The relationship between perceptions of neighborhood characteristics and substance use among urban African American adolescents

A trajectory analysis of alcohol and marijuana use among Latino adolescents in San Francisco, California

PURPOSE

We examined alcohol and marijuana use trajectories among Latino adolescents in the San Francisco Bay Area.

METHODS

A total of 410 Latino adolescents aged 14-19 years were recruited from community venues from years 2001 to 2004 and followed up for 2 years. In separate models, we identified groups with similar temporal patterns of alcohol and marijuana use using semi-parametric latent group trajectory modeling. Multivariable multinomial logistic regression was used to identify factors associated with the probability of trajectory group membership.

RESULTS

The use of alcohol (76%) and marijuana (55%) in the previous 6 months was common. Three alcohol-use trajectories were identified: low users (18%), moderate users (37%), and frequent users (45%). Low alcohol users (vs. moderate users) were found to be younger in age, preferred Spanish language, and had more parental monitoring. Frequent users were more likely to be male, sexually active, gang exposed, and have less parental monitoring than moderate users. Similarly, three marijuana-use trajectories were identified: low users (36%), moderate users (35%), and frequent users (28%), with similar correlates of group membership.

CONCLUSIONS

Urban Latino adolescents' substance use is shaped by complex cultural and environmental influences. Patterns of substance use emerge by early adolescence highlighting the need for timely intervention.

Perceived environmental risk as a predictor of teenage motherhood in a British population

Previous studies have shown that strong relationships exist between deprived environments and teenage motherhood. However, such studies have predominantly identified deprivation using neighbourhood-wide measures of socio-economic status. Few studies of teenage parenthood have examined how individuals perceive their environment and the importance of this perception on reproductive behaviour and timing. Using data collected from a sample of women living the county of Gloucestershire, UK, this paper explores the predictive value of two methods of assessing the environment: (1) the structural component-deprivation at the neighbourhood level and (2) the individual's subjective experience of her pre-pregnancy environment, when examining how the wider environmental context can influence the decision of becoming a teenage mother. The results indicate that a woman's perception of her neighbourhood of residence at the time she conceived, her perceived environmental risk, may be a more discriminating predictor of teenage motherhood than deprivation measured by ward economic and deprivation indicators.

Neighborhood Disadvantage, Stressful Life Events, and Adjustment Among Mexican American Early Adolescents

This study examined a stress-process model in which stressful life events and association with delinquent peers mediated the relationship of neighborhood disadvantage to Mexican American early adolescents' mental health. We also proposed that child gender, child generation, and neighborhood informal social control would moderate the relationship of neighborhood disadvantage to children's experiences of stressful life events. With data from 738 Mexican American early adolescents, results generally provided support for the theoretical model although the relationships of neighborhood disadvantage to stressful life events and adjustment were weaker than expected. Additional research is needed to corroborate these results and determine why neighborhood disadvantage may have different relationships to adjustment for Mexican American early adolescents than for others.

Contextual stress and health risk behaviors among African American adolescents

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder, and experiences with racial discrimination). Contextual stress in 8th grade was associated with aggressive behavior and substance use 2 years later for boys. For girls, contextual stress predicted later substance use, but not aggressive behavior. High academic competence and self-worth reduced the impact of contextual stress on substance use for boys. Implications for intervention and directions for future research on health risk behaviors among African American adolescents are discussed.

Contextual stress and health risk behaviors among African American adolescents

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder, and experiences with racial discrimination). Contextual stress in 8th grade was associated with aggressive behavior and substance use 2 years later for boys. For girls, contextual stress predicted later substance use, but not aggressive behavior. High academic competence and self-worth reduced the impact of contextual stress on substance use for boys. Implications for intervention and directions for future research on health risk behaviors among African American adolescents are discussed.

