Social Determinants of Alcohol, Drug and Gambling Problems Among Urban Aboriginal Adults in Canada

Abstract

Objective: Little is known about the determinants of addictive disorders within the rapidly growing urban Aboriginal population in Canada. The objectives of this dissertation were to examine whether racial discrimination, Aboriginal enculturation, and Canadian acculturation were associated with addictive problems among urban Aboriginal Canadians, and to test potential mediators of these associations. Methods: Data were collected via in-person surveys with two community-based convenience samples of Aboriginal adults living in a mid-sized city in western Canada. Sample 1 was recruited in 2008-09 and included Aboriginal university students (N = 60). Sample 2 was recruited in 2010 and included urban Aboriginal adults living in this city more generally (N = 381). Results: Both samples evidenced high levels of Aboriginal enculturation and Canadian acculturation. In Sample 1, enculturation served as a protective factor for alcohol problems. In Sample 2 enculturation served as a protective factor for illicit and prescription drug problems, as well as a resilience factor that buffered the effects of low educational attainment on increased illicit drug problems. In Sample 2, the protective impacts of enculturation on drug problems were partially mediated by elevated self-esteem among those who were more highly enculturated in this larger sample. Acculturation was not associated with alcohol or illicit drug problems, and served as a risk factor for prescription drug problems. Both samples experienced high levels of racial discrimination. Associations between racial discrimination and addictive problems were examined in Sample 2, with racism serving as a risk factor for prescription drug problems, problem gambling and gambling to escape in this sample. The impacts of racism on addictive problems were mediated by elevated symptoms of post traumatic stress among those experiencing high levels of discrimination. Conclusions: Findings support the growth of programs and services that encourage Aboriginal peoples to maintain their culture within the urban setting. Results also support policies and programs to reduce racism directed at Aboriginal peoples in urban areas, and services to help Aboriginal peoples cope with these experiences.