Discrimination, crime, ethnic identity, and parenting as correlates of depressive symptoms among African American children: a multilevel analysis

This study investigated the correlates of childhood depressive symptoms in an African American sample. We included processes that are likely to operate for all children, regardless of race or ethnicity, as well as events and circumstances that are largely unique to children of color. These various constructs were assessed at both the individual and community level. The analyses consisted of hierarchical linear modeling with a sample of 810 African American families living in Iowa and Georgia. Three individual-level variables were associated with childhood depressive symptoms: uninvolved parenting, racial discrimination. and criminal victimization. At the community level, prevalence of both discrimination and criminal victimization were positively related and community ethnic identification was negatively related to depressive symptoms. Further, there was evidence that community ethnic identification and neighborhood poverty serve to moderate the relationship between criminal victimization and depressive symptoms. Overall, the findings underscore the importance of considering factors unique to the everyday lives of the cultural group that is the focus of study, while demonstrating the dangers of a 'one model fits all" approach to studying children of color.

Effects of a School-Based, Early Childhood Intervention on Adult Health and Well-being

OBJECTIVE

To determine the effects of an established preventive intervention on the health and well-being of an urban cohort in young adulthood.

DESIGN

Follow-up of a nonrandomized alternative-intervention matched-group cohort at age 24 years.

SETTING

Chicago, Illinois.

PARTICIPANTS

A total of 1539 low-income participants who enrolled in the Child-Parent Center program in 20 sites or in an alternative kindergarten intervention.

INTERVENTIONS

The Child-Parent Center program provides school-based educational enrichment and comprehensive family services from preschool to third grade.

MAIN OUTCOME MEASURES

Educational attainment, adult arrest and incarceration, health status and behavior, and economic well-being.

RESULTS

Relative to the comparison group and adjusted for many covariates, Child-Parent Center preschool participants had higher rates of school completion (63.7% vs 71.4%, respectively; P = .01) and attendance in 4-year colleges as well as more years of education. They were more likely to have health insurance coverage (61.5% vs 70.2%, respectively; P = .005). Preschool graduates relative to the comparison group also had lower rates of felony arrests (16.5% vs 21.1%, respectively; P = .02), convictions, incarceration (20.6% vs 25.6%, respectively; P = .03), depressive symptoms (12.8% vs 17.4%, respectively; P=.06), and out-of-home placement. Participation in both preschool and school-age intervention relative to the comparison group was associated with higher rates of full-time employment (42.7% vs 36.4%, respectively; P = .04), higher levels of educational attainment, lower rates of arrests for violent offenses, and lower rates of disability.

CONCLUSIONS

Participation in a school-based intervention beginning in preschool was associated with a wide range of positive outcomes. Findings provide evidence that established early education programs can have enduring effects on general well-being into adulthood.

An empirical evaluation of proposed changes for gambling diagnosis in the DSM-5

AIMS

Recommendations related to pathological gambling for the fifth edition of the Diagnostic and statistic manual for mental disorders (DSM) are to eliminate the criterion related to committing illegal acts and reduce the threshold for diagnosis from five to four criteria. This study evaluated the impact of these changes on prevalence rates and classification accuracy.

DESIGN

Data were analyzed from five samples, varying in severity of gambling problems.

SETTINGS AND PARTICIPANTS

Surveys of randomly selected household residents in the United States (US) (n = 2417), gambling patrons (n = 450), individuals in brief intervention studies (n = 375), patients in community-based gambling treatment programs (n = 149) and participants in randomized intervention studies (n = 319).

MEASUREMENTS

The national opinion research center DSM-IV screen for gambling problems (NODS) was administered to all participants. Internal consistency and factor structure were evaluated using both 10 and nine criteria. Base rates, hit rates, sensitivity, specificity and overall agreement were compared across classification systems, using DSM-IV classification as the standard.

