J Youth Adolescence DOI 10.1007/s10964-013-0054-y

EMPIRICAL RESEARCH

Subjective Social Status, Immigrant Generation, and Cannabis and Alcohol Use Among Adolescents Hayley A. Hamilton • Mark van der Maas Angela Boak • Robert E. Mann

•

Received: 16 September 2013 / Accepted: 1 November 2013 Ó Springer Science+Business Media New York 2013

Abstract Research indicates that subjective perceptions of socioeconomic status (SES) affect aspects of health and behavior. There has been little research attention to how objective (e.g., education) and subjective aspects of SES may differ in their influence on the substance use of adolescent immigrants. The present study examined whether the associations between subjective SES and substance use, and between parental education and substance use varied by immigrant generation. Data were derived from the 2011 Ontario Student Drug Use and Health Survey, a representative survey of students in the 7th to 12th grade. The sample for this study consisted of 9177 students 12–19 years of age; 48.4 % were female, 66.4 % were White/European, 5.2 % Black/Afro-Caribbean, 16.4 % Asian and 12 % other. Results indicated that subjective SES was more strongly associated with cannabis and alcohol use among first-generation immigrants than among adolescents of other immigrant generations even after adjusting for parental education. First-generation immigrants with low subjective H. A. Hamilton (&)
A. Boak
R. E. Mann Centre for Addiction and Mental Health, 33 Russell St., 5th Floor, Toronto, ON M5S 2S1, Canada e-mail: [email protected] A. Boak e-mail: [email protected] R. E. Mann e-mail: [email protected] H. A. Hamilton
R. E. Mann Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada M. van der Maas Department of Sociology, University of Toronto, Toronto, ON, Canada e-mail: [email protected]

SES had a lower probability of cannabis and regular alcohol use, but there was no difference in use between immigrant generations at high subjective SES. The associations between parental education and cannabis and alcohol use did not significantly vary with immigrant generation. The findings highlight the importance of status beliefs among adolescents, particularly among first-generation immigrants, and suggest that further research attention to such beliefs would enhance our understanding of SES and its links to adolescent health risk behaviors. Keywords Subjective social status
Socioeconomic status
Immigrants
Adolescents
Cannabis use
Alcohol use

Introduction There is much research literature indicating that aspects of socioeconomic status (SES) are significantly associated with health and health-related behaviors (e.g., Link and Phelan 1995; Marmot et al. 1997; Wilkinson 1992). Much of the consistency within the literature relates to the SES gradient in health during adulthood, with much less consistent findings among adolescent populations Research examining the association between SES and adolescent health behaviors tends to focus on objective measures of SES such as parental income, occupation and education. The research literature, however, indicates that influential aspects of SES may extend beyond these more objective measures (i.e., education, income and occupation) and into subjective measures that reflect an individual’s perceptions of family SES (Gong et al. 2012; Hamilton et al. 2009b; Piko and Fitzpatrick 2001; Ritterman et al. 2009). This is particularly salient for adolescents because greater

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exposure to a wider diversity of individuals and experiences during this period of development may reduce the importance of particular aspects of objective SES. There is sparse research on the nature of the association between subjective SES and health behaviors, including substance use, among adolescents and what research exists often fails to consider the role of sociocultural factors and possible variations across subpopulations. To address this gap, this study investigates the association between subjective SES and substance use, and variations in associations across immigrant generations. There are two main perspectives with respect to the association between SES and substance use among adolescents. The first perspective reflects the view that SES is an important correlate of substance use among adolescents, although research is inconsistent on whether the direction of the relationship is positive or negative. The argument for a negative association whereby lower SES is linked to greater risk of substance use is based on greater experiences of negative life events and stress (Aseltine and Gore 2000; Biafora et al. 1994; Low et al. 2012), depressive symptoms (Crum et al. 2008; Galaif et al. 2007), and greater experiences with parents and others who model substance use behaviors (Galea et al. 2004; Latendresse et al. 2008; Li et al. 2002) among individuals of lower SES, all of which would increase the risk of substance use. The majority of studies seem to support this argument with findings of higher prevalence of substance use among adolescents with lower SES relative to their peers with high SES (e.g., Fothergill and Ensminger 2006; Goodman and Huang 2002; Hamilton et al. 2009b; Lemstra et al. 2008; Pena et al. 2008). The argument for a positive association whereby higher SES is linked to higher substance use is grounded in the greater access to resources, lower level of adult supervision, and greater pressure to achieve generally experienced by individuals with higher SES (Luthar and Becker 2002; Luthar and Latendresse 2005). Additional research has also supported a positive association between SES and substance use (Hanson and Chen 2007; Tuinstra et al. 1998). The second and alternate perspective on the link between SES and substance use among adolescents is that there is no significant association during this developmental period. This perspective reflects West’s (1997) argument that the effects of SES on health and behavior that are evident during childhood and adulthood are nullified during adolescence because of the increased influence of peers, school environment and youth culture and the reduced influence of family (Roberts 1997). Adolescence is marked by multiple physiological, psychological, and life changes as well as increasing separation from family, attachment to peers, autonomy and independence (Dornbusch 1989). It has been suggested that these factors are apt to be more influential for adolescents than more

