Session: The Interplay of Neighborhood, Substance Use, and Health Disparities (Society for Prevention Research 24th Annual Meeting)

Introduction: The neighborhood settings in which people live have been shown to have an important role in a range of health behaviors and health outcomes. While many studies have focused on physical health and, to some extent, mental health outcomes, less is known about how neighborhoods might affect substance use. At the same time, understanding environmental factors that can help explain health disparities in substance use is an important research priority. Although findings are mixed, some studies show that increased substance use problems may be associated with low-socioeconomic status as well as minority ethnic status. This panel will examine ways in which neighborhood characteristics are associated with problematic alcohol and nicotine use. Particular attention will be given to the role of neighborhood context among different socioeconomic and ethnic groups.

Methods: Data are from the Seattle Social Development Project (SSDP), a diverse Seattle-based longitudinal cohort of 808 that was interviewed 15 times from age 10 to age 39, corresponding to years 1985 to 2014. The SSDP sample is gender balanced, multiethnic (less than half European-American), and economically diverse (more than half eligible for the federal school lunch/breakfast program in the elementary grades). Self-reports of neighborhood characteristics were assessed throughout the study, and some objective measures of neighborhood features (GIS and Census-based) corresponding to residential addresses were added in the adult years. Substance use was assessed in all study waves, and substance use disorders corresponding to the DSM-IV were assessed in adulthood.

Results and Conclusions: Results from three distinct but related studies to be presented in the panel suggest that (a) it is possible to identify meaningful neighborhood subtypes that increase risk for alcohol misuse, and that distinguishing features may have more to do with socioeconomic disadvantage and neighborhood disorder than with alcohol accessibility per se; (b) neighborhood disorder has a persistent association with problem drinking across young adulthood from ages 21 to 39 such that more disorder is related to a slower decline in alcohol use disorder symptoms; and (c) neighborhood disorder experienced in childhood and adolescence may play a role in the link between unemployment and substance use in young adulthood. Findings will be discussed with respect to health disparities and prevention implications.