(PS10-6) Native Hawaiian and Pacific Islander Population Mental Health Disparities: Evaluating Ethnic Group Differences in Internalizing Problem Behaviors and Substance Use

Within the United States, research indicates that Native Hawaiian and Pacific Islander (NHPI) youth, along with other indigenous populations, have a high prevalence of mental health disorders, particularly with anxiety and substance use (Kaholokula et al., 2019). Despite this, there are conflicting findings in the literature, regarding whether internalizing problem behaviors is associated with an increase or decrease in substance use behaviors (Colder et al., 2013; Conway et al., 2018).  

However, studies often fail to examine these impacts on NHPI youth in isolation since studies tend to aggregate their data with individuals that identified as being Asian American (Nguyen et al., 2022). The aggregation of ethnic identity data masks disparities unique to NHPI populations and leads to inaccurate data reporting (Choi et al., 2024). To address this significant research gap, the current aim of this study is to explore the associations of internalizing behaviors on current substance use among NHPI youth.

Youth self-reported data was collected from the Youth Tobacco Survey (YTS). The survey consists of 91 items and includes the Anxiety, and Depression subscales from the Ohio Scales Problem Severity Scale to measure internalizing problem behaviors (Ogles et al., 2000). The YTS utilizes a two-stage probability sample design for school and student selection, resulting in fairly accurate population estimates. The survey was administered to 1,969 middle school and 2,063 high school students in Hawai‘i in 2019 (n = 4,032). The majority of students identified as male (52.3%) and indicated Asian (37.5%), followed by NHPI (36.5%), as their ethnicity. Deidentified data was requested from the Hawaii Health Data Warehouse. Multiple statistical methods will be utilized using SPSS Complex sample procedures. In addition to descriptive statistics, a logistic regression model will evaluate whether internalizing behaviors predicts current drug use within the NHPI sample. Cross-tabulation analysis and chi-square statistics will be utilized to evaluate significant differences in internalizing behaviors, and current drug use with various demographics, such as ethnicity, grade level, and sex. 

Results will further the public’s understanding of the mental health disparities faced by NHPI youth populations. Despite this, there may be further ethnic discrepancies within the NHPI classification (i.e., Micronesian, Samoan), therefore, future research should enhance ethnic identity measures to increase the precision of risk behavior and mental health prevalence estimates. In addition, results may inform community-based partners, such as school mental health programs, to advance efforts in the prevention of mental health disorders for historically marginalized communities. Furthermore, since existing evidence-based interventions tend to focus on internalizing problems or substance use, rather than simultaneously, community-based substance use youth treatment centers may consider the identification and treatment of internalizing problem behaviors (McDanal et al., 2021).