FINDINGS

Eliminating the illegal acts criterion did not impact internal consistency and modestly improved variance accounted for in the factor structure. In comparing a classification system using four of 10 criteria versus one using four of nine, the four of nine system yielded equal or slightly better classification accuracy in all comparisons and across all samples.

CONCLUSIONS

The inclusion of the illegal acts criterion in the proposed DSM-V pathological gambling diagnosis does not appear necessary for diagnosis of pathological gambling and, if it is eliminated, reducing the cut-point to four results in more consistent diagnoses relative to the current classification system.

Racial-ethnic disparities in substance abuse treatment: the role of criminal history and socioeconomic status

OBJECTIVE

Among persons with substance use disorders, those from racial-ethnic minority groups have been found to receive substance abuse treatment at rates equal to or higher than those of non-Latino whites. Little is known about factors underlying this apparent lack of disparities. This study examines racial-ethnic disparities in treatment receipt and mechanisms that reduce or contribute to disparities.

METHODS

Black-white and Latino-white disparities in any and in specialty substance abuse treatment were measured among adult respondents with substance use disorders from the 2005-2009 National Survey on Drug Use and Health (N=25,159). Three staged models were used to measure disparities concordant with the Institute of Medicine definition, assess the extent to which criminal history and socioeconomic indicators contributed to disparities, and identify correlates of treatment receipt.

RESULTS

Treatment was rare (about 10%) for all racial-ethnic groups. Odds ratios for black-white and Latino-white differences decreased and became significantly less than 1 after adjustment for criminal history and socioeconomic status factors. Higher rates of criminal history and enrollment in Medicaid among blacks and Latinos and lower income were specific mechanisms that influenced changes in estimates of disparities across models.

CONCLUSIONS

The greater likelihood of treatment receipt among persons with a criminal history and lower socioeconomic status is a pattern unlike those seen in most other areas of medical treatment and important to the understanding of substance abuse treatment disparities. Treatment programs that are mandated by the criminal justice system may provide access to individuals resistant to care, which raises concerns about perceived coercion.

The practice of honor crimes: a glimpse of domestic violence in the Arab world

Domestic violence, especially violence against women, is a serious health problem in the United States and in many countries of the world. However, information on violence against women in the Arab culture is scarce. The purpose of this descriptive study is to investigate the incidence of violence against women in one Middle Eastern country. The focus of the research is to determine the cultural context in which violent crimes against women are committed and the social and legal implications of such crimes. The research method included: (1) a review of all court files of women murdered during 1995 in the country of Jordan and, (2) the social norms and sanctions against persons who commit crimes against women. Of 89 homicide cases reviewed, 38 involved female victims. Analysis of the court files of the 38 murdered women indicated that a male relative of the female victim, primarily the brother, committed the majority of the murders. The most common cause for the murders provided in the files was "honor crime." Honor crime was defined as crime committed against women by their male family members because the women had violated the honor of their family. Cultural norms and practices including the legal practices related to honor crimes support the practice of killing women for sexual misconduct and excuse perpetrators of the crimes from punishment.

Violence against women in South Asian countries

In South Asian countries the amalgamation of Buddhist, Confucian, Hindu, Islamic and Christian traditions have shaped the personalities of women and determined their social status. Rigid cultures and patriarchal attitudes which devalue the role of women, result in the wide spread occurrence of violence against women. The family structure, in which the man is the undisputed ruler of the household, and activities within the family are seen as private, allows violence to occur at home. As well as traditional forms of violence such as wife-battering and sexual assault, women in these countries are also exposed to dowry crimes such as bride burning, kidnapping for the purposes of prostitution, and "honour killings". Laws permit discrimination against women and discourage reporting of violent acts. Efforts to remedy this situation must include changes in local laws as well as assistance from the United Nations and the international community.

