Elsevier

Drug and Alcohol Dependence

Volume 165, 1 August 2016, Pages 288-292
Drug and Alcohol Dependence

Short communication
Does substance use moderate the association of neighborhood disadvantage with perceived stress and safety in the activity spaces of urban youth?

https://doi.org/10.1016/j.drugalcdep.2016.06.019Get rights and content

Highlights

  • Exposure to neighborhood disadvantage is associated with substance use.

  • Neighborhood disadvantage is also associated with stress and lower perceived safety.

  • The association with stress is stronger for substance users compared to non-users.

  • Geospatial EMA facilitates the investigation of neighborhoods and substance use.

  • Substance use interventions for adolescents should consider neighborhood conditions.

Abstract

Background

This study investigates the association of activity space-based exposure to neighborhood disadvantage with momentary perceived stress and safety, and the moderation of substance use on those associations, among a sample of 139 urban, primarily African American, adolescents.

Method

Geospatial technologies are integrated with Ecological Momentary Assessment (EMA) to capture exposure to neighborhood disadvantage and perceived stress and safety in the activity space. A relative neighborhood disadvantage measure for each subject is calculated by conditioning the neighborhood disadvantage observed at the EMA location on that of the home neighborhood. Generalized estimating equations (GEE) are used to model the effect of relative neighborhood disadvantage on momentary perceived stress and safety, and the extent to which substance use moderates those associations.

Results

Relative neighborhood disadvantage is significantly associated with higher perceived stress, lower perceived safety, and greater substance use involvement. The association of relative neighborhood disadvantage with stress is significantly stronger among those with greater substance use involvement.

Conclusion

This research highlights the value of integrating geospatial technologies with EMA and developing personalized measures of environmental exposure for investigating neighborhood effects on substance use, and suggests substance use intervention strategies aimed at neighborhood conditions. Future research should seek to disentangle the causal pathways of influence and selection that relate neighborhood environment, stress, and substance use, while also accounting for the role of gender and family and peer social contexts.

Introduction

Substance use has a detrimental effect on adolescent brain function and development (Lisdahl et al., 2015), and earlier use in adolescence has been found to be an indicator of substance use and misuse in emerging adulthood (Nelson et al., 2015). Evidence suggests that substance use among youth is associated with neighborhood economic disadvantage (Mason et al., 2009, Reboussin et al., 2015), particularly in urban areas where disadvantaged neighborhoods are also often associated with violent crime and other characteristics of neighborhood disorder, which can produce feelings of chronic psychological stress and a lack of safety (Brenner et al., 2013a, Latkin and Curry, 2003). Such neighborhoods also often lack the community support and resources that may buffer the deleterious health effects of stressful neighborhood conditions (Latkin and Curry, 2003). Substance use can serve as a coping mechanism for stressful environments (Jackson et al., 2009), and thus users may differ from non-users in their stress response to such environments (Schmeelk-Cone et al., 2003). Exposure to neighborhood disadvantage may be particularly problematic for urban African American youth, who are more likely to reside in poor, segregated neighborhoods, as compared to whites (Massey and Denton, 1993).

Few studies, however, have explicitly investigated the interactions of neighborhood disadvantage, perceptions of stress and safety, and substance use among urban, African American youth. Of those that have, most have employed recall-based survey measures or have been limited to the characteristics of subjects’ home neighborhoods (e.g., Brenner et al., 2013b). New methods integrating Global Positioning System (GPS) and Geographic Information System (GIS) technologies with Ecological Momentary Assessment (EMA), referred to by Epstein et al. (2014) as Geographical Momentary Assessment (GMA), allow for the capture of perceived stress and safety in real-time and as georeferenced to an individual’s activity space, i.e., places visited outside the home on a routine basis (Mason et al., 2015, Stahler et al., 2013). Capturing exposure outside the home neighborhood is particularly important as research shows that the home and its immediate environs are typically considered safer places than elsewhere among urban youth, even among those residing in relatively disadvantaged neighborhoods (Wiebe et al., 2013). Activity space-based measures of neighborhood exposure capture the contexts of youth development more fully as compared to those utilizing only home neighborhoods (Browning and Soller, 2014, Mennis and Mason, 2011).

In the present study, we show how GMA is used to collect integrated data on substance use, momentary perceptions of stress and safety, and activity space exposure to neighborhood disadvantage among a sample of young, urban, primarily African American adolescents. Several research questions are addressed: First, is exposure to neighborhood disadvantage in the activity space associated with substance use? Second, is exposure to neighborhood disadvantage in the activity space associated with perceived stress and safety? And third, if so, does the association of exposure to neighborhood disadvantage with perceived stress and safety differ according to degree of substance use?

Section snippets

Recruitment and data collection

The present study uses the one year follow-up data from the Social-Spatial Adolescent Study, a longitudinal study based in Richmond, Virginia which examines peer network and geographic mechanisms of adolescent substance use. Study subjects (N = 248) were recruited between November 2012 and February 2014, with the majority of participants recruited from an adolescent medicine outpatient clinic. Criteria for study participation included being 13–14 years old, a registered clinic patient, and a

Results

Of the 139 adolescents in the sample, 57 (41%) are boys and 82 (59%) are girls, approximately half of whom are thirteen years old (N = 72) and half are fourteen (N = 67). African Americans comprise 89% (N = 123) of the sample. The AADIS values range between 2 and 55, with a mean of 11.7. The 139 subjects analyzed here do not differ significantly from the other 109 study participants in terms of age (χ2 = 0.64, p = 0.444), sex (χ2 = 0.589, p = 0.52), race (χ2 = 4.004, p = 0.41), or mean AADIS score (t = −1.153, p = 

Discussion

These results generally agree with previous research (Brenner et al., 2013a, Reboussin et al., 2015, Wiebe et al., 2013) in finding that exposure of urban adolescents to greater neighborhood disadvantage relative to the home neighborhood is associated with higher stress and lower perceived safety, plausibly due to the association of violence and other stressful conditions of neighborhood disorder with neighborhood disadvantage. The association between relative neighborhood disadvantage and

Role of funding source

This research was supported by grant No. 1R01 DA031724-01A1 from the National Institute on Drug Abuse. The findings and conclusions are those of the authors and do not necessarily represent the views of the National Institute on Drug Abuse, or the National Institutes of Health.

Contributors

Drs. Mennis and Mason conceptualized the study. Dr. Mason directed data collection. Dr. Way developed the computer program to enable the EMA. Dr. Mennis conducted the statistical analysis and prepared the manuscript. All authors contributed to writing and editing the manuscript.

Conflict of interest

No conflict declared.

Acknowledgement

We thank Dr. Adam Davey for his statistical expertise.

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