Explaining Cross National Differences in the Availability of Alcohol and Drugs in the Community and Neighbourhood Contexts in Mumbai, India; Melbourne, Australia and Seattle in Washington State, USA

Introduction: Children are strongly influenced by the community and the neighbourhood they live in. The neighbourhood may be particularly important for childhood well-being because of the constraints it imposes on their patterns of daily activities. Thus, addressing issues related to the impact of the community and neighbourhood context on childhood outcomes is of great concern. The present paper will cross-nationally compare potentially modifiable influences of community and neighbourhood context on the alcohol and drug availability. The study also looks into the role of community norms and availability as risk factors for youth alcohol and drug use.

Method and Study Design: This presentation will describe the International Youth Development Study (IYDS), a large survey of 4770 representative sample of school-age youth in Mumbai that was designed to enable matched comparisons with same-aged youth in Melbourne, Australia and Seattle in Washington State, US. IYDS uses the Communities That Care Youth Survey. The study used matched respondents grade levels Grade 7 (age 12-13) and Grade 9 (age 14-15). Sampling methods, survey procedures and instruments were matched to enable cross-national comparison with same-aged student cohorts surveyed in Washington State, U.S., (N = 2,866) and Victoria, Australia (N = 2,864) in 2002 in the International Youth Development Study.

Results: The results showed lower rates of alcohol, tobacco and other drug use in Mumbai. For example amongst Grade 5 boys (av age 11 years) rates of lifetime alcohol use were 4.1% (95% Confidence Interval [CI:] 2.4 - 6.9%) in Mumbai; 57.3% (CI: 51.4 - 62.9%) in Melbourne and; 25.4% (CI: 21.1 - 30.3%) in Seattle/ Tacoma. The results showed that the levels on risk factors for alcohol and drug availability and laws and norms were lowest in Seattle/ Tacoma and highest in Mumbai, with Melbourne intermediate between these extremes. Associations between alcohol and drug use and risk factors related to alcohol and drug availability and laws and norms tended to be weaker in Mumbai compared to Seattle and Melbourne.

Conclusions: These analyses are discussed with reference to differing policy options for adolescent alcohol and drug availability that are adopted in Mumbai, Seattle/ Tacoma and Melbourne. The low substance use in Mumbai is associated with low availability and norms. The logistic regression suggests availability is a common risk factor in each city.  Future research will examine policies that explain low availability in Mumbai. The findings have implications for scientific understanding of adolescent development and for planning international prevention programs.