Developmental trajectories of marijuana use from adolescence to adulthood: personality and social role outcomes

Longitudinal trajectories of marijuana use from adolescence into adulthood were examined for adverse life-course outcomes among African-Americans and Puerto Ricans. Data for marijuana use were analyzed at four points in time and on participants' personality attributes, work functioning, and partner relations in adulthood using growth mixture modeling. Each of the three marijuana-use trajectory groups (maturing-out, late-onset, and chronic marijuana-users) had greater adverse life-course outcomes than a nonuse or low-use trajectory group. The chronic marijuana-use trajectory group was highly associated with criminal behavior and partners' marijuana use in adulthood. Treatment programs for marijuana use should also directly address common adverse life-course outcomes users may already be experiencing.

Driving under the influence (DUI) among U.S. ethnic groups

OBJECTIVE

To report nationwide survey data on driving under the influence of alcohol and drugs (DUI) among U.S. ethnic groups.

METHODS

Data come from a probability sample of 39,250 adults 18 years of age and older interviewed by the U.S. National Household Survey on Drug Abuse in 2000. Interviews averaging 1h in length were conducted in respondents' homes by trained interviewers. The survey response rate was 74%.

RESULTS

Self-reported rates of DUI were highest among White men (22%), Native American/Native Alaskan men (20.8%) and men of Mixed race (22.5%). Twelve-month arrest rates for DUI were highest among men of Mixed race (5%) and Native American/Native Alaskan men (3.2%). Drinkers who DUI are more likely to be men (regardless of ethnicity), not married, consume more alcohol, and be alcohol dependent than drinkers who do not engage in alcohol-impaired driving. However, important ethnic specific predictors are also identified across the different ethnic groups.

Predictors of relapse after treatment for methamphetamine use

The purpose of this study is to describe treatment utilization and relapse and examine possible predictors of time to relapse after treatment for methamphetamine (MA) use. This analysis is based on natural history interview data from 98 subjects treated for MA use in publicly-funded programs in Los Angeles County in 1995-97 and interviewed two to three years following their treatment admission. Results showed that half of the subjects had resumed MA use: 36% within six months of the end of treatment, and 15% more within seven to 19 months. Survival analysis methods showed significant predictors of (shorter) time to relapse were shorter length of treatment, older age of first substance use, and involvement in selling MA; ethnicity (being Hispanic) and more previous time in treatment had weaker effects.

Race-ethnicity, crime, and other factors associated with adherence to inhaled corticosteroids

BACKGROUND

Previous studies have shown differences in adherence to inhaled corticosteroids (ICSs) by race-ethnicity, yet little is known about factors that contribute to adherence within these groups. Environmental stressors, such as crime exposure, which has been associated with asthma morbidity, might also predict ICS adherence.

OBJECTIVE

We sought to identify factors associated with ICS adherence among patients with asthma and among African American patients and white patients separately.

METHODS

Study patients with asthma were aged 18 to 50 years and were enrolled in a large southeast Michigan health maintenance organization between January 1, 1999, and December 31, 2001. The primary outcome, ICS adherence, was calculated by linking prescription-fill data with dosage information. Predictor variables included age, sex, race-ethnicity, measures of socioeconomic status (SES), average ICS copay, existing comorbidities, and crime rate in area of residence.

RESULTS

Adherence information was available for 176 patients. ICS adherence was lower among African American patients (n = 75) when compared with white patients (n = 94; 40% vs 58%, respectively; P = .002). Among white patients, adherence was significantly lower for women when compared with men. Among African American patients, age and residential crime rates were positively and negatively associated with ICS adherence, respectively. Area crime remained a predictor of adherence in African American patients, even after adjusting for multiple measures of SES.

CONCLUSIONS

This study suggests that an environmental stressor, area crime, provides additional predictive insight into ICS-adherent behavior beyond typical SES factors.

CLINICAL IMPLICATIONS

Better understanding of environmental factors that influence ICS adherence might aid in efforts to improve it.

