The role of neighborhood in urban black adolescent marijuana use
Introduction
National data show that marijuana use now exceeds the rate of cigarette smoking among adolescents. In 2014, rates of past 30 day marijuana use were 6.5%, 16.6% and 21.2% among 8th, 10th and 12th graders compared to 4.0%, 7.2% and 13.6%, respectively for cigarettes (Johnston et al., 2015). Perceptions of harm are also shifting; only 36% of high school seniors think regular marijuana use places the user at great risk compared to 52% in 2009 and a high of 78% in the early 1990s (Johnston et al., 2015). Adolescent marijuana use is concerning not only because of the increased acute risk for motor vehicle crashes, engagement in risky sexual behaviors, and deficits in attention and memory but because of the long-term psychosocial effects associated with early use (Volkow et al., 2014). Although 9% of those that use marijuana will develop a cannabis use disorder, this risk increases to 1 in 6 for those who initiate in adolescence (Hall and Degenhardt, 2009). In addition, several researchers have demonstrated an association between adolescent marijuana use and poor school performance, unemployment, arrest and incarceration, and diminished lifetime satisfaction and achievement (Brook et al., 2013, Fergusson and Boden, 2008, Lynskey and Hall, 2000, Bray et al., 2000).
The negative impact of adolescent marijuana use is particularly concerning for low-income, urban Black youth; many of whom face other vulnerabilities that may hinder their ability to successfully transition to adulthood. Historically, rates of marijuana use have been higher in Whites than Blacks. However, this difference began to narrow in the 1990s and Black 8th, 10th and 12th graders now have higher rates of past 30 day marijuana use than Whites (Johnston et al., 2014). Despite these trends, limited research exists on the epidemiology of marijuana use among low-income, urban Black adolescents and even less on neighborhood factors that may be particularly salient for this community (Copeland-Linder et al., 2011).
Black youth disproportionately reside in neighborhoods with high levels of neighborhood disorder; neighborhoods characterized by crime, drug use, and violence. Research shows that illicit drugs are more prevalent in Black neighborhoods (LaVeist and Wallace, 2000), Black youth are more likely to witness drug sales and drug activity in their neighborhoods, and Black youth are more likely to be offered drugs (Wallace and Muroff, 2002). Black youth also rate their communities as more threatening than youth of other racial groups (Aneshensel and Sucoff, 1996). Disordered neighborhoods in which Black youth reside are often characterized by weakened social cohesion and controls that invite a wide-array of illegal behavior, like drug selling and use, and incivilities (Sampson et al., 1997). Black youth also disproportionately reside in neighborhoods with high levels of poverty (USDHHS, 2001). Concentrated disadvantage can isolate residents from key resources supporting collective social control leading to perceived powerlessness to intervene on behalf of the community (Williams and Collins, 1995, Brooks-Gunn et al., 1993). Neighborhoods with high concentrations of poverty are also often characterized by high levels of neighborhood disorder (Gephart, 1997). Hence, neighborhood disorder and the concentrated disadvantage that often accompanies it may increase the risk for the initiation and continued use of marijuana, because it is widely available and because it may weaken beliefs about the potential harm of drug use and strengthen positive expectancies of use. Living in disordered neighborhoods with high rates of crime and violence can also bring with it a constant feeling of threat and danger (Ross and Jang, 2000). This chronic stress can result in feelings of hopelessness and helplessness that can lead to adverse psychological outcomes such as depressed mood. According to the stress reduction hypothesis, marijuana use may be a means of coping with or alleviating the depressed mood that accompanies the stress of living in a violent neighborhood (Conger, 2005).
Limited research has found that perceptions of neighborhood disorder are associated with 10th grade drug use (defined as alcohol, tobacco or marijuana use) among low-income, urban Blacks (Lambert et al., 2004). In one of the few studies specific to marijuana use, young adult Black men in Chicago reporting high levels of neighborhood disorder and violence were more likely to report a history of marijuana use (Seth et al., 2012). In a sample of primarily Black youth in Baltimore, neighborhood physical, but not social disorder, was associated with marijuana use after high school (Furr-Holden et al., 2011, Furr-Holden et al., 2014). Using data from the same study but restricted to Blacks, Reboussin et al. (2014) found that perceptions of neighborhood disorder, increased drug activity and exposure to violence in 8th grade were associated with initiation and progression to more frequent marijuana use between 9th and 12th grades.
A comprehensive understanding of how neighborhood impacts marijuana use among low-income, urban Blacks is critical to the development of effective prevention programs and policy initiatives. This study addresses multiple gaps in the literature by expanding the measures of neighborhood beyond those that are typically considered, and examining their association with early adolescent marijuana use, which has not been studied in any depth and has been shown to be particularly detrimental in the long-term. Specifically, this investigation will (1) identify stages of marijuana involvement during 6th through 9th grades in a longitudinal, community sample of primarily low-income Blacks living in Baltimore, Maryland, (2) estimate the probability of progressing between these stages, and (3) examine the influence of neighborhood disorder, drug activity, violent crime, safety and disadvantage on these progressions.
Section snippets
Participants
Data are from a community-based longitudinal study conducted at the Johns Hopkins University Baltimore Prevention Research Center (BPRC; Ialongo et al., 1999). In 1993, 798 children and families representative of students entering 1st grade in nine Baltimore City schools were recruited to participate. Three 1st grade classrooms in each of 9 elementary schools were randomly assigned to one of two intervention conditions or to a control condition. Teachers and students were then randomly assigned
Results
Marijuana involvement and neighborhood characteristics from 6th through 9th grades are presented in Table 1. For all five measures, involvement increased from 6th through 9th grade. By ninth grade, 61.0% were offered marijuana, 34.7% had used marijuana, 16.8% had used it at least three times, and 30.5% experienced social and 12.9% health problems related to marijuana use. Although we incorporate time-varying covariates into the models, there is relative stability in the neighborhood
Discussion
We found evidence that marijuana involvement increases steadily during adolescence with a slightly higher probability of transitioning from offers to use between 6th and 7th grades compared to later years. Our findings highlight several significant predictors of transitions in marijuana involvement during adolescence. Neighborhood disorder and neighborhood drug activity were both associated with an increased risk of transitioning to marijuana use and problems; either directly from no
Role of funding source
This work was supported by R01-DA032550 and K01-DA031738 from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.
Contributors
Drs. Reboussin, Green and Ialongo conceptualized and drafted the manuscript. Dr. Reboussin conducted the statistical analysis. Drs. Furr-Holden, Milam and Johnson conducted the literature review. All authors contributed to and have approved the final manuscript.
Conflict of interest
All authors declare they have no conflicts of interest.
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