This chapter reviews the role of cultural processes in substance use and other health problems among adolescents. The chapter focuses on Hispanics because of their status as both a minority group and an immigrant group, and because Hispanics have been a “lightning rod” for political discourse about immigration and US national identity. The core argument is that intergroup processes such as social dominance and system justification are responsible, at the population level, for unequal allocation of social resources—which, in turn, creates health disparities. These intergroup processes compound the effects of more proximal contexts such as individual, family, and neighborhood. It is argued that interventions to combat the social/cultural determinants of health disparities should be multilevel, including individual-, family-, community-, and population-level strategies.