Neighborhood-level LGBT hate crimes and current illicit drug use among sexual minority youth

Abstract

Objective

To investigate whether past-30 day illicit drug use among sexual minority youth was more common in neighborhoods with a greater prevalence of hate crimes targeting lesbian, gay, bisexual, and transgender (LGBT, or sexual minority) individuals.

Methods

We used a population-based survey of public school youth in Boston, Massachusetts, consisting of 1292 9th–12th grade students from the 2008 Boston Youth Survey Geospatial Dataset (sexual minority n = 108). Data on LGBT hate crimes involving assaults or assaults and battery between 2005 and 2008 were obtained from the Boston Police Department and linked to youths’ residential address. Youth reported past-30 day use of marijuana and other illicit drugs. Wilcoxon–Mann–Whitney tests and corresponding p-values were computed to assess differences in substance use by neighborhood-level LGBT assault hate crime rate among sexual minority youth (n = 103).

Results

The LGBT assault hate crime rate in the neighborhoods of sexual minority youth who reported current marijuana use was 23.7 per 100,000, compared to 12.9 per 100,000 for sexual minority youth who reported no marijuana use (p = 0.04). No associations between LGBT assault hate crimes and marijuana use among heterosexual youth (p > 0.05) or between sexual minority marijuana use and overall neighborhood-level violent and property crimes (p > 0.05) were detected, providing evidence for result specificity.

Conclusions

We found a significantly greater prevalence of marijuana use among sexual minority youth in neighborhoods with a higher prevalence of LGBT assault hate crimes. These results suggest that neighborhood context (i.e., LGBT hate crimes) may contribute to sexual orientation disparities in marijuana use.

Introduction

Adolescence is an important developmental period for the initiation of illicit drugs (Gruber and Pope, 2002, Latimer and Zur, 2010, CDC, 2012). National estimates report that 24.4% of 13–18 year olds report lifetime prevalence of illicit drugs (Swendsen et al., 2012). Marijuana is the most commonly used illicit drug among youth, by far (Johnston et al., 2003, Latimer and Zur, 2010). The 2011 High School Youth Risk Behavior Survey found that 39.9% of youth in the U.S. used marijuana in their lifetime and 23.1% of youth in the U.S. used marijuana in the last 30 days (CDC, 2012). Substance use in adolescence is associated with increased risk for substance use disorders, school failure, sexually transmitted infections, and other psychosocial and health problems (Behrendt et al., 2009, Chen et al., 2005, Gruber and Pope, 2002).

Both cross-sectional and longitudinal studies have shown that sexual minority youth (e.g., those who identify as lesbian, gay or bisexual or experience same-sex attractions and/or relationships) are more likely to use drugs than heterosexual youth (Corliss et al., 2010, Garofalo et al., 1998, Marshal et al., 2008, Russell et al., 2002). A meta-analysis found that the odds of substance use among sexual minority youth are nearly twice that of heterosexual youth (Marshal et al., 2008). Furthermore, sexual minority youth were 1.56 times more likely to report past 30-day marijuana use, and were 2.58 times more likely to report lifetime marijuana use, compared to their heterosexual peers (Marshal et al., 2008).

An Institute of Medicine (2011) report on sexual minority health disparities noted that the reasons for higher levels of substance use, including marijuana use, among sexual minority youth are largely unknown. However, the stigma related to sexual orientation is frequently cited as a risk factor for health disparities between sexual minority and heterosexual populations. Several studies have documented associations between various stigma-related stressors and substance use among sexual minority youth (Coker et al., 2010), including gay-related stressful life events (e.g., identity disclosure; Rosario et al., 1996), victimization at school (Bontempo and D’Augelli, 2002), and verbal/physical abuse (Savin-Williams, 1994). This research has provided important information on risk factors for substance use, including marijuana use, but has tended to focus on individual and interpersonal forms of stigma. Neighborhood environments play a significant role in shaping patterns of population health and health disparities (Berkman and Kawachi, 2000, Kawachi and Berkman, 2003, Link and Phelan, 1995, Marmot and Wilkinson, 2006). Although Healthy People 2020 suggested that neighborhood factors may influence sexual minority health, very limited research has examined whether neighborhood factors contribute to substance use among gay men (Buttram and Kurtz, 2013, Carpiano et al., 2011) and sexual minority adolescents (Hatzenbuehler et al., 2011).

We sought to address this gap in the literature by examining one neighborhood factor that is likely salient to the health of sexual minority youth—that of neighborhood-level hate crimes. Hate crimes are defined as “unlawful, violent, destructive or threatening conduct in which the perpetrator is motivated by prejudice toward the victim's putative social group” (Green et al., 2001). Sexual minorities are frequent targets of hate crimes (Herek, 2009); in fact, 17% of the 88,463 hates crimes in the U.S. from 1995 to 2008 were directed toward sexual minorities (FBI, 2012).

Previous empirical research with general (i.e., non-sexual minority) samples suggests that exposure to neighborhood violence is associated with youth substance use, including marijuana use (Copeland-Linder et al., 2011, Lambert et al., 2004). In these studies, neighborhood violence is conceptualized as a contextual effect. Thus, individuals do not have to experience violence directly to be negatively influenced by these social contexts. Similarly, even if sexual minority youth are not personally targets of LGBT hate crimes, living in neighborhoods with a greater prevalence of such crimes may nevertheless create a negative social climate for these individuals, contributing to increased levels of stress (Hatzenbuehler et al., 2011, Oswald et al., 2010). In turn, young sexual minorities may use marijuana and other substances to manage that stress (Boardman et al., 2001, Low et al., 2012). Based on this literature, we hypothesized that current marijuana use and other illicit drug use among sexual minority youth would be higher in neighborhoods with more LGBT hate crimes. To test this hypothesis, we obtained data on LGBT hate crimes from the Boston Police Department Community Disorders Unit and linked this information to individual-level data on drug use and sexual orientation from a population-based sample of Boston youth.