THE HEALTHY IMMIGRANT EFFECT ON ALCOHOL USE IN YOUTH

Abstract

This dissertation examined the Healthy Immigrant Effect (HIE) in relation to youth alcohol use. The HIE is a phenomenon in developed countries with recent immigrants reporting better health upon arrival compared to the majority population. Studies support the HIE for adult alcohol use, with more recent immigrants reporting less alcohol involvement than 2nd and 3+ generation immigrants. To move this field forward with implications for prevention, the HIE needed to be explored among Canadian youth. Moreover, I examined potential moderation by degree of assimilation into Canada’s mainstream culture (acculturation), adherence to original culture’s values (enculturation), and the role of country of origin (COO) drinking rates. Immigrants are a fast-growing population; understanding determinants of their alcohol consumption has implications for Canadian social and economic infrastructure. Study 1 (CoVenture trial) examined the HIE by comparing alcohol quantity and drinking onset across three adolescent groups (N=2713) of differing immigration statuses (defined by participants’ and parents’ place of birth) longitudinally from grades 7-11. Results revealed 1.5 generation immigrants reported the least alcohol use and later drinking onset compared to 3+ generation immigrants. Study 2 (UniVenture trial) compared four alcohol indicators (quantity, frequency, heavy episodic drinking, and alcohol-related problems) among undergraduates (N=1016; 1st and 2nd year) of differing immigration statuses. We also included moderated regression analyses of acculturation/enculturation by immigrant generation status on alcohol indicators, and the influence of COO drinking rates. First-and-a-half generation immigrants reported lower alcohol involvement than 3+ generation immigrants. Regarding moderation by levels of acculturation/enculturation, we found significant interactions between immigrant generation status and enculturation on alcohol frequency and alcohol-related problems. COO per capita alcohol consumption was positively associated with alcohol frequency and heavy episodic drinking among 1.5 and 2nd generation students. Overall, this dissertation supports the notion that immigration status is protective against alcohol use in youth. Therefore, this dissertation supports the inclusion of culturally sensitive alcohol use interventions in educational institutions to help preserve the HIE on alcohol use while facilitating immigrant youths’ healthy integration into Canadian society. Future research should examine other moderators to the HIE (e.g., host country) and consider longitudinal measures of acculturation and enculturation.