Adolescent coping and neighborhood violence: perceptions, exposure, and urban youths' efforts to deal with danger

Neighborhood violence is a persistent source of danger, stress, and other adverse outcomes for urban youth. We examined how 140 African American and Latino adolescents coped with neighborhood danger in low, medium, and high crime neighborhoods throughout Chicago. Participants reported using a range of coping strategies (measured via a modified version of the Ways of Coping Scale; R. S. Lazarus & S. Folkman, 1984). In low and medium crime rate areas, using confrontive strategies was significantly correlated with increased exposure to violence, and no strategies were associated with perceptions of safety. Coping strategies were associated with perceived safety to a substantial degree only in high crime neighborhoods, and none were associated with exposure to violence. A k means cluster analysis identified groups that differed in coping profiles and varied in rates of exposure to violence. Moderating effects of gender, ethnicity, and neighborhood were found for both person level and variable level analyses.

Developmental associations between externalizing behaviors, peer delinquency, drug use, perceived neighborhood crime, and violent behavior in urban communities

This study examines the precursors of violent behavior among urban, racial/ethnic minority adults. Data are from an on-going study of male and female African Americans and Puerto Ricans, interviewed at four time waves, Time 1-Time 4 (T1-T4), from adolescence to adulthood. Structural Equation Modeling was used to analyze the developmental pathways, beginning in mid-adolescence (T1; age = 14.0 years), to violent behavior in adulthood (T4; age = 29.2 years). The variables assessed were: components of externalizing behaviors (i.e., rebelliousness, delinquency; T1, T3); illicit drug use (T2); peer delinquency (T2); perceived neighborhood crime (T4); and violent behavior (T3, T4). Results showed that the participants' externalizing behaviors (rebelliousness and delinquency) were relatively stable from mid-adolescence (T1; age = 14.0 years) to early adulthood (T3; age = 24.4 years). The participants' externalizing behaviors in mid-adolescence also had a direct pathway to peer delinquency in late adolescence (T2; age = 19.1 years). Peer delinquency, in turn, had a direct pathway to the participants' illicit drug use in late adolescence (T2), and to externalizing behaviors in early adulthood (T3). The participants' illicit drug use (T2; age = 19.1 years) had both direct and indirect paths to violent behavior in adulthood (T4). The participants' externalizing behaviors in early adulthood (T3) were linked with violent behavior at T3, and perceived neighborhood crime (T4), both of which had direct pathways to violent behavior in adulthood (T4). The findings suggest developmental periods during which externalizing behaviors, exposure to delinquent peers, illegal drug use, and neighborhood crime could be targeted by prevention and intervention programs in order to reduce violent behavior.

Quality of life of Chinese schizophrenia outpatients in Hong Kong: relationship to sociodemographic factors and symptomatology

OBJECTIVE

To explore the relationships between sociodemographic and clinical factors and quality of life (QOL) in a cohort of Chinese schizophrenia outpatients.

METHOD

Two hundred subjects with a diagnosis of DSM-IV schizophrenia aged 18-60 years were randomly selected, and their sociodemographic and clinical characteristics including psychotic and depressive symptoms, extrapyramidal symptoms (EPS), and quality of life were assessed. Correlation and multiple regression analyses were used to evaluate the relationships of sociodemographic, clinical data and QOL.

RESULTS

Compared to normative data obtained for the general population in Hong Kong, significantly lower scores in physical, psychological, and social QOL domains were found in the patient group. History of suicidal attempts and the presence of positive, negative, depressive, anxiety and EPS symptoms were all significantly correlated with QOL in schizophrenia patients. After controlling for the effects of variables that were significantly correlated with QOL in the correlation analysis, however, only depressive symptoms were still significantly correlated with each QOL domain. Multiple regression analysis showed that depressive symptoms predicted all QOL domains, while positive symptoms predicted overall and physical QOL domains.

CONCLUSIONS

Chinese outpatients with schizophrenia had poorer QOL than the general population. In this patient population, QOL was more strongly related to the severity of depressive symptoms and was independent of sociodemographic factors.

