drug progression during the years from childhood to early adulthood; and (4) an analysis of longitudinal trajectories of Latino male drug use taking into account various structural indicators. We will use a well-known national data set collected by the U.S. Public Health Service and a large longitudinal data set collected by the authors that was designed to address many questions pertinent to the theme of this chapter. What factors increase drug use among Latinos? The key assumption is that structural factors, such as poverty and low educational achievement, act selectively to produce general vulnerability to drug use precisely because they increase exposure to certain types of risk factors and decrease the availability of protective factors. This general vulnerability is expressed through interactions between an individual and his or her environment. Using the well-known construct of "segmented assimilation," it refers directly to the social structure of urban areas and is reflected in neighborhood quality of life and the educational and economic opportunity structures afforded therein to residents (Portes and Zhou 1993; Vega and Gil 1999). For example, ethnic enclaves provide a subsociety for the residents of a neighborhood to meet their daily needs. Too often, neighborhoods characterized by poverty are more disorganized or even chaotic and provide avenues for illegal activities, and subcultures that support them, to thrive. The conditions in neighborhoods with high concentrations of poor people are more likely to produce chronic social stress and expose residents to traumatic experiences (Williams and Jackson 2005). There is more delinquency and crime and higher percentages of single-parent households in poverty. © 2010 by Rutgers University Press. All rights reserved.
- December 1, 2010
International Standard Book Number (ISBN) 13
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