Influence of Family and Community Socioeconomic Status on the Risk of Adolescent Drug Use

Abstract

Background: Adolescent drug use increases the risk of mental, physical and social problems later in life and so it is important to understand its complex etiology that likely includes socioeconomic status (SES). We undertook the present analysis using data from a population-based retrospective cohort study to examine the influence of family and community SES in relation to adolescent drug use. We hypothesized that lower levels of community and parental SES would increase the risk of use and that there would be stronger associations for the more proximate family-level factors. Methods: We used self-administered questionnaires (N=1,402) to obtain information on use of marijuana, inhalants, heroin, cocaine/crack, psychedelics/hallucinogens, Ritalin without a prescription, and club drugs during adolescence. Family SES was gathered from birth certificate data on maternal educational level and paternal occupation. Community SES characteristics at birth, age 10 and age 18 were obtained from the US Census Bureau. Results: An increased risk of adolescent drug use was associated with lower maternal education, non-white collar occupations among fathers, and lower community median income, and poverty and unemployment levels at age 18. The strongest associations were seen for the use of multiple drugs (Risk Ratio (RR): 1.7, 95% CI: 1.4-2.2), inhalants (RR: 2.5, 95% CI: 1.5-2.2), crack/cocaine (RR: 2.8, 95% CI: 1.7-4.5), psychedelics/hallucinogens (RR: 1.8, 95% CI: 1.4-2.4), and club/designer drugs (RR: 1.8, 95% CI: 1.2-2.7) among adolescents whose mothers had only a high school education. Conclusions: These results suggest that use of certain drugs during adolescence is associated with both family and community SES measures. However, maternal education appears to have the greatest influence on use, suggesting that a multi-level approach that engages mothers is needed to prevent adolescent drug use.

Keywords:

• Socioeconomic status
• maternal education
• paternal occupation
• census data
• adolescent
• drug use

Authors’ contribution statements

Ann Aschengrau conceived of the investigation, supervised the data collection and analysis, and drafted the manuscript. Alexandra Grippo collected and computerized the U.S. Census data, helped conduct the data analysis, and reviewed the manuscript. Michael Winter helped collect the study data, helped conduct the data analysis, and reviewed the manuscript.

Disclosure statement

The authors report no conflicts of interest.

Ethics approval

This study involved human participants and was approved by the Institutional Review Boards (IRBs) of Boston University Medical Center and the Massachusetts Department of Public Health. The authors certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Data and/or code availability

Non-identifiable data and computer codes will be made available if approved by the IRBs of Boston University Medical Center and the Massachusetts Department of Public Health.

Additional information

Funding

This work was supported by the National Institute of Environmental Health Sciences Superfund Research Program (5P42ES00738).