Drug abuse and dependence hospitalization rates among Chinese ethnic enclaves and ethnoburbs in California, 2007-2011

Background:Prior research has found that greater substance use occurs among immigrant minorities living in ethnic enclaves, neighborhoods in large urban centers that have high concentrations of an ethnic group and serve as ports-of-entry to the U.S. However, a different type of immigrant enclave has emerged in the suburbs among minority populations with higher socioeconomic status and English language fluency, called “ethnoburbs”.

Methods:We examine relative risk for drug problems among populations in Chinese ethnic enclaves and ethnoburbs using hospitalizations involving drug abuse or dependence throughout California over the years 2007-2011. First, we use spatial analysis techniques to identify and map Chinese ethnic enclaves and ethnoburbs at the zip code level across the state. Second, we use Bayesian space-time models to examine relationships between neighborhood rates of drug-involved hospitalizations and key neighborhood dimensions that characterize ethnic enclaves and ethnoburbs (i.e. Chinese ethnic density, percent foreign born, urban versus suburban location, household socioeconomic status, English fluency, and professional occupations).

Results: Drug abuse and dependence rates are lower among Chinese ethnoburbs than Chinese ethnic enclaves. Areas with more Chinese residents, more foreign-born residents, fewer English-speaking residents, and higher median income are associated with lower rates of substance abuse. Rates are higher in urban areas than in suburban locations, and among neighborhoods with a greater number of residents in professional occupations.

Conclusions: Chinese ethnic enclaves and ethnoburbs have high concentrations of co-ethnics that buffer against drug use and abuse, but both types of areas are characterized by different dimensions that increase risk for this outcome.