Neighborhood context and substance use disorders: A comparative analysis of racial and ethnic groups in the United States

Abstract

Background There is evidence that ethnic/racial minorities are conferred differential risk for substance use problems based on where they live. Despite a burgeoning of research focusing on the role of neighborhood characteristics on health, limited findings are available on substance use. Our study uses nationally representative data (N= 13, 837) to examine: (1) What neighborhood characteristics are associated with risk of substance use disorders?; (2) Do the associations between neighborhood characteristics and substance use disorders remain after adjusting for individual-level factors?; and (3) Do neighborhood characteristics associated with substance use disorders differ by race/ethnicity after adjusting for individual-level factors? Methods Data were drawn from the Collaborative Psychiatric Epidemiology Studies (CPES-Geocode file) with 836 Census tracts. Analyses included African Americans, Asians, Caribbean Blacks, Latinos, and non-Latino whites. Separate logistic regression models were fitted for any past-year substance use disorder, alcohol use disorder, and drug use disorder. Results Living in more affluent and residentially unstable census tracts was associated with decreased risk of past-year substance use disorder, even after adjusting for individual-level factors. However, when we investigated the interaction of race/ethnicity and census latent factors with past-year substance use disorders, we found different associations for the different racial/ethnic groups. We also found different associations between neighborhood affluence, residential instability and any past-year substance use and alcohol disorders by nativity. Conclusions Characteristics of the environment might represent differential risk for substance disorders depending on a person’s ethnicity/race and nativity status.

Evaluating the service provision for ethnic minorities in Islington in the treatment of substance misuse

“…Recently, research in the UK and US identified low socio-economic class and poverty as the main factors of mental illness (Tobler et al, 2013, Lê Cook et al, 2011, similar to studies in the US examining ethnic minority populations in substance misuse (Field et al, 2012, Molina et al, 2012. The US research focus was on socio-economic factors, making drug users from poorer backgrounds more vulnerable to contracting HIV and Hepatitis C.…”

“…More up-to-date research on ethnicity and drug use in the US shows that research does inform and improve practice (Field et al, 2012: Molina et al, 2012: Daniulaityte et al, 2012. It identifies how ethnic groups have different needs when presenting to drug services and that their treatment packages need to be tailored to achieve effective outcomes (Daniulaityte et al, 2012).…”

“…This is also very similar to the Camden and Islington research conducted in 2004 (Fernandez, 2004). It appears a different presentation should always be treated using a flexible clinical approach if it is to be effective (Molina et al, 2012).…”

“…2003; Lê Cook & Alegría, 2011;Molina et al, 2012 (Fountain, 2009a-e), and a teaching session for the Borough would be useful for all managers and senior clinician staff.…”

“…Some were aware of the local research completed by myself (Fernandez, 2004) and the research literature review completed by Jane Fountain (2003). However, there was no knowledge of the work conducted in the US (Lê Cook et al, 2011;Molina et al, 2012), thus there is a need to run sessions to update staff members' knowledge base on some socio-economic factors.…”