Change in distress about police brutality and substance use among young people, 2017-2020

Cumulative Police Exposures, Police Violence Stress, and Depressive Symptoms: A Focus on Black LGBQ Youth in Baltimore City, Maryland

The present study investigates associations between cumulative police exposures, police violence stress, and depressive symptoms among Black youth, and whether LGBQ (lesbian, gay, bisexual, and queer) identities moderate these associations. Data come from the Survey of Police-Adolescent Contact Experiences (SPACE), a cross-sectional survey of a community-based sample of Black youth ages 12-21 in Baltimore City, Maryland (n = 345), administered from August 2022 to July 2023. We used multivariable ordinary least squares regression to estimate direct associations and product-term analysis to test for effect modification by sexual identities. We also calculate covariate-adjusted predicted depressive symptoms scores by cumulative police exposures and police violence stress across sexual identities. Findings indicate that LGBQ youth collectively reported higher levels of police violence stress than heterosexual youth. Still, LGBQ youth varied in their cumulative police exposures, which were significantly higher among bisexual and queer youth than lesbian or gay youth. Associations between cumulative police exposures, police violence stress, and depressive symptoms were significantly moderated by LGBQ identity, with the largest associations emerging for bisexual and queer youth. Police exposures and police violence stress also compounded to worsen depressive symptoms among the subsample of LGBQ youth. Collectively, our findings suggest that LGBQ youth-especially bisexual and queer youth-may be particularly vulnerable to the mental health harms of cumulative police exposures and police violence stress. Intersectional, public health approaches that combine prevention and treatment strategies are needed to mitigate LGBQ mental health inequities stemming from cumulative police exposures and police violence stress.

Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis

BACKGROUND AND AIMS

Psychological and social status, and environmental context, may mediate the likelihood of experiencing overdose subsequent to illicit drug use. The aim of this systematic review was to identify and synthesise psychosocial factors associated with overdose among people who use drugs.

METHODS

This review was registered on Prospero (CRD42021242495). Systematic record searches were undertaken in databases of peer-reviewed literature (Medline, Embase, PsycINFO, and Cinahl) and grey literature sources (Google Scholar) for work published up to and including 14 February 2023. Reference lists of selected full-text papers were searched for additional records. Studies were eligible if they included people who use drugs with a focus on relationships between psychosocial factors and overdose subsequent to illicit drug use. Results were tabulated and narratively synthesised.

RESULTS

Twenty-six studies were included in the review, with 150,625 participants: of those 3,383-4072 (3%) experienced overdose. Twenty-one (81%) studies were conducted in North America and 23 (89%) reported polydrug use. Psychosocial factors associated with risk of overdose (n = 103) were identified and thematically organised into ten groups. These were: income; housing instability; incarceration; traumatic experiences; overdose risk perception and past experience; healthcare experiences; perception of own drug use and injecting skills; injecting setting; conditions with physical environment; and social network traits.

CONCLUSIONS

Global rates of overdose continue to increase, and many guidelines recommend psychosocial interventions for dependent drug use. The factors identified here provide useful targets for practitioners to focus on at the individual level, but many identified will require wider policy changes to affect positive change. Future research should seek to develop and trial interventions targeting factors identified, whilst advocacy for key policy reforms to reduce harm must continue.

Distress about social problems and tobacco and cannabis use outcomes among young adults in Los Angeles County

OBJECTIVE

To examine associations of concern, worry, and stress about discrimination, shootings/violence, and police brutality and exclusive and dual tobacco and cannabis use among young adults.

METHODS

A prospective, racially/ethnically diverse cohort of young adults (n = 1960) living in Los Angeles, California completed a baseline survey in 2020 (age range: 19-23) and a follow-up survey in 2021. Exploratory factor analysis (EFA) was employed on nine variables assessing levels of concern, worry, and stress about societal discrimination, societal shootings/violence, and community police brutality at baseline. Past 30-day tobacco and cannabis use at follow-up was categorized as current exclusive tobacco, exclusive cannabis, and dual tobacco and cannabis (vs never/former) use based on eleven use variables. Multinomial logistic regressions estimated adjusted associations between each factor score (translated to standard deviation units) with exclusive and dual tobacco and cannabis use.

RESULTS

The EFA produced four factor scores representing concern/worry/stress (i.e., distress) about community police brutality (F1), distress about societal shootings/violence (F2), and distress about societal discrimination (F3), as well as generalized stress about police brutality, shootings/violence, and discrimination (F4). F1, F2, and F3 were associated with subsequent exclusive current cannabis use, with F1 having the strongest association (OR: 1.35, 95% CI: 1.18-1.55), while only F1 (OR: 1.51, 95% CI: 1.27-1.78) was associated with dual tobacco and cannabis use. None of the factors were associated with exclusive tobacco use.

CONCLUSIONS

Young adult concern, worry, and/or stress about social problems may increase risk of cannabis use with or without concurrent tobacco use 6-12 months later.

Do Police Encounters Increase the Risk for Cardiovascular Disease? Police Encounters and Framingham 30-Year Cardiovascular Risk Score

INTRODUCTION

Despite increased attention to the societal consequences of aggressive policing, the focus on rarer instances of deaths/severe injuries fails to fully capture the day-to-day experiences that racially minoritized groups face during police encounters (PEs). We explored differential vulnerability by race/ethnicity in the relationship between PEs and cardiovascular disease (CVD) risk.