Geographic clustering of underage drinking and the influence of community characteristics

The aim of this paper was to examine the extent to which underage drinking clusters geographically in a sample of communities, and to investigate the manner in which community-level contexts are related to this process. We used data from a randomized community trial of underage drinking to provide the first quantitative estimates of the magnitude of the geographic clustering of underage drinking based upon pairwise odds ratios (PWORs). The Enforcing Underage Drinking Laws Randomized Community Trial provided data from repeated cross-sectional samples of youth aged 14-20 from 68 communities surveyed in 2004, 2006, and 2007 (n=18,730). Past 30-day drinking, binge drinking, getting drunk, experiencing non-violent consequences as a result of drinking and making a purchase attempt all significantly clustered within-communities with PWORs ranging from 1.05 to 1.21. After adjustment for individual-level characteristics, results remained relatively unchanged. However, there was evidence that the magnitude of the clustering varied as a function of neighborhood disadvantage, neighborhood disorder, and family structure. Clustering of drunkenness and experiencing non-violent consequences as a result of drinking was greatest in the least economically disadvantaged and least disordered communities with the greatest percentage of married-couple families. The clustering of making a purchase attempt, however, was greatest in more disordered communities, specifically the largest communities with the highest degree of residential mobility and housing density. These findings that clustering of underage drinking behaviors varies by community context has the potential for identifying the types of communities to target for underage drinking behavior-specific preventive interventions.

Stress and tobacco use among African-American adolescents: the buffering effect of cultural factors

Tobacco is a leading contributor to morbidity and mortality and a primary reason for health disparities among African Americans. In this study we explore the role of stress in smoking and cultural factors that protect against stress among African-American adolescents. Our sample consisted of 239 youth who were recruited into the study while enrolled in 8th and 12th grade. Measures of risk factors (stress, school transition stress, and community disorganization), moderator or protective factors (religious support and intergenerational connections), and 30-day tobacco use were collected. Hierarchical multiple regression analyses were conducted. Intergenerational connections moderated the effect of stress on past 30-day tobacco use. Religious support moderated the effect of neighborhood disorganization on past 30-day tobacco use. Religious support also moderated the effect of stress on past 30-day tobacco use. The findings have implications for prevention efforts to consider religious beliefs and practices and also to link youth with supportive adults in their community.

The influence of neighborhood disadvantage and perceived disapproval on early substance use initiation

The current study examined the role of neighborhood disadvantage, perceived caregiver disapproval, and perceived peer disapproval in early initiation of substance use in a sample of 126 aggressive 9th graders (66% male; 79% African American). Findings suggested that perceived caregiver and peer disapproval as well as neighborhood disadvantage were associated with early substance use initiation. However, when associations were simultaneously examined, neighborhood disadvantage was the only factor related to early substance use initiation. Implications for findings are discussed.

Parent, family, and neighborhood effects on the development of child substance use and other psychopathology from preschool to the start of adulthood

OBJECTIVE

We examined the long-term effects of childhood familial and neighborhood risk on adolescent substance use and psychiatric symptomatology.

METHOD

This study used data from an ongoing 2-decade long study that recruited alcoholic and neighborhood control families through fathers' drunk-driving records and door-to-door canvassing in a four county area. The sample included 220 male, initially 3- to 5-year-old children of the participant families, who received in-home assessments at baseline and thereafter at 3-year intervals. Parental lifetime psychopathology and offspring symptomatology at ages 18-20 were assessed by semistructured diagnostic interviews. Census tract variables were used to indicate neighborhood characteristics.

RESULTS

The isomorphic parental symptomatology predicted offspring psychopathology. For marijuana-use disorder, major depressive disorder, and nicotine dependence, the other parental comorbidities were also significant predictors. Neighborhood residential instability in childhood contributed to the development of late adolescent alcohol-use disorder, marijuana-use disorder, major depressive disorder, antisocial personality disorder, and nicotine-dependence symptomatology. Although lower family socioeconomic status in childhood contributed to more adolescent marijuana-use disorder, major depressive disorder, and nicotine-dependence symptoms, neighborhood socioeconomic status did not predict adolescent psychopathology. Longitudinal changes in neighborhood environments from early childhood to adolescence had significant effects on alcohol-use disorder, marijuana-use disorder, and major depressive disorder symptoms in late adolescence. A higher frequency of family mobility from early childhood to adolescence predicted more nicotine-dependence symptoms in late adolescence.

CONCLUSIONS

Findings indicate that parental psychopathology, family socioeconomic status, and neighborhood residential instability are all important risk factors for the development of substance-use disorder and other comorbid psychopathology. Intervention programming might effectively use these early parental psychopathology indicators to identify risk and might target community activity to stabilize the social environment and provide youth services to counteract the effects of family transience.