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objective aspects of family SES such as parental income, education or occupation (Mason et al. 2013; Steinberg et al. 1994). Reviews of the links between SES and alcohol and cannabis use among adolescents have provided some support for the equalization perspective (e.g., Hanson and Chen 2007). Subjective Social Status Inconsistency in the research linking more objective aspects of SES to adolescent health behaviors, and increasing recognition that the concept of social status is much broader than income, education, or occupation led to investigations of other aspects of SES that may contribute to increased knowledge of the mechanisms behind socioeconomic inequalities and health (Goodman et al. 2001; Goodman et al. 2007). Subjective SES is an individual’s perception of his or her status position relative to that of other individuals (Adler et al. 2000). The concept is related to Wilkinson’s (1992) perspective that people’s position within the social hierarchy, or their relative income, is influential in explaining the relationship between income inequality and health. Subjective measures are often constructed by asking respondents to rate themselves in comparison to their immediate community or to a larger society (Gong et al. 2012; Piko and Fitzpatrick 2001; Ritterman et al. 2009). Subjective assessments of SES may be highly consistent with more objective assessments, but they may also reflect additional meanings or interpretations that individuals attach to their circumstances (Frojd et al. 2006). Among adolescents, subjective assessments of SES may reflect their beliefs or perceptions of their social deprivation and life chances relative to others, including educational expectations and lifestyle choices (McCulloch et al. 2006; Ridgeway et al. 1998). Such beliefs may be more important than the reality of other aspects of SES such as parental education or income (Ridgeway et al. 1998) and thus may affect health and behaviors. Generally, assessments of lower status are likely to elicit reactions that may subsequently impact health and behavior (Singh-Manoux et al. 2005). An important factor in adolescents’ assessments of SES is their interactions with peers who are likely to vary in background and material resources (Ridgeway et al. 1998). Such peer interactions guide the development of status beliefs, which have an important role in broader social inequality (Ridgeway et al. 1998). Although adolescents who have parents with high income or education are likely to enjoy more social and structural advantages than adolescents whose parents have lower income or education, adolescents do not control the resources that arise from their parents’ high income or education. As such, adolescents’ perceptions of status may be determined from other

J Youth Adolescence

status characteristics such as those derived through the possession of name-brand material goods, physical attractiveness, and social skills, characteristics which often establish a status hierarchy within schools (Garner et al. 2006). Regardless of parental income, education or occupation, adolescents who do not feel that they have the advantages, skills, or material resources that they desire or that make them equal in status to their peers may perceive that their family SES is lower relative to others. Research examining the link between subjective SES and substance use is limited, but results from the research that does exist have been somewhat mixed. There is evidence that supports the perspective that there is an association between subjective SES and substance use, with findings, for example, indicating that adolescents with higher subjective SES were at greater risk of alcohol use (Piko and Fitzpatrick 2001; Ritterman et al. 2009), tobacco use (Ritterman et al. 2009), and cannabis use (Piko and Fitzpatrick 2001) than peers with lower subjective SES. On the other hand, there is also support for the perspective that there is no association between subjective SES and substance use, in findings of no significant association between subjective SES and overall illicit drug use (Hamilton et al. 2009b; Ritterman et al. 2009) as well as harmful and hazardous drinking (Hamilton et al. 2009b). With respect to the issue of whether subjective SES is more important for adolescent health risk behaviors than objective aspects of SES, there is evidence for both (e.g., Hamilton et al. 2009b; Shek 2003). Immigrant Generation The association between aspects of SES and substance use may be particularly complex for different immigrant generations. More objective measures of SES may not reflect similar experiences or positions for immigrants and nonimmigrants. This is clearly evident in research showing significant gaps between levels of education and income among adult immigrants as well as higher levels of underemployment relative to non-immigrants (Green et al. 2007; Leow et al. 2006; Poureslami et al. 2010). This means that parents with high education and high status jobs prior to immigrating often end up in low status jobs after immigrating to countries such as the US and Canada. SES is thus a complex construct and different aspects of SES may have different meanings and influences for different immigrant generations. There is little knowledge, however, of whether subjective SES functions in a comparable or different manner across different immigrant generations of adolescents. There has been some recognition that the association between subjective SES and health risk behaviors may vary with adolescent age and sex (Goodman et al. 2001; Hamilton et al. 2009b). As individuals progress through

