Understanding the Relative Influence of Neighborhood, Family, and Youth on Adolescent Drug Use

Abstract

In the United States, a variety of programs have been developed to prevent substance use among youth. These programs often target youth directly, and may also have components that address the relational influence of families, schools, and communities. We discuss clustering of youth marijuana use within and between households and neighborhoods. As often discussed in the literature, we consider analyzing "components of variance" in a hierarchical sample design with two or more levels. With a continuous outcome variable, the estimated relative size of variance components at each level can be interpreted as its relative "importance." We estimate variance components when the outcome is dichotomous, and find that for the use of marijuana in the past year, the role of the individual (individual adolescent vs. role of household vs. role of neighborhood) is quite prominent (79% of variation). A similar result is observed for the continuous scale variable of individual positive attitudes toward drug use (83%). For continuous constructs related to either household (parental monitoring) or neighborhood (neighborhood disorganization) the majority of variation still occurs at the individual level (67% and 51%, respectively), although they reveal significant percent variation (about 30%) at the corresponding family or neighborhood levels as well. We discuss the use of variance component methodology and the relevance for prevention programs.

Perceived neighborhood illicit drug selling, peer illicit drug disapproval and illicit drug use among U.S. high school seniors

“…By and large, our findings are consistent with existing studies evaluating the role of neighborhood environments in illicit drug use [16,18-20]. However, because aggregate measures of neighborhood social disorder include other factors such as alcohol use, drug use, drug addiction, and prostitution, it is unclear whether multiple aspects of neighborhood social disorder are simultaneously needed to detect significant effects on illicit drug use.…”

“…In addition, prior research shows that exposure to neighborhood violence and crime is associated with illicit drug use [15-17]. Using and analyzing aggregate measures of neighborhood social disorder (including neighborhood drug selling as a component), some other studies have found a relationship between neighborhood social disorder and illicit drug use behaviors [16,18-20]. A recent study by Epstein and colleagues (2014) showed that neighborhood-level drug activity and social disorder were associated with heroin and cocaine craving among drug misusers [21].…”

“…Neighborhood illicit drug selling is a distinctive indicator of neighborhood social disorder that may be amenable to policy. We recognize that composite measures (e.g., of neighborhood social disorder) can be important, but might diminish the importance of any one individual component and might be less transferable to policymakers [30-32] (as studies usually use and analyze aggregate measures of neighborhood social disorder—not stratifying by the myriad social disorder components such as neighborhood drug selling) [16,18-20]. Further, while previous research on neighborhood factors and illicit drug use has used a variety of methods to categorize neighborhood factors (e.g., survey, geographic information systems [GIS]), additional research is needed to examine perceptions of neighborhood characteristics, which may be more closely linked to health and behavior than objectively measured neighborhood characteristics.…”

School context and American Indian substance use

“…Although the use of multilevel models to assess the complex associations between contextual factors and individual level factors on health generally is still a relatively recent phenomenon (Kawachi & Berkman, 2003), there is an emerging literature that examines the role of contextual factors for a variety of health outcomes (Boardman et al 2001; Kawachi and Berkman, 2003; Latkin and Curry 2003; Boardman, Saint Onge, Rogers, & Denney, 2005; Hill, Ross, & Angel, 2005; Choi, Harachi, & Catalano, 2006; Wright, Bobashev, & Folsom, 2007; Ross & Mirowsky, 2009; see Leventhal & Brooks-Gunn 2000 for a review). A strong trend in health research is multilevel explorations of the role of school factors/characteristics in explaining various adolescent health outcomes (e.g., Kulis, Marsiglia, Nieri, Sicotte, & Hohmann-Marriott, 2004; Leatherdale, Brown, Cameron, & McDonald, 2005; Monshouwer et al, 2007).…”

Monitoring the stability of risk factors for adolescent cannabis use

“…Community-level influences, especially drug availability, have been shown to increase the risk of adolescent drug use (Wright, Bobashev, & Folsom, 2007). A recent Swedish study found that low levels of social capital were related to higher levels of adolescent drug use, reinforcing the importance of community belonging and opportunity (Aslund & Nilsson, 2013).…”