Rethinking Acculturation: A Study of Alcohol Use of Korean American Adolescents in Southern California

Given the considerable variability in drinking practices among Asian American groups, the generalizations that suggest an increase in their alcohol use associated with acculturation need to be questioned. Also, the experience of children of immigrants growing up in the United States may be much more complex than a focus on acculturation can capture. Informed by the theory of segmented assimilation, this study addresses two research questions: 1) Is acculturation associated with alcohol use of Korean American adolescents? and 2) What other social, economic, and cultural forces influence their alcohol use? Survey data collected from 202 adolescents of Korean descent in Southern California were used. Multivariate regression analyses revealed that acculturation was not a significant predictor of most measures of alcohol use, while peer influence, scholastic achievement/aspirations, and current smoking were predictive. Gender and social class were unrelated to drinking. Findings suggest focusing research on an integrative approach to understanding drinking in complex social, economic, and social contexts may be useful.

An exploratory study of substance use among Irish youth: a service providers perspective

This research aimed to provide a qualitative perception of Irish youth substance use according to youth and drugs service providers in Waterford, Ireland. Semi-structured interviews were conducted with a self-selecting sample of community, law enforcement, and drug services (N = 42). The research provided detailed knowledge about levels of youth substance use involvement and gaps in regional service provision. The results suggest that adolescents' attitudes and substance using practices have become more liberal and indeed more "normalized," and that drug services may be aiming at a "transient target" of drug and alcohol taking patterns within the rural context. Successful and proactive programs of service delivery must therefore incorporate the complexity of adolescent regional culture, perceptions of risk and maturational processes.

School contextual influences on the risk for adolescent alcohol misuse

This study investigates the association between school context and adolescent alcohol misuse. Data are from the first two waves of the National Longitudinal Study of Adolescent Health (N = 10,574 adolescents nested within 128 schools). Multilevel multinomial logistic regression is used to assess the association between school-level characteristics and the risk for non-, moderate, and heavy drinking. The risk for adolescent alcohol misuse varies significantly across schools after adjusting for adolescent-level predictors. Several school-level characteristics predict alcohol misuse. Notably, the risk for heavy drinking is elevated in schools located in communities that are socioeconomically advantaged, have high proportions of Non-Hispanic White residents, and are located in suburban (versus urban) areas. High aggregate levels of intoxication in schools increases the risk for heavy drinking among individual adolescents. Results suggest that the influence of social contexts on health is not uniform and that adolescent drinking is more likely in communities that are conceptualized as advantaged.

Longitudinal precursors of young adult light smoking among African Americans and Puerto Ricans

INTRODUCTION

Studies have consistently documented the importance of examining light smoking among African American and Latino adolescent and adult smokers. Little is known, however, about the psychosocial antecedents of adolescent and young adult light smoking in these racial/ethnic minority groups.

METHODS

This study examined the longitudinal interrelationships and pathways leading to light smoking among African Americans (n = 288) and Puerto Ricans (n = 262). Specifically, we assessed parental factors, perceived discrimination, peer smoking, personality factors, and light smoking in late adolescence as precursors to light smoking among African American and Puerto Rican young adults.

RESULTS

The results of structural equation modeling showed that a history of greater parental smoking, less parental educational attainment, and more perceived discrimination were each mediated by peer smoking and the youth's maladaptive personality and behavior in late adolescence. The youth's maladaptive personality and behavioral characteristics and light smoking in late adolescence, in turn, predicted light smoking in young adulthood. There were no significant racial/ethnic or gender differences in the pathways to light smoking.

DISCUSSION

Findings highlight the longitudinal pathways to light smoking among African Americans and Puerto Ricans. The results suggest that effective prevention and cessation programs must address peer and parental social influences, perceived discrimination, and especially, emotional and behavioral problems in late adolescence to reduce light smoking among late adolescents and young adults in these racial/ethnic groups.