adolescence, the influence of subjective SES is likely to diminish and give way to the realities of education and income thus allowing them to more concretely define and assess SES as they transition into adulthood (Goodman et al. 2001). The nature of subjective SES and its development through peer interactions and status beliefs suggest that it may also be relevant in research on adolescent immigrants. As people’s perception of their SES relative to others may encompass meanings, interpretations and factors beyond objective SES (Frojd et al. 2006), the experiences of immigration and adaptation are likely to contribute to the perception of foreign-born adolescents. For the foreign-born, perceptions of their social disadvantage relative to others and their life chances relative to others (McCulloch et al. 2006; Ridgeway et al. 1998) might be distinctly different from those of other immigrant generations because experiences and status position prior to immigration and norms and values of the home country may help to shape their current perceptions of their SES within the adoptive country. Foreign-born adolescents also have the challenge of adopting norms and values from their adoptive country, thereby juggling the demands of two cultures, which make their adolescent years more precarious (Harris 1999). The perceptions of foreign-born adolescents are thus likely shaped by the challenges of immigrant adaptation and the influences of peer interactions, the latter of which contributes to adolescents’ greater eagerness to acculturate compared to adults (Rumbaut 1994). In addition to facilitating adolescents shedding of norms that are no longer considered desirable, peer interactions are also likely to drive the development of status beliefs described by Ridgeway et al. (1998). Foreign-born adolescents may be particularly vulnerable because their eagerness to be accepted by peers and form friendship networks may cause them to adopt values and norms imposed upon them, with sanctions such as isolation and exclusion (Garner et al. 2006) awaiting those who fail to comply, all of which are likely to impact individuals’ beliefs about their status relative to others. For the foreignborn, the conflicts between upholding traditional values stressed by parents and embracing behaviors that will enhance acceptance into a desired peer group may be difficult and may result in a sense of detachment from parents (Phinney et al. 2000; Portes and Rumbaut 2001), which may elevate the risk for substance use (McQueen et al. 2003). This suggests that subjective assessment of SES, which is derived through interactions with peers, may be particularly important for adolescent immigrants, and may be associated with adolescent substance use in different ways for immigrants and non-immigrants. Despite the challenges of adapting to a new culture, research findings often indicate lower risk of substance use among foreign-born adolescents or first-generation

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immigrants, relative to those of other immigrant generations (e.g., Blake et al. 2001; Canadian Council on Social Development 2007; Gfroerer and Tan 2003; Hamilton et al. 2009a; Hamilton et al. 2012; Hjern 2004; Pena et al. 2008). There is also evidence that the probability of substance use increases with each immigrant generation (e.g., Hamilton et al. 2012; Pena et al. 2008). Such findings of less health risk behaviors are often attributed to the protection provided by immigrant’s culture and the retention of norms and values from that culture (e.g., greater social and family bonds, monitoring of behavior, and motivation for academic achievement) (Kulis et al. 2007; Zhou 1997) as well as the resilience of individuals and families selected during the immigration process (Burnam et al. 1987; Vega et al. 2004). For foreign-born individuals who are not so resilient, however, the conflict created by juggling the demands of two cultures and the overall stress associated with adaptation may be difficult, which may heighten the risk of health risk behaviors (Phinney et al. 2000; Portes and Rumbaut 2001). Some research has found that greater acculturation is associated with lower rates of drug use (e.g., Melchior et al. 2011). Research also suggests that the association may be different for different types of substances. For example, Svensson and Hagquist (2010) found lower rates of alcohol use and higher rates of cannabis use among immigrant compared to non-immigrant junior high students in Norway. Whether there is lower or higher risk of substance use among the foreign-born relative to the native-born, it is not known whether the association extends across all levels of SES. One perspective would suggest that immigrant generation significantly moderates the association between SES and substance use. With regard to subjective SES, this may be indicated by evidence that foreign-born adolescents who are low in subjective SES have significantly different risks of substance use than foreign-born adolescents who are higher in subjective SES or adolescents of other immigrant generations. This would be consistent with the argument that high subjective SES may be a reflection of high status within peer groups, greater acceptance of the norms and values of the adoptive country, and greater acculturation (Wong 1999), which may translate into greater health risk behaviors among the foreign-born. Thus, the risk of substance use among the foreign-born who are high in subjective SES would be more similar to that of adolescents who are second- or third- and later-generation immigrants. This similarity would reflect that foreign-born adolescents who are high in subjective SES share in the values and norms of the adoptive country to a degree that is usually most evident among adolescents who are secondgeneration and third- and later-generation immigrants. An example of this may be reflected in the influence of peers, with research evidence that adolescents who have friends

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who engage in drug use are at greater risk of drug use themselves (Chabrol et al. 2006; Mandara and Murray 2006; Saint-Jean 2010). A second perspective would suggest that the association between subjective SES and substance use does not vary significantly by immigrant generation. Thus, despite the many additional factors that could contribute to subjective assessment of SES among foreign-born relative to nativeborn adolescents, they do not translate into greater or lower risk of substance use among the foreign-born compared to second-generation or third- and later-generation immigrants.