Mental health and other risk factors for jail incarceration among male veterans

Data derived from the 2002 Survey of Inmates in Local Jails and the 2000 National Survey of Veterans show that having mental health problems in addition to such sociodemographic characteristics as being a member of a minority group, not being married, having less education, and being younger are risk factors for incarceration among veterans, as they are for the general population. As in previous studies veterans who served during the Vietnam Era and to an even greater extent, those who served in the early years of the All Volunteer Force were at greater risk of incarceration than veterans from the most recent period of the AVF, after controlling for age and other factors.

Lack of support for the association between facial shape and aggression: a reappraisal based on a worldwide population genetics perspective

Antisocial and criminal behaviors are multifactorial traits whose interpretation relies on multiple disciplines. Since these interpretations may have social, moral and legal implications, a constant review of the evidence is necessary before any scientific claim is considered as truth. A recent study proposed that men with wider faces relative to facial height (fWHR) are more likely to develop unethical behaviour mediated by a psychological sense of power. This research was based on reports suggesting that sexual dimorphism and selection would be responsible for a correlation between fWHR and aggression. Here we show that 4,960 individuals from 94 modern human populations belonging to a vast array of genetic and cultural contexts do not display significant amounts of fWHR sexual dimorphism. Further analyses using populations with associated ethnographical records as well as samples of male prisoners of the Mexico City Federal Penitentiary condemned by crimes of variable level of inter-personal aggression (homicide, robbery, and minor faults) did not show significant evidence, suggesting that populations/individuals with higher levels of bellicosity, aggressive behaviour, or power-mediated behaviour display greater fWHR. Finally, a regression analysis of fWHR on individual's fitness showed no significant correlation between this facial trait and reproductive success. Overall, our results suggest that facial attributes are poor predictors of aggressive behaviour, or at least, that sexual selection was weak enough to leave a signal on patterns of between- and within-sex and population facial variation.

Criminal behavior and emotional disorder: comparing youth served by the mental health and juvenile justice systems

This study explored whether youth involved in joint service systems differed from single-agency users in terms of types of crimes committed and clinical functioning. Data from 4,924 youth involved in one county's public mental health and juvenile justice service systems were examined. Twenty percent of those youth receiving mental health services had recent arrest records, and 30% of youth arrested received mental health services. Of all youth arrested in the county, mental health service users had more arrests than non-mental health service users. A subsample of 94 mental health service users with arrests was matched on demographics with 94 mental health service users without arrests. Youth with arrests had a higher frequency of conduct disorder, higher Child Behavior Checklist Externalizing and Total Problem Scale scores, and more functional impairment on the Child and Adolescent Functional Assessment Scale as compared to youth without arrests. Implications for behavioral health service delivery were discussed.

Fifteen years later: can residential mobility programs provide a long-term escape from neighborhood segregation, crime, and poverty?

We examined whether the Gautreaux residential mobility program, which moved poor black volunteer families who were living in inner-city Chicago into more-affluent and integrated neighborhoods, produced long-run improvements in the neighborhood environments of the participants. We found that although all the participants moved in the 6 to 22 years since their initial placements, they continued to reside in neighborhoods with income levels that matched those of their placement neighborhoods. Families who were placed in higher-income, mostly white neighborhoods were currently living in the most-affluent neighborhoods. Families who were placed in lower-crime and suburban locations were most likely to reside in low-crime neighborhoods years later.

The Hispanic Americans baseline alcohol survey (HABLAS): DUI rates, birthplace, and acculturation across Hispanic national groups

OBJECTIVE

This article examines the association between birthplace, acculturation, and self-reported driving under the influence of alcohol (DUI), 12-month and lifetime DUI arrest rates among Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans in the U.S. population.

METHOD

Using a multistage cluster sample design, 5,224 adults (18 years of age or older) were interviewed from households in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles.

