Background: Black Young Adults (BYA) are a diverse group with a significant proportion who are foreign-born. However, studies assume homogeneity in this group implying similarities in determinants and risk of substance use. This study aimed to investigate the association of psychosocial stressors with substance use among foreign-born (FB) and U.S.-born BYAs.

Methods: Cross-sectional survey data were collected from 484 U.S. BYAs (18-25 years). Participants self-reported their societal concern regarding: 1) police brutality, 2) violence in schools, and 3) hostility and discrimination. Experience of racist events was assessed using the 17-item Schedule of Racist Events (SRE) and discrimination was assessed with the 9-item everyday discrimination scale (EDS). Study outcomes were ever use of cannabis, nicotine/tobacco, and past 30-day binge drinking. Multivariable logistic regression models were conducted to examine association of these psychosocial stressors with substance use among FB and U.S.-born BYAs.

Results: Foreign- and U.S.-born BYAs were not different in their mean societal concern and racist experiences. Everyday discrimination was lower among foreign- vs. U.S.-born born BYAs (14.4 vs. 16.8, p=0.002). Among study participants overall, societal concern was associated with increased odds of binge drinking (aOR=1.11, 95%CI 1.01-1.23), being foreign-born was protective of cannabis use (aOR=0.50, 95%CI 0.33-0.75), and SRE was consistently associated with increased odds of all substances studied. Specifically among FB BYAs, societal concern was associated with reduced odds of nicotine/tobacco use (aOR=0.78, 95%CI 0.66-0.90) and racist experience was associated with binge drinking (aOR=1.05, 95%CI 1.02-1.09). Among U.S.-born BYAs, SRE was associated with increased odds of nicotine/tobacco (aOR=1.04, 95%CI 1.02-1.06) and cannabis (aOR=1.03, 95%CI 1.01-1.05) use.

Conclusion: Foreign-born and U.S.-born BYAs showed similarities in their societal concern and experiences of racist events. However, the differences in substance use correlates suggests that interventions may need to be tailored to these distinct groups rather than assuming homogeneity.