| This dissertation utilizes data from the 1998 Statewide Household Survey on Substance Abuse to show that a distinct socioeconomic hierarchy exists among the major ethnic groups in Hawai'i, and that socioeconomic status fails to explain between-group differences in substance abuse. Caucasians' and Native Hawaiians occupy opposite ends of the socioeconomic hierarchy, and prevalence of substance use and abuse was highest between these two ethnic groups, even when controlling for income, education, and occupational prestige. Respondents of Japanese and Filipino descent had much lower substance use prevalence, in spite of the socioeconomic difference between the two groups.;Ethnicity and gender were the strongest predictors of substance use in Hawai'i. Hawai'i's population is multiethnic, with the largest group comprising only 25 percent of the population. However, three quarters of the state's population are generally lumped together as "Asians and Pacific Islanders." National measures of health fail to catch significant health-related problems in population subgroups. There are distinct cultural differences between Asian Americans and Pacific Islanders. There is also a distinct socioeconomic divide in which Caucasians and Japanese control most of the state's wealth, and Native Hawai'ians and Filipinos control the least.;If socioeconomic differences do not explain differences in prevalence of substance use or abuse, then what are the most important variables to examine? The research utilizes logistic regression analysis to examine of a host of environmental and psychosocial factors. Environmental factors of geographic location and acculturation had significant predictive value for substance use and related disorders for some ethnic groups. Psychosocial factors produced mixed results in the analysis. Members of some ethnic groups are more likely to use substances either as a coping tool or, for other groups, as a means of enhancing affect.;State substance treatment and prevention efforts in Hawai'i should de-emphasize "one-size fits all" or "Western" approaches. Motivations for substance use, and the resources available to mitigate substance use, vary widely between the ethnic groups in Hawai'i and are largely culturally based. Therefore, Western modes of substance treatment and prevention should be examined in terms of their applicability or utility for Hawai'i's multiethnic population. |
