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Article Excerpt
UNTIL VERY RECENTLY, most ethnic minorities have been underrepresented in alcohol research (Caetano et al., 1998; Harachi et al., 2001). During the last 2 decades, studies have begun to examine drinking patterns among different minority ethnic groups, including blacks and Hispanics (Caetano, 1983, 1987; Farrell and White, 1998; Grant et al., 2004). Nonetheless, the drinking behavior of Asian Americans continues to draw relatively little attention (Harachi et al., 2001; Zane and Huh-Kim, 1994). For example, as of 2001, this ethnic group was not included in some of the most extensive surveys of adolescent alcohol and drug use, such as the National Household Survey on Drug Abuse and Monitoring the Future (Harachi et al., 2001). Although a few recent studies have examined drinking patterns among Asian American subgroups, such as Koreans, Chinese, Japanese, and Filipinos (Hendershot et al., 2005; Luczak et al., 2001; Wong et al., 2004), there is still a paucity of research on immigrant populations from other Asian countries (e.g., Vietnam, Cambodia; Harachi et al., 2001; Zane and Huh-Kim, 1994).
The relative absence of research on one Asian American subgroup in particular (i.e., Cambodian Americans) constitutes a critical gap in the literature. Cambodian Americans--or, more precisely, Cambodian refugees--are widely believed to be at high risk for alcohol problems (D'Avanzo, 1997; O'Hare and Van Tran, 1998). This presumption derives largely from knowledge that Cambodian refugees were subjected to one of the most traumatic periods of the past century before immigrating to the United States (Rummel, 1994). Insofar as a strong association exists between heavy drinking and trauma exposure (Stewart, 1996), Cambodian refugees might be expected to be at increased risk for alcohol-use problems.
A small body of research does, in fact, suggest that Southeast Asians, including Cambodian refugees, are at heightened risk for alcohol abuse (e.g., Amodeo et al., 1997; D'Avanzo, 1997; D'Avanzo et al., 1994). However, there are significant limitations to these studies. First, most are based on small convenience or clinical samples (e.g., D'Avanzo et al., 1994; Morgan et al., 1984; Nicassio and Pate, 1984; Yee and Thu, 1987). Thus, when 60% of Southeast Asian youth in one study reported drinking to "forget their past" (Morgan et al., 1984), this has been taken as evidence of a potential problem. Yet this finding is based on only 41 respondents of uncertain generalizability to the broader community of Cambodian refugees. Similarly, when authors report that 52% of Cambodian refugee women report drinking, this percentage includes only 31 women from a convenience sample (D'Avanzo et al., 1994). Unfortunately, other researchers may selectively quote these percentages to highlight problem drinking among this population without noting the significant problems associated with generalizing from those estimates.
Another problem is that most of the previous studies have not used standard quantity and frequency consumption measures over a representative period, nor have they used accepted screeners for alcohol-use disorders (Varma and Siris, 1996). Thus, it is difficult to compare drinking levels across different studies (Makimoto, 1998), particularly between studies of these special populations and studies on the broader population. For example, drinking among this population has been assessed by using "never," "social or infrequently," "weekly," and "daily" (D'Avanzo et al., 1994), by reporting "drinking alcohol in the previous six months" with no other qualifiers (Morgan et al., 1984), and by a personal evaluation of the seriousness of "alcohol abuse" in their life (Nicassio and Pate, 1984). Similarly, documenting that individuals may drink to "forget their past" does not establish a pattern of drinking that constitutes problematic use. Given the use of nonstandard assessment methods, it is difficult to draw conclusions about the extent to which drinking is a significant problem among Cambodian refugees (Varma and Siris, 1996).
Finally, the existing data on drinking among Cambodian refugees are based on studies that were conducted between i0 and 20 years ago. Thus, it is reasonable to wonder whether this earlier research provides an accurate reflection of current drinking behavior and potential treatment needs of Cambodian refugees. The long elapsed period between the publication of most empirical research raises concerns about the value of these data for public health planning as well as for describing the challenges facing this community.
The current study was designed to address the foregoing limitations of existing research and provide the best available data regarding patterns of drinking behavior in a representative sample of the largest single Cambodian refugee community in the United States. We have chosen to address current drinking in this population by assessing past 30-day alcohol use so that we can better understand the present problems among this community. Additional goals were to identify sociodemographic and other correlates of past 30-day alcohol consumption and problem drinking in this population.
Method
Sample design and participants
We derived our sample from a geographically contiguous area composed of the four census tracts with the largest proportion of Cambodians in gong Beach, CA, containing approximately 15,000 total households. We used a three-stage random sample of individuals within households within blocks. In the...
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