Perceptions of racism and depressive symptoms in African American adolescents: the role of perceived academic and social control

Experiences with racism are a common occurrence for African American youth and may result in negative self perceptions relevant for the experience of depressive symptoms. This study examined the longitudinal association between perceptions of racism and depressive symptoms, and whether perceived academic or social control mediated this association, in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling revealed that experiences with racism were associated with low perceived academic control, which in turn was associated with increased depressive symptoms. Findings suggest that experiences with racism can have long lasting effects for African American youth's depressive symptoms, and highlight the detrimental effects of experiences with racism for perceptions of control in the academic domain. Implications for intervention are discussed.

Selected community characteristics and underage drinking

This study assessed the relationship between community characteristics and alcohol use among 6,636 youth, aged from 14 to 20, in 2004. After adjusting for individual-level characteristics, youth from communities with a greater proportion of grandparents as caregivers, larger numbers of married couple families, and higher employment rates were significantly less likely to report past 30-day alcohol use. Youth from communities with higher median household income were significantly more likely to report past 30-day alcohol use. Adolescents in communities with a greater percentage of whites were significantly more likely to report binge drinking. The results indicate that the community context is an important predictor of alcohol use.

Risk factors for distress in the adolescent children of HIV-positive and HIV-negative drug-abusing fathers

In contrast to previous research on parental drug abuse, the present study examined comorbid drug addiction and HIV infection in the father as related to his adolescent child's psychological distress. Individual structured interviews were administered to 505 HIV-positive and HIV-negative drug-abusing fathers and one of their children, aged 12-20. Structural equation modelling tested an hypothesized model linking paternal latent variables, ecological factors and adolescent substance use to adolescent distress. Results demonstrated a direct pathway between paternal distress and adolescent distress, as well as an indirect pathway; namely, paternal distress was linked with impaired paternal teaching of coping skills to the child, which in turn was related to adolescent substance use and, ultimately, to the adolescent's distress. There was also an association between paternal drug addiction/HIV and adolescent distress, which was mediated by both ecological factors and adolescent substance use. Findings suggest an increased risk of distress in the adolescent children of fathers with comorbid drug addiction and HIV/AIDS, which may be further complicated by paternal distress. Results suggest several opportunities for prevention and treatment programmes for the children of drug-abusing fathers.

Perceived neighborhood safety and depressive symptoms among African American crack users

This study examined the association between perceived neighborhood safety and depressive symptoms among 443 out-of-treatment African American crack cocaine users interviewed between 2000 and 2002 in North Carolina and tested the regression of depression on perceived neighborhood safety and common predictors of depression. Perceived neighborhood safety was an important predictor of depressive symptoms in models that adjusted for other correlates of depression. The findings are limited by the cross-sectional nature of the data and the complex etiology and course of depression. Additional research is needed to clarify the relationship between perceived neighborhood safety and depression. The study was supported by the National Institute on Drug Abuse.

The built environment and alcohol consumption in urban neighborhoods

OBJECTIVES

To examine the relations between characteristics of the neighborhood built environment and recent alcohol use.

METHODS

We recruited participants through a random digit dial telephone survey of New York City (NYC) residents. Alcohol consumption was assessed using a structured interview. All respondents were assigned to neighborhood of residence. Data on the internal and external built environment in 59 NYC neighborhoods were collected from archival sources. Multilevel models were used to assess the adjusted relations between features of the built environment and alcohol use.

RESULTS

Of the 1355 respondents, 40% reported any alcohol consumption in the past 30 days, and 3% reported more than five drinks in one sitting (heavy drinking) in the past 30 days. Few characteristics of the built environment were associated with any alcohol use in the past 30 days. However, several features of the internal and external built environment were associated with recent heavy drinking. After adjustment, persons living in neighborhoods characterized by poorer features of the built environment were up to 150% more likely to report heavy drinking in the last 30 days compared to persons living in neighborhoods characterized by a better built environment.

CONCLUSIONS

Quality of the neighborhood built environment may be associated with heavy alcohol consumption in urban populations, independent of individual characteristics. The role of the residential environment as a determinant of alcohol abuse warrants further examination.

The effect of working for pay on adolescent tobacco use

OBJECTIVES

We investigated the links between working for pay and adolescent tobacco use to determine whether working for pay increases smoking risk.

