Investigating Intra-Group Heterogeneity in Alcohol Use, Marijuana Use and Depressive Symptoms Among Black South African Adolescents

Significant health disparities exist in South Africa stemming from Apartheid-era policies, and primarily impact Black South Africans. The World Bank concluded that, as of 2018 data, racial inequity was the primary driver of income disparity in South Africa (World Bank, 2022). Data from the National Income Dynamics Study (NIDS) suggests that the typical Black household holds only 5% of the wealth held by a typical White household in South Africa (Chelwa et al., 2024). Resultingly, Black individuals are more likely to use public healthcare compared to White, Indian, and Coloured (South African term for bi-racial/multiracial) South Africans (Mhlanga & Garidzirai, 2020). Black South Africans appear to experience higher psychological distress compared to White or Coloured South Africans (Harriman et al., 2021). Additionally, lower SES individuals, young people, and Black individuals appear to engage in more binge drinking compared to other groups (Fontes Marx et al., 2021). In this study, using data collected from South African adolescents in the Free State province, we will seek to further examine drivers of alcohol use, marijuana use, and depressive symptoms among Black South Africans. Namely, considerable within-group heterogeneity exists among Black South Africans on the basis of SES, ethnolinguistic diversity, and cultural values which may serve as additional risk or protective factors for alcohol, substance, and depressive outcomes. Specifically, we will seek to investigate associations of language, family beliefs, and peer norms on alcohol frequency, marijuana use frequency, and depressive symptoms above and beyond key sociodemographic variables such as age, gender, and SES.