Current Study Research suggests that the nature of experiences during adolescent development are likely to reduce the importance of more objective aspects of SES on health behaviors, and enhance the importance of adolescents own subjective assessment of family SES (Goodman et al. 2001). Little research, however, has investigated the nature of the association between subjective SES and substance use, or considered the importance of sociocultural factors. This research study will address this gap by investigating the association between immigrant generation, subjective family SES, and substance use among adolescents. In particular, we will examine whether the association between subjective SES and the use of cannabis and alcohol among adolescents vary with immigrant generation. We hypothesize that the association between subjective SES and substance use will vary with immigrant generation, and that the variations will be most evident between the foreign-born or first-generation and adolescents of other immigrant generations. A secondary objective of the study is to determine if the associations between parental education and cannabis and alcohol use vary with immigrant generation in a similar manner to the associations involving subjective SES. We hypothesize that the associations involving subjective SES will differ from those involving parental education and will actually be stronger. We focus on parental education only and did not include income and occupation in these analyses because the latter two were not available within the dataset, which was based on adolescent self-reports. Although parental education by itself cannot fully address the strength of objective SES as a whole, this is a step towards increasing our knowledge of subjective SES and its associations across immigrant generations. In testing our research hypotheses, we included basic demographic variables such as age, sex, and family structure. Research indicates that adolescents in intact families are less likely to engage in substance use (e.g., Ledoux et al. 2002; McArdle et al. 2002). Ethnic background is also included because it is strongly connected to immigrant

J Youth Adolescence

generation and will increase the robustness of findings. Research has also indicated a significant association between ethnic background and substance use (Cheung 1993; Choi et al. 2012; Vega et al. 1993). The findings will help to determine the importance of subjective SES in the substance use behaviors of adolescents and will contribute to research focused on understanding the types of factors that may contribute to substance use among adolescents who are foreign-born.

Methods Participants Data were derived from the 2011 cycle of the Ontario Student Drug Use and Health Survey (OSDUHS), a representative province-wide survey of 9,288 students in the 7th to 12th grade (Paglia-Boak et al. 2011). The OSDUHS, ongoing since 1977, is a biennial cross-sectional survey that investigates substance use, gambling, delinquent behavior, and mental and physical health among students. The survey was based on a stratified two-stage cluster design (school, class) and involved students from 40 school boards, 181 schools, and 581 classrooms. The participation rate among students was 62 %, with non-participants consisting of students who were absent (12 %) and those with parental refusal or unreturned consent forms (26 %). Post- stratification weight adjustments were applied such that the sample reflected the sex by grade distribution of students according to school enrolment figures within the province (Paglia-Boak et al. 2011). Participation was considered above average for a student survey where active consent from a parent or guardian was necessary (Courser et al. 2009; White et al. 2004). The sample was 66 % White or Caucasian, 10.2 % East or Southeast Asian, 6.4 % South Asian, and 5.2 % Black or African Canadian compared to 71.6, 9.1, 7.6 and 4.3 %, respectively of individuals from Ontario within the 2011 Canadian National Household Survey (Statistics Canada 2013). Analyses were restricted to individuals ages 12–19, thus 34 cases outside of this age range were dropped. The study design and methods are described in more detail elsewhere (Paglia-Boak et al. 2011). Measures Cannabis Use Cannabis use in the last 12 months was treated as a dichotomous measure for analysis purposes. Students who indicated that they had used cannabis once or more in the last 12 months were coded as having used cannabis. Those students who reported that they had never used cannabis, or

did not know what cannabis was, were classified as not having used cannabis. Alcohol Use Alcohol use in the last 12 months was measured using 10-categories ranging from never used to used almost every day. Categories were recoded to create two alcohol use variables for analysis purposes. The first variable reflected a 3-category measure—none, occasional, and regular. Students who had never drunk, did not drink in the last 12 months, or only had a sip were classified as non-drinkers. Drinking once per month or less often, or on special occasions was classified as occasional drinking. Drinking twice per month or more often was classified as regular drinking. The second variable reflected a dichotomous measure—none or low drinking (coded 0) vs. regular drinking (coded 1). Immigrant Generation Immigrant generation was constructed using three categories. Adolescents who were foreign-born were classified as first-generation immigrants. Native-born adolescents with at least one parent who was foreign born were classified as second-generation immigrants. Native-born adolescents with native-born parents were classified as third- and latergeneration immigrants. Subjective SES Subjective socioeconomic status was measured using the MacArthur Scale of Subjective Social Status (Goodman et al. 2001). The youth version of the scale that assesses the family’s place within society was utilized with minor modifications. Adolescents were asked: ‘‘Imagine this ladder below shows how Canadian society is set up’’. At the top of the ladder are people who are the ‘‘best off’’—they have the most money, the most education, and the jobs that bring the most respect. At the bottom are the people who are ‘‘worst off’’— they have the least money, little education, no job or jobs that no one wants. Now think about your family. ‘‘Please check off the numbered box that best shows where you think your family would be on this ladder.’’ Response choices are shown on a diagram of a ladder and range from ‘‘Best off’’ (10) at the top of the ladder to ‘‘Worst off’’ (01) at the bottom. The MacArthur Scale has been shown to be a reliable measure of subjective social status (Goodman et al. 2001). Parental Education Parental education was created from two questions asking father’s and mother’s highest level of education. The measure reflects the education of the parent with the

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highest level of education. The seven response options were grouped into three categories for analysis purposes: high school or less, some college or university, and university degree. Ethnicity Ethnicity was based on student responses to a question that asked them to choose one or more categories that best described their ethnic background. The categories listed within the questionnaire were similar to those in the 2006 Canadian Census (Statistics Canada 2006). Adolescents who selected a single ethnic background were grouped into 4 categories: White, Black, Asian (East Asian and South Asian), and other. Those who selected two or more ethnic backgrounds (7.5 % of the sample) were coded as other. Other Variables Several additional measures were included as control variables in analyses. Sex was measured as male or female. Adolescent age reflected individual years from 12 to 19 inclusive. Family or parental structure was measured as living with two biological or adoptive parents (coded 1) versus living in other family types (coded 0).