METHODS

We performed retrospective and prospective analyses using data from a cohort of 799 predominantly African American students in Baltimore, Md, who had been followed since the first grade.

RESULTS

At the 10th year of follow-up, when the adolescents were aged 14 to 18 years, there was a positive relationship between the time they spent working for pay and current tobacco use. This relationship was attenuated somewhat after adjustment for potential selection effects. Adolescents who spent more than 10 hours per week working for pay also tended to initiate tobacco use earlier than did their peers. Among adolescents who had not yet used tobacco, those who started to work 1 year after assessment and those who worked over 2 consecutive assessments had an elevated risk of initiating use relative to adolescents who did not start working.

CONCLUSIONS

There is a strong link between working for pay and adolescent tobacco use. Policymakers should monitor the conditions under which young people work to help minimize young workers' tobacco use and potential for initiating use.

Marijuana use patterns among African-American middle-school students: a longitudinal latent class regression analysis

The aim of this paper was to describe patterns of marijuana involvement during the middle-school years from the first chance to try marijuana down through the early stages of experiencing health and social problems from marijuana use in a sample of African-American adolescents. A total of 488 urban-dwelling African-American middle-school students were interviewed in sixth, seventh and eighth grades as part of a longitudinal field study. Longitudinal latent class models were used to identify subgroups (classes) of adolescents with similar patterns of marijuana involvement. Three classes were identified; little or no involvement (prevalence 85%, 71%, 55% in sixth, seventh and eighth grade, respectively), marijuana exposure opportunity (12%, 19% and 26%), and marijuana use and problems (2%, 9% and 19%). High levels of aggressive/disruptive behavior exhibited as early as first grade and moderate to high levels of deviant peer affiliation were associated with an increased risk of marijuana exposure opportunities in middle-school. Moderate to high levels of aggressive/disruptive behavior and deviant peer affiliation, moderate to low levels of parent monitoring and high levels of perceived neighborhood disadvantage were associated with an increased risk of marijuana use and problems. Significant interactions with grade provided evidence that the influences of parent monitoring and neighborhood disadvantage decrease through the middle-school years. Although not statistically significant, the magnitude of the effects of deviant peer affiliation on marijuana use and problems increased two-fold from sixth to eighth grade. These findings highlight the importance of marijuana exposure opportunities in the pathway to marijuana use and problems and the potential to intervene on behaviors exhibited as early as first grade. It also underscores the importance of developing interventions that are sensitive to the strong influence of parents at entry into middle-school and the shift to peer influences by the end of middle-school.

Understanding differences in past year psychiatric disorders for Latinos living in the US

This study seeks to identify risk factors for psychiatric disorders that may explain differences in nativity effects among adult Latinos in the USA. We evaluate whether factors related to the processes of acculturation and enculturation, immigration factors, family stressors and supports, contextual factors, and social status in the US account for differences in 12-month prevalence of psychiatric disorders for eight subgroups of Latinos. We report results that differentiate Latino respondents by country of origin and age at immigration (whether they were US-born or arrived before age 6: In-US-as-Child [IUSC]; or whether they arrived after age 6: later-arrival immigrants [LAI]). After age and gender adjustments, LAI Mexicans and IUSC Cubans reported a significantly lower prevalence of depressive disorders than IUSC Mexicans. Once we adjust for differences in family stressors, contextual factors and social status factors, these differences are no longer significant. The risk for anxiety disorders appears no different for LAI compared to IUSC Latinos, after age and gender adjustments. For substance use disorders, family factors do not offset the elevated risk of early exposure to neighborhood disadvantage, but coming to the US after age 25 does offset it. Family conflict and burden were consistently related to the risk of mood disorders. Our findings suggest that successful adaptation into the US is a multidimensional process that includes maintenance of family harmony, integration in advantageous US neighborhoods, and positive perceptions of social standing. Our results uncover that nativity may be a less important independent risk factor for current psychiatric morbidity than originally thought.

