The influence of childhood and early adult adversities on substance use behaviours in racial/ethnically diverse young adult women: a latent class analysis

PURPOSE: Childhood and adult adversities occur more frequently among women and persons of colour, possibly influencing racial/ethnic disparities in substance use behaviours. This study investigates how childhood and adult adversities cluster together by race/ethnicity and how these adversity clusters predict binge drinking, tobacco, e-cigarette, and marijuana use in women. METHODS: Latent class analysis (LCA) was used in a combined sample from the 2015 and 2018 Minnesota College Student Health Survey to identify clusters of childhood adversities plus highly correlated adult adversities among Asian, Black, Latina, and White women aged 18-25. The LCA method allowed unique clusters of adversity to emerge from these data, stratified by race/ethnicity. Each substance use outcome was regressed on each adversity cluster across each race/ethnicity group. RESULTS: A seven-cluster model was selected for White women, a five-cluster model for Black women, and four-cluster models for Asian and Latina women. Differences across racial/ethnic clusters included the presence of a lifetime sexual assault only cluster in the White, Black, and Asian women that did not exist among Latina women. Across all racial/ethnic groups and substance use outcomes, the high adversity cluster exhibited the greatest risk. Significant racial/ethnic disparities were observed across several substance use behaviours; these were narrowed substantially among women with fewer adversities. CONCLUSIONS: In this study, subtyping women according to their histories of adversity revealed differences in substance use risk. The reduced substance use disparities found among those with lower adversities suggest that prevention of adversities may advance health equity.