METHODS

Using data from the National Longitudinal Study of Adolescent to Adult Health, we regressed the Framingham 30-Year CVD risk score on a high number of lifetime PEs (6 + among men and 2 + among women). To explore differential vulnerability by race, we added an interaction between PEs and race/ethnicity. We also examined sex- and race and sex-stratified models.

RESULTS

We observed no association between PEs and CVD risk in the sample overall, but the interaction between PEs and race/ethnicity was statistically significant. In race stratified models, we found that higher PEs were associated with a lower CVD risk among Black respondents, whereas among White respondents there was no relationship. In the sex-stratified analysis, reporting higher PEs was associated with lower CVD risk among men, while among women there was no relationship. In sex- and race-stratified models, higher PEs was associated with lower CVD risk among Black men and higher CVD risk among White women, while there was no association among Black women and White men.

CONCLUSION

The association between PEs and CVD risk depends on race/ethnicity and sex. More work is needed to understand the counterintuitive finding that high PEs are associated with lower CVD risk among Black men.

Perceived racism and discrimination and youth substance use in the United States - Intersections with sex and ethnicity

OBJECTIVES

This study sought to examine associations between U.S. adolescents' perceived racism and discrimination (PRD) at school and current substance use.

METHODS

Data were drawn from the Adolescent Behaviors and Experiences Survey (ABES), a probability sample of U.S. high school students in 2021 (n = 7705). Multivariable regression models were conducted to examine associations of PRD with current (past 30-day) use of tobacco products, marijuana, alcohol, and prescription opioid misuse. Interaction effects of PRD and demographic factors were tested.

RESULTS

Among participants in the 2021 ABES, PRD was associated with higher odds of current use of tobacco (AOR = 1.3, p = 0.03), marijuana (AOR = 1.3, p = 0.03), alcohol (AOR = 1.2, p = 0.03), and misuse of prescription opioids (AOR = 1.6, p = 0.004). The effects of PRD on current tobacco and alcohol use differed by Hispanic and non-Hispanic adolescents (interaction effect = 0.007 and 0.01, respectively) with higher odds among Hispanic youth than among non-Hispanic counterparts. The associations of PRD and current tobacco use, marijuana use, alcohol use, and misuse of prescription opioids were moderated by sex with more pronounced effects on males than females.

CONCLUSIONS

Efforts to promote awareness and create support environments that value diversity and inclusivity at school are needed to mitigate adolescent exposure to racism and discrimination.

Alcohol use in multiracial American youth compared with monoracial youth: A meta-analysis

BACKGROUND AND AIMS

Although multiracial people comprise the fastest growing population in the United States, multiracial youth are nearly invisible in alcohol research. This meta-analysis synthesized the youth alcohol literature to estimate the magnitude of difference in alcohol use as a function of multiracial status.

DESIGN AND MEASUREMENTS

Empirical studies reporting multiracial and monoracial comparisons in youth (aged 10-24 years) alcohol use were identified through a systematic literature search. A random-effects meta-analysis was conducted using 85 effect sizes extracted from 16 studies assessing life-time, past-year, past-month and binge alcohol use.

SETTING AND PARTICIPANTS

A total of n=1 555 635 youth were assessed in the United States.

FINDINGS

Multiracial youth are suggested to be more likely to endorse life-time alcohol use than Asian youth [number of studies (k) = 3; odds ratio (OR) = 1.81, 95% confidence interval (CI) = 1.01, 3.24; p = 0.04], with significant between-study heterogeneity (Q = 8.42; p < 0.001; I2  = 76%) in effect size comparisons. Multiracial youth are suggested to be more likely to endorse past-month alcohol use than Black (k = 6; OR = 1.54, 95% CI = 1.38, 1.71; p < 0.001) and Asian (k = 4; OR = 2.09, 95% CI = 1.52, 2.88; p < 0.001) youth, but less likely than White (k = 6; OR = 0.87, 95% CI = 0.84, 0.91; p < 0.001) youth, with significant between-study heterogeneity for Black youth (Q = 11.94; p = 0.03; I2  = 58%) in effect size comparisons. Lastly, multiracial youth are suggested to be more likely to endorse binge alcohol use than Black (k = 4; OR = 1.98, 95% CI = 1.62, 2.44; p < 0.001) and Asian (k = 4; OR = 2.82, 95% CI = 2.28, 3.48; p < 0.001) youth, but less likely than White (k = 5; OR = 0.75, 95% CI = 0.70, 0.81; p < 0.001) and American Indian/Alaska Native (k = 3; OR = 0.78, 95% CI = 0.71, 0.85; p < 0.001) youth, with significant between-study heterogeneity among Black (Q = 23.99; p < 0.001; I2  = 87%) and Asian (Q = 17.76; p < 0.001; I2  = 83%) youth in effect size comparisons.

CONCLUSIONS

In the United States, multiracial youth report distinct alcohol use patterns compared with monoracial youth and may be at elevated alcohol use risk compared with Black and Asian youth.