Neighborhood socioeconomic status and substance use by U.S. adults

Abstract

Background This study examined relationships of extremes in neighborhood socioeconomic status with use of tobacco, alcohol, marijuana and other drugs. Hypotheses were (1) residence in disadvantaged neighborhoods would be positively associated with stress-related and higher-risk substance use patterns (e.g., drug use), and (2) residence in affluent neighborhoods would be positively associated with “healthy” substance use (e.g., drinking within recommended guidelines) and negatively associated with substance use patterns incompatible with a culture of health. Age was examined as a potential moderator. Methods Data were from nationally-representative samples of U.S. adults (N=14,531) from the 2000 and 2005 National Alcohol Surveys linked with indicators of neighborhood SES from the 2000 U.S. Decennial Census. Analyses included gender-stratified multivariate logistic regression using weights to adjust for sampling and non-response. Results As hypothesized, compared to middle-class neighborhoods, residence in disadvantaged neighborhoods was associated with higher odds of both men’s and women’s tobacco use and with women’s other drug use. Residence in affluent neighborhoods was associated with lower odds of men’s tobacco use and women’s marijuana use. The association of neighborhood SES with men’s tobacco use was modified by age, with the highest odds of daily tobacco use evident for all men in disadvantaged neighborhoods, as well as for younger men in middle-class neighborhoods. There were no significant associations of either alcohol outcome with neighborhood SES. Conclusions Increased risk of substance use for younger residents in both disadvantaged and middle-class neighborhoods and for older residents in disadvantaged neighborhoods suggest a need for targeted prevention interventions.

The association between childhood relocations and subsequent risk of suicide attempt, psychiatric problems, and low academic achievement

“…We first showed that an increase in the frequency of relocations was associated with numerous other risk factors. Those who relocated in childhood were more likely to have been born to young parents and have parents who abuse substances, have lower incomes, and engage in criminal activity, which supports previous research (Dohrenwend et al , 1992, Karriker-Jaffe, 2013, US Census Bureau, 2013). We then utilized analyses to incorporate both measured covariates and family-based comparisons, including the comparison of differentially exposed cousins and siblings.…”

Personal responsibility within health policy: unethical and ineffective

“…The majority of stigmatised behaviours included in the considered cases—cigarette use, various kinds of substance abuse, poor eating habits—are taken up most frequently by those at the bottom of the socioeconomic hierarchy 55–57. Interestingly, alcoholism does appear to spread itself fairly evenly across tax brackets,58 but unremitting alcoholism is associated with disadvantaged neighbourhoods 59. Many of these behaviours co-occur with psychiatric illnesses, and especially so in the least well off 60.…”

Urban landscapes of adolescent substance use

“…The main finding is that inhabitants of socio-economically disadvantaged areas have increased risks for daily smoking, heavy alcohol use and the use of hard illegal drugs (Blomgren et al, 2004, Cerda et al, 2010, Karriker-Jaffe, 2013, Martikainen et al, 2003. Theories of social marginalization and deprivation (for a summary, see Sampson, 2011) suggest that socio-economically poor areas may suffer from a lack of 'collective efficacy', poor policing and schools that fail to maintain social order.…”

“…Actually, few studies address living conditions and sociocultural aspects of lifestyles in areas inhabited by those with middle and high levels of education and income (Sampson, 2011, Sampson et al, 2015, and some studies even suggest that adolescents in such areas may have specific risk factors for maladaptive outcomes (Luthar, 2003). Moreover, all psychosocial problems may not necessarily follow the typical pattern of a concentration in areas of disadvantage, and there is increasing evidence that this may be true for the use of psychoactive substances , Karriker-Jaffe, 2011, Karriker-Jaffe, 2013). Here we ask: To what degree does the use of such substances reflect the socio-economic characteristics of a certain area?…”