Tests for unequal residual variation across immigrant generations were run prior to running interaction models within logistic regression (Allison 1999). Heterogeneous choice models under ordinal generalized linear models were used for testing (Williams 2008, 2009), but none of the tests was significant. Thus, findings of differences between immigrant generations were not due to unobserved heterogeneity. Subsequently, Wald tests were used to determine the significance of differences between immigrant generations. The proportion of cases with missing values was below 5 % for all variables, with the exception of parental education at approximately 14 %. Missing cases were handled through multiple imputation (Schafer 1999) using chained equations within Stata 12. In addition to the variables to be imputed, the imputation model included the survey design variables and performed separate imputations by immigrant generation to accommodate interaction terms within the main regression models (Statacorp 2011a). A total of 15 datasets were imputed with high relative efficiencies. Immigrant generation was not imputed because it was the basis of the group variable. Missing values on cannabis and alcohol use were multiple imputed, but the imputed values were deleted from regression models as cannabis and alcohol use were the dependent variables (von Hippel 2007).

Data Analysis Logistic regression was used to examine the association between immigrant generation, socioeconomic status, and cannabis use. Both multinomial and binary logistic regressions were used to examine associations with alcohol use. First, multinomial regression was used to determine whether the significance of immigrant generation, socioeconomic status and demographic factors differed for the three levels of alcohol use (none, low, regular). Second, given the results of the multinomial analysis and a desire to improve the interpretation of results, the two lower categories of alcohol use were combined into a single category and binary logistic regression was used to test interactions. Ordered logistic regression was not used because of violations of the proportional odds assumption (Long and Freese 2006; Williams 2006). Two-way interactions between immigrant generation and the two SES measures were included in logistic regression models to examine whether the associations between SES and cannabis and alcohol use vary with immigrant generation. Subjective SES and age variables were centered on their mean to reduce correlations between linear and interaction terms (Aiken and West 1991). Weights were used within the analyses to adjust for the unequal probability of selection. Taylor series methods within Stata 12 were used to compute unbiased variances, standard errors, and point estimates given a complex sample design (Statacorp 2011b).

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Results Descriptive statistics provided in Table 1 indicate that the sample was about 48 % female, 71 % were from households with two biological or adoptive parents, 66 % were White/European, and 50 % had at least one parent with a university degree. A comparison between immigrant generations indicate that a greater proportion of the third- and later-generation sample were females and reported higher subjective SES; a greater proportion of the second generation resided in two-parent households; and a greater proportion of the first generation had at least one parent with a university degree. Results from binary logistic regression that examined the association between immigrant generation, SES, demographic factors and cannabis use are provided in Table 2. Results from Model 1 indicate that subjective SES was not significantly related to cannabis use after adjusting for parental education, immigrant generation and demographic characteristics. Results for parental education indicated that adolescents whose parents had some college or university education had greater odds of using cannabis than their peers whose parents had university degrees; however, a Wald test indicated that parental education as a whole was not significant. With regard to immigrant

J Youth Adolescence Table 1 Descriptive statistics (weighted percentage or mean with standard deviation in bracket)

First generation N = 1,264

Second generation N = 2,532

Third generation N = 5,381

Total N = 9,177

Age

15.3 (1.8)

15.1 (1.8)

15.1 (1.9)

15.1 (0.1)

Female

42.2 %a

48.0 %b

50.5 %c

48.4 %

Two-biological or adoptive parents

74.0 %a

Subjective SES

7.0 (1.41)

75.2 %b a

7.0 (1.50)

68.1 %c a

71.1 %

7.3 (1.55)

b

7.1 (.03)

Parental education High school or less

12.7 %a

19.5 %b

16.1 %c

16.6 %

Some college/university

19.4 %

34.7 %

38.0 %

34.0 %

University degree

67.9 %

45.8 %

45.9 %

49.4 %

White

24.3 %a

41.1 %b

92.3 %c

66.4 %

Black/Afro-Caribbean Asian

10.3 % 47.5 %

10.9 % 28.9 %

0.7 % 0.5 %

5.2 % 16.4 %

Other

18.0 %

19.1 %

6.4 %

12.0 %

13.9 %a

22.6 %b

24.1 %c

22.0 %

a

b

39.3 %c

44.8 %

Ethnicity

Statistically significant differences between generations are indicated by different superscript letters (e.g., a and b) within cells of the same table row. Differences are significant at the p \ 0.05 level

Table 2 Logistic regression of cannabis use by SES, immigrant generation and demographic factors (N = 9,154)

Substance use Cannabis use Alcohol: none

55.6 %

49.1 %

Alcohol: low/occasional

34.6 %

34.1 %

37.4 %

36.0 %

9.8 %

16.8 %

23.3 %

19.2 %

Alcohol: regular

Age (centered at mean)

