title: Panic attacks in minority Americans: the effects of alcohol abuse, tobacco smoking, and discrimination.
abstract: BACKGROUND
  Lifetime prevalence of panic attacks is estimated at 22.7%, and research on the correlates and causes of depression, anxiety, and other mental illnesses have yielded mixed results in minority groups. Therefore, the purpose of this study is to evaluate the relationship between panic attacks, minority status, and nativity by focusing on the effects of health lifestyle behaviors and discrimination.
  
  
  METHODS
  Multivariate analysis was performed using logistic regression, which was used to estimate the probability of meeting the criteria for panic attacks (n=17,249).
  
  
  RESULTS
  Demographic and socioeconomic variables had significant associations; females had over 2.4 times higher odds than males of meeting the criteria for panic attacks. The more frequently respondents were treated as dishonest, less smart, with disrespect, threatened, or called names, the more likely they met the criteria for panic attacks. Additionally, smoking and alcohol abuse were significant predictors of panic attacks. Those who abused alcohol have over 2 times the odds of having panic attacks. Similarly, smokers had 52% higher odds of panic attacks than non-smokers.
  
  
  CONCLUSIONS
  The primary limitation of this project was the lack of a true acculturation measure with a secondary limitation being the inability to determine respondents׳ legal status.
  
  
  CONCLUSIONS
  Key findings were that health lifestyle choices and exposure to discrimination significantly affected the chance of having panic attacks. Nativity was protective; however, its effect was counteracted by exposure to discrimination or engagement in smoking behavior or alcohol abuse. Thus, this study offers insight into contextual factors for clinicians caring for racial and ethnic minorities diagnosed with panic attacks.
authors.affiliation: University of Alabama at Birmingham, Health Services Administration, 563 School of Health Professions Building, 1705 University Boulevard, Birmingham, AL 35294, USA.
authors.forename: Kristine Ria
authors.initials: KR
authors.lastname: Hearld
authors.affiliation: University of Alabama at Birmingham, Health Care Organization and Policy, 517D Ryals Public Health Building, 1665 University Boulevard, Birmingham, AL 35294, USA; University of Alabama at Birmingham, UAB Sparkman Center for Global Health, 517 Ryals Public Health Building, 1665 University Boulevard, Birmingham, AL 35294, USA. Electronic address: budhwani@uab.edu.
authors.forename: Henna
authors.initials: H
authors.lastname: Budhwani
authors.affiliation: University of Alabama at Birmingham, UAB Sparkman Center for Global Health, 517 Ryals Public Health Building, 1665 University Boulevard, Birmingham, AL 35294, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chavez-Yenter
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000208:ethnology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data*; D016017:Odds Ratio; D016584:Panic Disorder / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D017678:Sex Distribution; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000208:ethnology; D063508:Social Discrimination / Q000208:ethnology / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
keywords: Alcohol abuse; Discrimination; Healthy migrant effect; Immigrants; Panic attacks; Tobacco smoking