Contextual predictors of injection drug use among black adolescents and adults in US metropolitan areas, 1993-2007

H.L.F. Cooper, B. West, S. Linton, J. Hunter-Jones, M. Zlotorzynska, R. Stall, M.E. Wolfe, L. Williams, H.I. Hall, C. Cleland, B. Tempalski and S.R. Friedman

American Journal of Public Health, 2016, vol. 106, issue 3, 517-526

Abstract: Objectives. We sought to determine whether contextual factors shape injection drug use among Black adolescents and adults. Methods. For this longitudinal study of 95 USmetropolitan statistical areas (MSAs), we drew annual MSA-specific estimates of the prevalence of injection drug use (IDU) among Black adolescents and adults in 1993 through 2007 from 3 surveillance databases. We used existing administrative data to measure MSA-level socioeconomic status; criminal justice activities; expenditures on social welfare, health, and policing; and histories of Black uprisings (1960-1969) and urban renewal funding (1949-1974). We regressed Black IDU prevalence on these predictors by using hierarchical linear models. Results. Black IDU prevalence was lower in MSAs with declining Black high-school dropout rates, a history of Black uprisings, higher percentages of Black residents, and, in MSAs where 1992 White income was high, higher 1992 Black income. Incarceration rates were unrelated. Conclusions. Contextual factors shape patterns of drug use among Black individuals. Structural interventions, especially those that improve Black socioeconomic security and political strength, may help reduce IDU among Black adolescents and adults.

Keywords: adolescent; adult; African American; civil disorder; criminal law; economics; epidemiology; ethnology; female; health care cost; human; income; longitudinal study; male; middle aged; organization and management; politics; prevalence; prison; social welfare; socioeconomics; statistics and numerical data; substance abuse; United States; urban population; young adult, Adolescent; Adult; African Americans; Criminal Law; Female; Health Expenditures; Humans; Income; Longitudinal Studies; Male; Middle Aged; Politics; Prevalence; Prisons; Riots; Social Welfare; Socioeconomic Factors; Substance Abuse, Intravenous; United States; Urban Population; Young Adult (search for similar items in EconPapers)
Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2015.302911_8

DOI: 10.2105/AJPH.2015.302911

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