58 A meta-analytic review of the relationship between racial discrimination and substance and alcohol use outcomes in racial/ethnic minority groups

Abstract EP1.4, e-Poster Terminal 1, September 4, 2025, 11:35 - 13:00 Aims This study assessed the strength of the relationship between racial discrimination (RD) and distinct substance and alcohol use outcomes (SAU) in racial/ethnic minorities. And sought to determine if race/ethnicity, gender, age, exposure timing and study design moderate these associations, using meta-analytic methods. Method Database and citation searches were conducted in September 2024. Eligibility criteria: 1) used quantitative methods, 2) included RD as an exposure, 3) included a SAU outcome, 4) contain a racial/ethnic minority sample, 5) do not include RD into a measure of general/ intersecting discriminations, 6) not a previous meta-analyses on the association. Screening and data extraction were performed by two independent coders, quality assessment was conducted using the NIH tool for Observational Cohort and Cross-sectional studies. Univariate random-effects models were performed in R studio. Results 130 studies, contributing 273 effect sizes were included, and 17 discrete SAU outcomes were identified. Significant, positive associations between RD and 16 SAU outcomes were revealed, with the strongest associations for at-risk alcohol use (r = .24, 95% CI = 0.17, 0.3), at-risk cannabis use (r = .24, 95% CI = 0.18, 0.29) and substance use disorder (r = .25, 95% CI = 0.14, 0.36). Subgroup analyses revealed the RD – tobacco consumption and composite substance use relationships were stronger for American Indian’s/Alaskan Natives, than Black Americans and Latinx. Moderation by age group identified a trend of stronger associations for older ages compared to younger across 6 SAU domains. Exposure timing was a significant moderator in the illicit substance and tobacco consumption domains, where lifetime exposures produced stronger associations than past year or less exposure. Conclusion RD is a consistent predictor of SAU for racial/ethnic minorities, but the magnitude of the association varies across outcomes. Moreover, the moderating role of race/ethnicity, age and exposure timing differs across SAU outcomes.