Immigration policies as political determinants of alcohol and drug misuse among US-born Latinos

Background: The role of immigration policies as political determinants of health among US-born Latinos is significantly understudied. Immigration policies can produce immigration-related stressors that have 'spill over' effects on the health behaviors of US-born Latinos. However, less is known about how immigration-related stressors relate to substance misuse among US-born Latinos. Methods: 1,784 US-born Latinos were recruited via web-panels in September 2021 to complete an online questionnaire. Inclusion criteria included: (1) self-identifying as Latino; (2) born in the US; and (3) being 18 years of age or older. Participants were asked 14-items related to immigration-related stressors and past-year substance use behaviors. Dependent variables included past-year: heavy drinking, high intensity drinking, illicit drug use, prescription drug misuse, cannabis use, cocaine use, methamphetamine use, prescription sedative misuse, and prescription opioid misuse. Two separate multivariable logistic regression models were conducted for each outcome to investigate associations between (1) specific immigration-related stressors and substance misuse; and (2) experiencing greater (vs. fewer) number of immigration-related stressors and substance misuse.Results: On average, US-born Latinos reported experiencing 3 immigration-related stressors. In multivariable analyses, being fearful or worried about being detained for immigration reasons was associated with increased odds of engaging in heavy drinking, high intensity drinking, and illicit drug use. Having ever feared or worried about being potentially deported for immigration reasons and having ever witnessed or experienced an immigration raid was associated with high intensity drinking. Parental detentions and deportations in childhood were independently associated with high intensity drinking, illicit drug use, and prescription drug misuse. Notably, greater number of immigration-related stressor experiences increased the odds of substance misuse.Conclusion: Punitive immigration and enforcement policies give rise to multiple stressors that may render US born Latinos vulnerable to misusing substances as a way of coping. Policies and public health interventions aimed at preventing and treating substance misuse should consider how immigration policies impact the behaviors of US-born Latinos.