Model 1 Odds ratio (95 % CI)

Model 2 Odds ratio (95 % CI)

1.63 (1.55–1.73)***

1.64 (1.55–1.737)***

Female (reference = male)

.90 (0.77–1.05)

Two-biological or adoptive parents (reference = other)

.71 (.60–.83)***

.89 (.76–1.04) .72 (.61-.84)***

Subjective SES (centered at mean)

.97 (-.92–1.03)

.93 (.86–1.02)

Parental education (reference = univ. degree) High school or less

1.17 (.86–1.60)

1.17 (.85–1.60)

Some college/university

1.27 (1.03–1.56)*

1.26 (1.03–1.56)*

Immigrant generation (reference = 3rd or later) 1st generation 2nd generation Ethnicity (reference = white) Black/Afro-Caribbean Asian Other

.55 (.42–.74)***

.59 (.44–.80)**

1.06 (.81–1.39)

1.06 (.81–1.38)

1.10 (.65–1.87)

1.11 (.67–1.85)

.43 (0.30–.62)*** 1.35 (.96–1.89)

.42 (.29–.61)*** 1.35 (0.97–1.89)

Interaction

* p \ .05, ** p \ .01, *** p \ .001

1st gen 9 subjective SES

1.29 (1.12–1.49)***

2nd gen 9 subjective SES

1.02 (.92–1.14)

Constant

generation, first-generation adolescents had lower odds of cannabis use than third and later generations (Model 1) and lower odds than second-generation adolescents (Wald test (F(1, 163.1) = 18.72, p \ .001)). Model 2 indicates that the association between subjective SES and cannabis use varied significantly by immigrant generation. At average levels of subjective SES, the odds of cannabis use was 1.29

.31 (.26–.37)***

.31 (.26–.37)***

times greater for first-generation than third- and latergeneration immigrants. The interaction between subjective SES and immigrant generation is illustrated in Fig. 1 and shows that at low levels of subjective SES, first-generation immigrants have a lower probability of cannabis use than adolescents of other immigrant generations. However, it is also evident from Fig. 1 that the probability of cannabis use

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Fig. 1 Probability of cannabis use by subjective family SES and immigrant generation

among first-generation immigrants increases with higher subjective SES such that there is no difference in the probability of cannabis use between immigrant generations among adolescents who report high subjective SES. In contrast to findings for subjective SES, the association between parental education and cannabis use did not significantly vary with immigrant generation. The results from multinomial regression analysis relating immigrant generation, SES, and demographic Table 3 Multinomial logistic regression for low and regular use of alcohol compared to nonuse (N = 9,132)

characteristics to the frequency of alcohol use are provided in Table 3. The model indicates that immigrant generation was not significantly associated with the odds of low frequency of alcohol use versus no alcohol use. Age and ethnic background were the only variables that indicated significant differences in the odds of low versus no alcohol use. In contrast, immigrant generation, in addition to age, family structure, and ethnic background, were significantly associated with the odds of regular alcohol use compared to no alcohol use. Given only small differences between low and no alcohol use, the two categories were combined into one category in subsequent analyses that compared no to low (no/low) alcohol use versus regular alcohol use. Binary logistic regression analysis was used to investigate whether the association between SES and alcohol use varied by immigrant generation (Table 4). Model 1 results were consistent with the results from the multinomial regression indicating that age, family structure, and ethnic background were significantly associated with regular alcohol use. Model 2 indicates that the association between subjective SES and alcohol use varied significantly by immigrant generations. At average levels of subjective SES, the odds of regular alcohol use was 1.37 times greater for first-generation than third- and later-generation immigrants. An illustration of this interaction in Fig. 2 indicates that adolescents who are first-generation immigrants have a Low/occasional use Relative risk ratio (95 % CI)

Regular use Relative risk ratio (95 % CI)

1.59 (1.51–1.66) ***

2.15 (2.02–2.29) ***

Male

1.00

1.00

Female

1.05 (.92–1.21)

2.02 (.87–1.21)

Other

1.00

1.00

Two-biological or adoptive

.87 (.73–1.03)

.72 (.59–.86)***

1.02 (0.97–1.08)

1.05 (.98–1.13)

University degree

1.00

1.00

Some college/university

1.10 (.91–1.32)

1.08 (.84–1.40)

High school or less

1.09 (.83–1.44)

.93 (.67–1.30)

3rd or later generation

1.00

1.00

2nd generation 1st generation

.97 (.80–1.18) .88 (.65–.1.17)

.87 (.61–1.23) .42 (.26–.69)**

White

1.00

1.00

Black/Afro-Caribbean

.72 (.49–1.06)

.40 (.18–.86)*

Asian

.38 (.28–.50)***

.21 (.13–.36)***

Age (centered at mean) Sex

Parent structure

Subjective SES (centered at mean) Parental education

Immigrant generation

Ethnicity

* p \ .05, ** p \ .01, *** p \ .001

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Other

.89 (.66–1.20)

.88 (.59–1.33)

Constant

1.17 (.96–1.43)

.70 (.55–.90)**

J Youth Adolescence Table 4 Logistic regression of regular alcohol use by SES, immigrant generation and demographic factors (N = 9,132)