RESULTS

Birthplace was not associated with DUI, 12-month DUI arrest rates, or lifetime DUI arrest rates. Mexican Americans in the medium- and high-acculturation groups were more likely to engage in DUI. A higher proportion of U.S.-born than foreign-born respondents as well as those in the high-acculturation group, irrespective of national origin, reported having been stopped by police when driving. U.S.-born Cuban Americans, Mexican Americans, and South/Central Americans thought they could consume a higher mean number of drinks before their driving is impaired compared with those who are foreign born.

CONCLUSIONS

There are considerable differences in DUI-related behavior across Hispanic national groups. U.S.-born Hispanics and those born abroad, but not those at different levels of acculturation, have equal risk of involvement with DUI.

At the borders, on the edge: use of injected methamphetamine in Tijuana and Ciudad Juarez, Mexico

Injection drug use is of increasing concern along the US-Mexico border where Tijuana and Ciudad (Cd.) Juarez are located. Methamphetamine has long been manufactured and trafficked through Mexico, with low rates of use within Mexico. With methamphetamine use now considered epidemic in the United States, and with associated individual and community harms such as HIV, STDs, domestic violence and crime, there is concern that rates of methamphetamine in the Northwestern border regions of Mexico may be rising. We conducted a qualitative study to explore the context of injection drug use in Tijuana and Cd. Juarez and included questions about methamphetamine. Guided in-depth interviews were conducted with 10 male and 10 female injection drug users (IDUs) in Tijuana and 15 male and 8 female IDUs in Cd. Juarez (total N = 43). Topics included types of drug used, injection settings, access to sterile needles and environmental influences. Interviews were taped, transcribed verbatim and translated. Content analysis was conducted to identify themes. The median age of injectors in both cities was 30. Methamphetamine was injected, either alone or in combination with other drugs by injectors in both Tijuana (85%) and Cd. Juarez (17%) in the 6 months previous to interview. Several important themes emerged with respect to methamphetamine use in both cities. IDUs in both cities considered methamphetamine to be widely used in Tijuana and infrequently used in Cd. Juarez, while the converse was true for cocaine. In both cities, stimulant (either cocaine or methamphetamine) use was widespread, with 85% in Tijuana and 83% in Cd. Juarez reporting current use of a stimulant, most often used in combination with heroin. Some injectors reported knowledge of local manufacturing and one had direct experience in making methamphetamine; some cross-border use and trafficking was reported. Injectors reported concerns or experience with serious health effects of methamphetamine such as abscesses or tuberculosis. Our study suggests that injected methamphetamine is entrenched in Tijuana and that Cd. Juarez may experience a methamphetamine outbreak in the future. Robust targeted interventions for both injected and non-injected methamphetamine should be a public health priority in both cities.

Immigration and violence: the offsetting effects of immigrant concentration on Latino violence

Despite longstanding interest in the effects of immigration on American society, there are few studies that examine the relationship between immigration and crime. Drawing from social disorganization theory and community resource/social capital perspectives, this study examines the effects of Latino immigration on Latino violence. Data on violence (i.e., homicide, robbery, and Violent Index) and the structural conditions of Latino populations are drawn from the California Arrest Data (CAL), New York State Arrest Data (NYSAD), and U.S. Census data for approximately 400 census places during the 1999-2001 period. Findings suggest that immigrant concentration has no direct effect on Latino homicide or Violent Index rates but may reduce Latino robbery. Immigration also appears to have multiple, offsetting indirect effects on Latino violence that work through social disorganization and community resource measures. These results suggest that (1) immigrant concentration does not contribute to Latino violence and may even reduce some forms of violence, (2) immigration simultaneously stabilizes and destabilizes structural conditions in Latino populations, and (3) it is useful to examine both the direct and indirect effects of immigration on crime.

