Association between Acculturative Stress and Risky Alcohol Use Among Immigrant Parents In the United States

Background and Purpose: Acculturative stress is a critical determinant of health behaviors among immigrant populations, yet its relationship with risky alcohol use remains understudied, particularly among immigrant parents who navigate both cultural adaptation and family responsibilities. Acculturative stress may function as one of the stressors that increase psychological strain, which may lead immigrants to adopt maladaptive coping strategies, such as alcohol use, to overcome the stress. Risky alcohol use among parents also has specific implications for family and child well-being. In this study, we examined whether acculturative stress is related to risky alcohol use among immigrant parents in the United States. We hypothesized that higher levels of acculturative stress are associated with an increased likelihood of risky alcohol use.

Methods: We employed a cross-sectional survey design using an online survey distributed through Centiment, a paid audience panel service. Eligible participants were foreign-born adults aged 18 years or older living in the United States with at least one child under the age of 13. Acculturative stress was measured using a modified 21-item version of the Social, Attitudinal, Familial, and Environmental Acculturative Stress Scale (SAFE), with items scored from 0 (not applicable) to 5 (extremely stressful), and summed up to create a total score. Risky alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT) and dichotomized using sex-specific cutoffs (≥8 for men and ≥5 for women). Covariates included age, sex, marital status, education, employment status, household income, region of origin, language use, legal status, and years in the United States. Multivariable logistic regression was used to estimate the association between acculturative stress and risky alcohol use, adjusting for all covariates.

Results: Our sample included 323 immigrant parents with a mean age of 39.07 years (SD = 7.19); 66.56% were female, and 59.87% were U.S. citizens. Most participants were originally from Asia (62.03%), followed by North America (18.04%), Latin America (12.34%), and other regions (7.59%). Overall, 22.91% met criteria for risky alcohol use. The mean acculturative stress score was 38.91 (SD = 22.92). In multivariable logistic regression analyses, higher acculturative stress was significantly associated with increased odds of risky alcohol use (OR = 1.02, 95% CI [1.00, 1.03], p = .021), adjusting for demographic and socioeconomic covariates.

Conclusions and Implications: The findings of our study suggest that acculturative stress is a key determinant of risky alcohol use among immigrant parents. It highlights the importance of addressing acculturative stress within substance use prevention and intervention efforts, particularly among immigrant parents. Social work practitioners should incorporate culturally responsive approaches that support adaptive coping strategies and reduce stress related to acculturation. Interventions aimed at reducing alcohol use risk among immigrant parents should target acculturative stressors to enhance cultural relevance and effectiveness. Future studies should explore the potential mediators between acculturative stress and risky alcohol use and identify intervention strategies that reduce stress and promote resilience in these populations.