Model 1 Odds ratio (95 % CI)

Model 2 Odds ratio (95 % CI)

Age (centered at mean)

1.67 (1.59–1.75)***

1.68 (1.59–1.76)***

Female (reference = male)

1.00 (.85–1.18)

Two-biological or adoptive parents (reference = other) Subjective SES (centered at mean)

.78 (.67–.91)** 1.04 (.98–1.10)

.99 (.84–1.16) .79 (.68–.92)** 1.01 (.95–1.08)

Parental education (reference = univ. degree) High school or less Some college/university

.88 (.65–1.20)

.88 (.65–1.19)

1.03 (.83–1.27)

1.02 (.82–1.27)

Immigrant generation (reference = 3rd or later) 1st generation

.45 (.30–.68)***

.47 (.32–.70)***

2nd generation

.88 (.66–1.17)

.87 (.65–1.17)

Ethnicity (reference = white) Black/Afro-Caribbean

.48 (.23–1.01)

.49 (.24–1.01)

Asian

.36 (.23–.56)***

.35 (.22–.55)***

Other

.95 (.65–1.38)

.96 (.66–1.39)

Interaction 1st gen 9 Subjective SES

1.37 (1.10–1.70)**

2nd gen 9 Subjective SES * p \ .05, ** p \ .01, *** p \ .001

Constant

Fig. 2 Probability of regular alcohol use by subjective family SES and immigrant generation

lower probability of regular alcohol use relative to adolescents of other immigrant generations, but there is no difference in alcohol use between immigrant generations at high levels of subjective SES.

Discussion There is increasing recognition that the concept of social status is much broader than objective assessments of SES such as income, education, or occupation, and that other aspects of SES may be important for adolescents (Goodman et al. 2001; Goodman et al. 2007). Subjective aspects

.99 (.88–1.11) .30 (.24–.38)***

.30 (.24–.38)***

of SES that reflect adolescents’ perceptions of family SES are considered particularly relevant because of experiences with peers of diverse backgrounds during this developmental stage, and the status beliefs that develop through peer interactions. Subjective assessments of SES may reflect adolescents’ beliefs or perceptions of their social disadvantage and life chances relative to others (McCulloch et al. 2006; Ridgeway et al. 1998). The nature of subjective SES and its development through peer interactions and status beliefs suggest that it may also be relevant in research on adolescent immigrants given the importance of peers in the adaptation and acculturation process. The main objective of this study was to investigate the associations between subjective SES and cannabis and alcohol use among adolescents and possible variations with immigrant generation. Parental education was also examined to address the question of whether subjective assessments of SES had an important role in adolescent cannabis and alcohol use beyond the more objective SES measure of parental education. Results indicated that there was some variation in the association between subjective SES and substance use by immigrant generation. The findings from main effects models in this study indicated that subjective SES was not associated with cannabis or regular alcohol use among adolescents. Although these findings are consistent with some existing research indicating that subjective SES is not significantly associated with illicit drug use or harmful drinking (Hamilton et al. 2009b), this study illustrates that the associations are not uniform across population groups.

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Consistent with results from previous studies (e.g., Gfroerer and Tan 2003; Hamilton et al. 2009a), results from the main effects models indicated that the odds of cannabis and regular alcohol use were lower among first-generation immigrants than among adolescents of other immigrant generations. The present study extends earlier research by confirming the hypothesis that the associations between subjective SES and cannabis and regular alcohol use among adolescents vary with immigrant generation, with stronger associations among first-generation immigrants. At low levels of subjective SES, there is a large gap in the probability of cannabis and regular alcohol use between firstgeneration immigrants and adolescents of other immigrant generations, but this gap decreases at higher subjective SES. At high levels of subjective SES, there is no difference in substance use between immigrant generations. A possible explanation for these findings may be that first-generation adolescents’ perceptions of family SES are tied to acculturation, with high subjective SES reflecting high status beliefs which would have been influenced by peers and social networks. Foreign-born adolescents’ high status within peer groups may reflect greater adoption of the values and norms within the host country, at least those valued by a particular youth culture, which would indicate higher levels of acculturation. If higher status beliefs reflect greater progress on the path towards acculturation, these findings would be consistent with other research that suggests a gradient in the association between substance use and time since immigration (Blake et al. 2001; Gfroerer and Tan 2003). This is an area for much further research. In contrast to findings for subjective SES, the association between parental education and cannabis and regular alcohol use did not vary significantly with immigrant generation. Thus, the hypothesis that the associations involving parental education would differ from those involving subjective SES was supported. These findings are particularly noteworthy because shifts in family social status often accompany immigration, evidenced by frequent underemployment among immigrant parents (Green et al. 2007; Poureslami et al. 2010). As such, parental education may not reflect similar SES among families with foreign-born parents and families with native-born parents because the former often do not have jobs that reflect their educational attainment. This would suggest that parental education may be linked to substance use in different ways for different immigrant generations. Findings from this study, however, indicate that parental education is not more strongly or weakly associated with cannabis use and regular alcohol use among adolescents who are first-generation immigrants than those of other immigrant generations, but rather is similar across generations. In addition to no significant interaction with immigrant generation, parental education was not significantly

