The Role of Race/Ethnicity, Sexual Identity, and Religiosity in Understanding Substance Use.


Fahey, K.M.L. & Dermody, S.S (2023). The Role of Race/Ethnicity, Sexual Identity, and Religiosity in Understanding Substance Use..


Purpose: Religiosity is protective for substance use in heterosexual samples; it has no association with substance use in LGB (lesbian, gay, bisexual, etc.) samples. Race/ethnicity may further moderate this relationship as: 1) Religiosity may be more or less salient dependent on racial/ethnic identity; and 2) Compounding minority identities may exacerbate stress' effect on outcomes.
Method/Data: Data were from Wave V (2016–18) restricted dataset of the National Longitudinal Study of Adolescent to Adult Health (AddHealth; N = 11,822; Mage = 37.99). Religiosity was examined as a latent variable including frequency of attendance, frequency of prayer, affiliation (yes vs. no), and importance. Race/ethnicity categories were White (reference; 60.8%), Black (20.2%), Hispanic (12.5%), and Asian/Pacific Islander (API; 6.5%). Sexual identity categories included heterosexual (reference; 85.3%), mostly heterosexual (10.6%), and LGB (4.1%). Logistic regression models in Mplus examined associations and interactions between race/ethnicity, sexual identity, and religiosity on five substance use outcomes: cigarette, e-cigarette, and marijuana use (non-use vs. past 30 day use); alcohol use (non-drinker, drinker, moderate/heavy drinker in the past 30 days); and heavy episodic drinking (HED; none vs. any in the past year). Covariates were sex, age, and SES.
Results: Significant three-way interactions were present for e-cigarette (for API mostly heterosexual [b = −6.25, p = 0.043], and LGB [b = −1.53, p = 0.032]), marijuana (Hispanic LGB+ [b = −1.37, p = 0.031]), and alcohol (API LGB [b = −2.00, p = 0.026]). Simple slopes in these models revealed religiosity was protective in the following groups (ps <0.05): White heterosexual adults: all three substances; Black heterosexual adults: marijuana, alcohol; Hispanic heterosexual adults: marijuana; Hispanic LGB+ adults: marijuana; API heterosexual adults: e-cigarette, alcohol; API mostly heterosexual adults: e-cigarette; API LGB+ adults: e-cigarette, marijuana, alcohol. Religiosity was less protective for API heterosexual adults (e-cigarette and alcohol) and less protective for Hispanic heterosexual adults (marijuana).
Conclusions: The association between religiosity and substance use is moderated by race/ethnicity and sexual identity. Religiosity was more protective for certain substances in Hispanic and API adults with non-heterosexual identities than in Hispanic and API heterosexual adults; this pattern was not found in non-heterosexual White and Black adults.

Reference Type

Conference paper

Book Title

Research Society on Alcohol 46th Annual Scientific Meeting


Fahey, K.M.L.
Dermody, S.S

Year Published


City of Publication

Bellevue, WA

Reference ID