Paternal, perceived maternal, and youth risk factors as predictors of youth stage of substance use a longitudinal study

This longitudinal study examined paternal, perceived maternal, and youth risk factors at Time 1 (T1) (e.g., substance use, violent victimization, parental rules) as predictors of the stage of substance use in the adolescent child at Time 2 (T2). Participants (N = 296) consisted of drug-abusing fathers and one of their adolescent children, aged 12 to 20 years. Fathers and youths were each administered structured interviews separately and in private. Adolescents were re-interviewed approximately one year later. Pearson correlation analyses showed that the paternal, perceived maternal, and youth risk factors were significantly related to adolescent stage of substance use at T2. With an increase in risk factors, there was an increase in T2 stage of substance use in the child. Findings imply that father-oriented treatment programs should focus on how paternal behaviors, such as illegal drug use, inadequate parenting skills, and a poor father-child relationship contribute to youth problem behaviors, including alcohol, tobacco, and illicit drug use.

The moderating effects of culture on peer deviance and alcohol use among high-risk African-American Adolescents

African-American adolescents have lower rates of alcohol consumption than White youth. However, African-American youth suffer disproportionately more adverse social, mental, and physical health outcomes related to alcohol use. Affiliating with negative peers is a risk factor for alcohol initiation and consumption. Cultural variables have shown moderating effects against other risk factors for African-American youth and therefore were the focus of this study. Specifically, we tested whether three culturally-relevant variables, Africentric beliefs, religiosity, and ethnic identity were promotive or protective for alcohol initiation and use within the context of negative peer affiliations. The sample consisted of 114 at-risk African-American adolescents whose ages ranged from 13 to 20. Participants were administered a questionnaire with measures of alcohol initiation and use, peer risk behaviors, ethnic identity, Africentric beliefs, religiosity, and demographic items. Peer risk behaviors accounted for significant percentages of the variance in age of alcohol initiation, lifetime use, and current and heavy alcohol use after adjusting for age and gender. Cultural variables showed both promotive and protective effects. Africentric beliefs were promotive of delayed alcohol initiation, whereas both Africentrism and religiosity moderated peer risk behaviors effect on alcohol initiation. Africentric beliefs were also inversely related to lifetime alcohol use revealing a promotive effect. Moreover, there were significant protective effects of ethnic identity and religiosity on heavy alcohol consumption. One implication of these findings is that prevention programs that infuse cultural values and practices such as Africentrism, ethnic identity, and religiosity may delay alcohol initiation and reduce use especially for youth with high risk peers.

Psychiatric and psychosocial predictors of substance use disorders among adolescents: longitudinal study

BACKGROUND

Few studies have prospectively examined psychosocial and psychiatric predictors of adolescent substance use disorders simultaneously.

AIMS

To identify psychosocial and psychiatric predictors of substance use disorders in adolescence.

METHOD

School children aged 12 years (s.d.=0.3) free from any substance use disorder at grade 7 (n=428) were assessed in three consecutive years, using a standardised psychiatric interview. Their baseline psychosocial information was also collected. The outcome was the onset age of a substance use disorder. The Cox regression model was used for data analysis.

RESULTS

The most significant predictive factors for adolescent substance use disorder included male gender, attention-deficit hyperactivity disorder, conduct disorder and sibling use of tobacco. Three protective factors against such morbidity included living in a household with two parents, a good academic grade at grade 7 and objection to the use of substances.

CONCLUSIONS

Early intervention for disruptive behaviour disorders and specific psychosocial risk factors might prevent substance use disorders in early adolescence.

The Relative Importance of Mothers' and Youths' Neighborhood Perceptions for Youth Alcohol Use and Delinquency

Prior studies have examined the influence of neighborhood perceptions on youth outcomes, but few studies have examined whose report of neighborhoods, parents' or youths', are most important in predicting youth outcomes. This study addresses the relative associations of youths' and mothers' neighborhood perceptions with youth alcohol use and delinquency. The sample includes 499 mother-child dyads (youth age: 10 to 16 [mean = 13.3; SD = 2]). Structural equation modeling showed that youths' perceived neighborhood problems were significantly associated with their delinquency but not their alcohol use. However, mothers' perceived neighborhood problems were not related to either youth alcohol use or delinquency, suggesting that youths' perceptions are better indicators of youth behavior. Youth reports may reflect their activities in the neighborhood and their exposure to different forms of deviance, so youths' reports would be better indicators of exposure to neighborhood risk. Challenges for prevention are discussed.