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associated with regular alcohol use and was not associated with cannabis use overall when adjusting for immigrant generation and other sociodemographic factors in main effect models. These findings are inconsistent with previous research that found greater probability or frequency of drug and alcohol use among adolescents whose parents are less educated (e.g., Fothergill and Ensminger 2006; Hamilton et al. 2009b; Pena et al. 2008). The findings from this study may be due to the specific aspects of substance use examined, namely cannabis use and regular alcohol use (twice per month or more often) in the past 12 months. It is noteworthy, however, that cannabis and alcohol are two of the most widely and frequently used substances during adolescents and thus the findings are particularly relevant. The findings may also be evidence of some equalization in the association between parental education and health behaviors during adolescence (West 1997). Contrasting results for subjective SES and parental education highlight the importance of differentiating between aspects of SES in examinations of substance use. Subjective SES was found to have a stronger relationship with the cannabis and regular alcohol use of first-generation immigrants than did parental education. This suggests that important links between social status and substance use remains during adolescence, but that those links are based more on adolescents’ own subjective assessment of family SES than on their parents’ level of education. The importance of subjective SES is particular noteworthy for adolescents who are foreign-born and suggest the need for greater research to examine the links between aspects of acculturation, subjective SES, and health risk behaviors. Despite the strength of this study in highlighting the importance of subjective SES among adolescents who are first-generation immigrants even after adjusting for ethnic background, there are several limitations worth noting. First, only single measures of subjective and objective SES were available within the dataset. The measure of subjective SES focused on assessing family status within society only and did not assess adolescents’ perceptions of their individual status within schools. The use of a measure that could assess status within schools might have led to additional findings that were more reflective of adolescent experiences. With regard to objective SES, only adolescents’ reports of parental education were available within the dataset; however, additional indicators of SES such as parental reports of occupation and household income would have strengthened our ability to address objective SES more fully. Second, the study is cross-sectional and thus the temporal order of associations between subjective SES and past year substance use could not be determined. Whereas parental education is likely to be stable with little change over a 1 year period, subjective SES may fluctuate depending on changes to the group to whom individuals are

J Youth Adolescence

comparing themselves. Third, further consideration of acculturation among first-generation immigrants, through examinations of characteristics such as age at immigration would potentially have enhanced our ability to address subjective SES among first-generation immigrants in more detail. A limited sample of first generation immigrants and limited questioning on these topics within the survey prevented further work in this area. Future research may find that these aspects of acculturation are also important in the relationship between SES and substance use.

Conclusion This study highlights that adolescents’ perceptions of their own family SES has an important role in cannabis and regular alcohol use. Whereas more objective measures of SES such as parental education may determine the structural conditions under which socialization occurs, subjective SES is important for specific aspects of substance use and specific subpopulations. Status beliefs are an important component in the development of social inequality (Ridgeway et al. 1998) and this may be particularly true for adolescents who are first-generation immigrants. For adolescent immigrants, social exclusion within schools due to status characteristics may have severe consequences, especially among those with few supports or resources. Achieving and maintaining high status, however, may entail engaging in behaviors that reflect those of adolescent peers or social networks. Greater attention to the status beliefs held by adolescents, particularly those who are first-generation immigrants, is an important part of reducing or preventing substance use. Further research is needed to separate the potentially complex ways in which subjective SES works to influence health behaviors. Acknowledgments The OSDUHS was funded in part through ongoing and targeted funding from several provincial agencies (PI: R. Mann). Author contributions HH was the lead in developing the hypotheses, conducted most of the data analysis, and wrote most of the manuscript content. M. V. assisted with the data analysis and manuscript preparation, and critically reviewed the manuscript. A. B. participated in the design and coordination of the survey on which the analyses are based, provided assistance during data analysis, and critically reviewed the manuscript. R. M. is the principal investigator of the survey on which the analyses are based and provided critical reviews of the manuscript. All authors read and approved the final manuscript.

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Author Biographies Hayley A. Hamilton, Ph.D. is a research scientist at the Centre for Addiction and Mental Health, and an assistant professor in the Dalla Lana School of Public Health at the University of Toronto. She received her doctorate in sociology from The Ohio State University. Much of her research focuses on social factors that influence mental health, drug, and alcohol problems among adolescents. Mark van der Maas, M.A. is a Ph.D. candidate in the Department of Sociology at the University of Toronto. He is also enrolled in the Collaborative Program in Addiction Studies. His research primarily focuses on drug use and problem gambling in relation to social stratification. Angela Boak, M.A. is a research analyst at the Centre for Addiction and Mental Health and research coordinator of the Ontario Student Drug Use and Health Survey, the longest ongoing school survey of adolescents in Canada. She received her master’s degree in psychology from York University. Robert E. Mann, Ph.D. is a senior scientist at the Centre for Addiction and Mental Health and an associate professor in the Dalla Lana School of Public Health at the University of Toronto. He received his doctorate in psychology from the University of Waterloo. His research interests include the epidemiology of drug, alcohol and mental health problems.

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