Race-Related Stress and Alcohol Use Among Black American Adults: A Moderated Mediation of Racial Centrality and Justice Involvement

Abstract

Exposure to racism, namely racism-related stress, is a pervasive social determinant of health that has led to increased alcohol use among Black Americans. However, limited research has examined how racial stress may impact one’s response to their racial identity (i.e., racial centrality), especially when considered alongside the intersection of other social health determinants, such as criminal legal system involvement. The present study employed the Racism and Health Framework to conceptualize the associations between race-related stress and alcohol use, with racial centrality as a mediator and justice-involvement status as a moderator. A sample of justice- involved (n = 211) and non-justice-involved (n = 424) Black Americans (N = 635) participated in this online survey. Mediation and moderated mediation models analyzed (1) the direct association between race-related stress and alcohol use, (2) the mediating role of racial centrality, and (3) the moderating role of justice-involvement status on the mediation. Results indicated a significant association between race-related stress and alcohol use, and a significant indirect effect on alcohol use via racial centrality. Specifically, greater racial centrality scores were associated with reduced alcohol use, and conditional effects based on justice-involvement status suggested that justice-involved Black Americans’ elevated alcohol use scores increased as their experiences of race-related stress increased; however, the full moderated mediation only held for non-justice-involved versus justice-involved participants. Combined, the results may help inform future clinical interventions and research that address race-related stress, alcohol use, and the impacts of justice involvement to improve health behaviors and outcomes among Black Americans.