“In general, what you see is a higher level of drinking and binge drinking among Puerto Ricans and Mexican Americans, compared with Cuban-Americans and South/Central Americans,” says Dr. Raul Caetano, MD, MPH, PhD, Senior Research Scientist at the Prevention Research Center of the Pacific Institute for Research and Evaluation.
Cuban-Americans tend to have lower rates of heavier drinking than the other three groups, said Dr. Caetano, who spoke at the recent Association for Medical Education and Research in Substance Abuse annual meeting.
Dr. Caetano has also studied Mexican-Americans who live along the U.S.-Mexico border, and compared their drinking patterns with Mexican-Americans who live off the border. He found young men and women, ages 18 to 29, drink much more and have more alcohol-related problems when they live on the border, compared with those of the same age who live off the border.
“We were able to verify that increased drinking in this age group along the border was closely associated with attendance at bars. We saw increased drinking on the Mexican side of the border, where the legal drinking age is 18, but we also saw increased drinking at bars on the U.S. side of the border,” he noted. He says he hopes the findings will be used to implement regulatory practices for controlling hours of alcohol sales, enforcing the legal drinking age, and working with bar owners to try to curb promotions such as two-for-one drinks and nights where women drink for free.
Dr. Caetano says some of the differences among Hispanic groups have roots in cultural norms and acceptance of drinking in each country. “Mexicans have a history of what’s called fiesta drinking—a pattern of more infrequent drinking, but when they drink, they drink heavily,” he said.
Socioeconomic status plays a big role as well, Dr. Caetano added. “Many Cuban-Americans have a very different history of immigration from other Hispanic groups,” he said. “Many of them were political refugees, with a higher socioeconomic status. They are very urban, and largely located in Miami.” In contrast, he said, while there are also many Mexican-Americans in cities, a large number are migrant farm workers with lower socioeconomic status and education levels.
Dr. Caetano said he decided to study the issue of Hispanic groups and drinking because the federal government lumps together different national groups under the term Hispanic. “We knew they were very different because drinking in their countries is very different,” he said. “But there were no consistent large-scale analyses that could show what the differences were.”
The information from his research could be used at the local level to help public health officials better target prevention messages and treatment to Hispanic groups in each community, he said.
Dr. Caetano has just begun to analyze data about drinking rates among people living in Puerto Rico. In the future, he plans to compare Puerto Ricans on the island with those who were born on the island and moved the U.S. mainland, and people of Puerto Rican descent who were born on the U.S. mainland. His preliminary analysis confirms previous findings that U.S.-born Puerto Ricans drink much more than those living on the island and those who moved from the island to the mainland.
“It’s a common immigrant story – those who are born in this country are at greater risk for a series of bad health-related outcomes, compared with immigrants who were born elsewhere and moved here,” he said.
There are two main hypotheses for this, Dr. Caetano explained. One is known as selective migration—only people who are healthier migrate, so the first generation of immigrants is strong enough for the physical and mental challenges they face in their new country.
Another theory is that migrants come with relatively low expectations, and anything they acquire is seen as positive. “People who are born in the U.S., in contrast, grow up with many more expectations. Because they are in a minority ethnic group and have a disadvantaged socioeconomic status, they are at risk for bad health outcomes,” Dr. Caetano said. “No one knows if one of these theories is stronger than the other, or whether they are both at work.”