Social causation and neighborhood selection underlie associations of neighborhood factors with illicit drug-using social networks and illicit drug use among adults relocated from public housing

Abstract

Theories of social causation and social influence, which posit that neighborhood and social network characteristics are distal causes of substance use, are frequently used to interpret associations among neighborhood characteristics, social network characteristics and substance use. These associations are also hypothesized to result from selection processes, in which substance use determines where people live and who they interact with. The potential for these competing selection mechanisms to co-occur has been underexplored among adults. This study utilizes path analysis to determine the paths that relate census tract characteristics (e.g., economic deprivation), social network characteristics (i.e., having ³ 1 illicit drug-using network member) and illicit drug use, among 172 African American adults relocated from public housing in Atlanta, Georgia and followed from 2009 to 2014 (7 waves). Individual and network-level characteristics were captured using surveys. Census tract characteristics were created using administrative data. Waves 1 (pre-relocation), 2 (1st wave post-relocation), and 7 were analyzed. When controlling for individual-level sociodemographic factors, residing in census tracts with prior economic disadvantage was significantly associated with illicit drug use at wave 1; illicit drug use at wave 1 was significantly associated with living in economically-disadvantaged census tracts at wave 2; and violent crime at wave 2 was associated with illict drug-using social network members at wave 7. Findings from this study support theories that describe social causation and neighborhood selection processes as explaining relationships of neighborhood characteristics with illicit drug use and illicit drug-using social network characteristics. Policies that improve local economic and social conditions of neighborhoods may discourage substance use. Future studies should further identify the barriers that prevent substance users from obtaining housing in less disadvantaged neighborhoods.

Socioeconomic risk factors for fatal opioid overdoses in the United States: Findings from the Mortality Disparities in American Communities Study (MDAC)

“…[48] A study of housing relocation in Atlanta suggest that drug use wains when people move from these settings to neighborhoods with more economic advantage. [49] Authors of the Atlanta study recommended research on barriers that prevent people who use substances from obtaining housing in less disadvantaged neighborhoods. Campaigns to enhance quality of life in less affluent housing neighborhoods may also have merit.…”

311 service requests as indicators of neighborhood distress and opioid use disorder

“…Studies shown in much of the country, the counties with the lowest levels of social capital have the highest overdose rates, suggesting the role of community fragility in the drug overdose epidemic 15 . Residential mobility studies suggest that drug misuse improves when people move to a community with less social and economic disadvantage 16 . There is increasing recognition that the opioid crisis is fueled by economic and social upheaval; its etiology rooted in concentrated disadvantages, isolation and social upheaval 6 .…”

Associations between neighborhood‐level factors and opioid‐related mortality: A multi‐level analysis using death certificate data

“…Using PubMed/Medline, we identified area-level factors found to impact mental and physical health [36][37][38][39], substance use [40][41][42], overdose [28] and mortality [28,43]. Based on clinical expertise and strong conceptual links to opioid-overdose death, we refined and curated a list of area-level variables that were organized according to our four overarching categories.…”