The Link Between Childhood Neighborhood Characteristics and Adult Substance Use Disorder Symptoms

Introduction: Most existing studies of the role of neighborhood factors such as neighborhood-level poverty for problematic substance use have relied on data from cross-sectional designs, or did not look beyond adolescent substance use. Moreover, studies of the influence of childhood neighborhood context (CNC) on adult substance use, particularly beyond the normative peak age of use, are lacking. Hence, little is known about possible mechanisms linking CNC and adult substance use disorder symptoms. Our central research questions include: 1) Are two domains of CNC – neighborhood-level disadvantage (DIS) and residential stability (RST) – associated with alcohol use disorder symptoms (AUDS), nicotine dependence symptoms (NDS), and/or marijuana use disorder symptoms (MUDS) at age 39? 2) Do DIS and RST differentially predict these disorder symptoms? and 3) Does socioeconomic status during young adulthood, operationalized as educational attainment, help explain the impact of CNC on the disorder symptoms?

Method: Data are from the Seattle Social Development Project, and include participants who were living in Seattle at 9th grade and followed-up at age 39 (n=437). AUDS, NDS, and MUDS were assessed at age 39 using the Diagnostic Interview Schedule. Principle components analysis was conducted to summarize ten neighborhood variables linked to 9th grade residence from the 1990 census data and DIS (e.g., higher loadings on families living in poverty) and RST (e.g., higher loadings on owner-occupied homes) emerged. Educational attainment was measured at age 21 (those with a high school diploma = 1 and 0 otherwise). Covariates included baseline symptoms of psychopathology, baseline substance use, gender, and ethnicity. A series of hierarchical zero-inflated negative binominal models were estimated.

Results: Adjusting for covariates, RST was significantly associated with lower NDS and MUDS, but not with AUDS. DIS was not associated with any of the symptom measures. When educational attainment at age 21was added, RST remained statistically significant for MUDS. However, there was no longer any statistically significant association between RST and NDS.

Conclusions: Findings suggest that growing up in neighborhoods with greater stability is a potent protective factor for adult nicotine dependence and marijuana use disorder symptoms. We argue that childhood neighborhood stability should be considered in prevention efforts seeking to curb adult substance use problems persisting beyond the normative peak age. Findings also suggest that promoting educational attainment among young adults might be an effective secondary prevention target to minimize the influence of low neighborhood stability in childhood on adult nicotine dependence symptoms.