The implementation and development of complex alcohol control policies in indigenous communities in Queensland (Australia)

Very high rates of injury and death during the 1990s were linked with increased alcohol availability and misuse in discrete Indigenous communities in rural and remote Queensland (Australia). To address widespread concerns about a public health crisis, from 2002, the Queensland Government implemented alcohol control strategies known as 'Alcohol Management Plans' (AMPs) in 19 of these communities. Although resources for prevention and treatment were promised, AMPs became increasingly focused on local prohibition, restricted access to alcohol and punitive measures for breaching restrictions. An examination of legislation, regulations, explanatory notes, and published documents indicates this focus evolved across four phases since 2002. The first phase, from 2002 to 2004, saw 'restricted areas' with alcohol 'carriage limits' introduced, restricting the amounts and types of liquor permitted within some communities. The second phase (2002-2007) featured evaluations and reviews by the Queensland Government bringing recommendations for more stringent controls. Additionally, beyond the 'restricted areas', licenced premises situated within the 'catchments' of the targeted communities, mainly located in the nearby regional towns, became subject to 'minimising harm' provisions. These more stringent controls were implemented widely in the third phase (2008-2011) when: the operations of seven community-managed liquor outlets were terminated; the trading arrangements of two others were modified; Police powers to search and seize were increased; and 'attempting' to take liquor into a 'restricted area' also became an offence. Some communities have seen a reduction in alcohol-related harms that have been attributed to these alcohol control strategies. This commentary maps the recent regulatory history of Queensland's alcohol controls targeting discrete Indigenous communities highlighting their increasing focus on punitive measures to reduce access to alcohol. With AMPs in Queensland currently under Government review, and with community resolve for change rising, the limits to Government controls and punitive measures may have been reached.

Development and Validation of a Brief Mental Health Screening Instrument for Newly Incarcerated Adults

The authors report the development and initial psychometric evaluation of gender-specific brief screening instruments to identify undetected psychiatric impairment on incarceration. Women and men completed the Correctional Mental Health Screen (CMHS), a 56-item screen derived from validated measures. Representative subsamples completed structured diagnostic interviews within 5 days. An 8-item screen for women and a 12-item screen for men identified inmates with current Axis I psychiatric disorders with 83% to 100% accuracy on the basis of cut points chosen to maximize negative predictive power. The CMHS showed evidence of incremental predictive utility compared with two previously validated correctional mental health screening measures with White and Black men and White women. Incremental validity was not supported with Black women, for whom the CMHS performed well in identifying true cases but not in ruling out noncases. Analyses of internal consistency, interrater, and retest reliability and convergent, discriminant, and criterion validity supported the psychometric status of the CMHS.

Assessing and quantifying high risk: comparing risky behaviors by youth in an urban, disadvantaged community with nationally representative youth

OBJECTIVE

This study examined whether youth who live in an urban, disadvantaged community are significantly more likely than youth representing the nation to engage in a range of health-compromising behaviors.

METHODS

Analyses were based on the Youth Violence Survey conducted in 2004 and administered to students (n=4131) in a high-risk school district. Students in ninth grade (n=1114) were compared with ninth-grade students in the 2003 national Youth Risk Behavior Survey (n=3674) and the National Longitudinal Study of Adolescent Health conducted in 1995/1996 (n=3523). Analyses assessed the differences in prevalence of risk and protective factors among ninth-grade students from the three studies using Chi-square tests.

RESULTS

The results showed that youth in this urban, disadvantaged community were significantly more likely than their peers across the country to report vandalism, theft, violence, and selling drugs. Youth in this community also reported significantly less support from their homes and schools, and less monitoring by their parents. Moreover, youth in this community were significantly less likely to binge drink or initiate alcohol use prior to age 13 than youth across the U.S.

CONCLUSIONS

Youth who live in this urban, disadvantaged community reported significantly higher prevalence of some, but not all, risky behaviors than nationally representative U.S. youth. These findings highlight that some caution is justified when defining what might constitute high risk and that demographic and other characteristics need to be carefully considered when targeting certain high-risk behaviors.