Unemployment and Substance Use Disorder Symptoms: The Role of Childhood Low Socioeconomic Status and Neighborhood Disadvantages

Introduction Scholars have suggested that unemployment may lead to psychiatric problems including problematic substance use, but existing empirical evidence is inconclusive. Furthermore, little is known about the role of early individual and neighborhood disadvantages in the link between unemployment and problematic substance use. The central research questions addressed in the present study are: 1) is unemployment during young adulthood associated with alcohol use disorder symptoms (AUDS) and nicotine dependence symptoms (NDS) at age 39?; 2) do individual low SES and neighborhood disadvantages in childhood explain or condition the impact of unemployment on the disorder symptoms?; and 3) do general (GNE) and substance-use specific neighborhood (SNE) disadvantages in childhood differentially predict the disorder symptoms? Based on emerging evidence in the literature, potential sex differences will also be examined.

Method Data are from the Seattle Social Development Project (n=808). AUDS and NDS were assessed at age 39 using the Diagnostic Interview Schedule. The unemployment measure summarized the number of years when respondents were unemployed from ages 21 to 33. Child SES was indicated by parental education and income. Self-reported childhood GNE (e.g., crime, run down housing) and SNE (e.g., drug selling, adult drug use) were assessed at ages 10-18, respectively. Covariates included baseline symptoms of psychopathology, baseline substance use, gender, and ethnicity. A series of negative binominal models were estimated.

Results Years of unemployment was associated with higher levels of AUDS and NDS, even after adjusting for all analysis variables. Individual childhood SES did not play a role in the association between unemployment and the two disorder symptom measures. General and substance-use specific neighborhood disadvantages in childhood partially accounted for the association between unemployment and NDS, whereas neither measure of neighborhood disadvantages was related to AUDS. Findings also suggested that incident rates of NDS were disproportionately higher among females who experienced unemployment and/or spent their earlier years in substance-use tolerant neighborhoods.

Conclusions Findings suggest that unemployment is a potent risk factor for alcohol use disorder and nicotine dependence symptoms, indicating that prevention efforts providing strategies to cope with unemployment, particularly for females who spent their earlier life in substance-use tolerant neighborhoods, may be useful. Findings also suggest that a broad spectrum of neighborhood characteristics in childhood, particularly substance-use specific neighborhood characteristics, should be considered in efforts to effectively ameliorate adult substance use problems.