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Helen Wu, PhD, Department of Obstetrics & Gynecology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0587, 409-772-1021, zhwu@utmb.edu, Karl Eschbach, PhD, Sealy Center on Aging, University of Texas Medical Branch, 301 University Blvd., 3.222 Jennie Sealy Rte 0460, Galveston, TX 77555-0460, and James Grady, DrPH, Office of Biostatistics, University of Texas Medical Branch, 700 Harborside, Galveston, TX 77555-1148.
This study assessed contextual risks for polydrug use in a tri-ethnic sample (non-Hispanic White, African American, Hispanic) of 384 young, unmarried women who sought care at state-funded family planning clinics in southeast Texas from Dec 2001 to May 2003. The outcome was the number of illicit drugs (including marijuana, ecstasy, crack cocaine, and other hard drugs) used in the last year. Individual risks included number of sexual partners, delinquent behavior, peer drug use, ethnicity, age, and employment. Contextual risks included a census tract socioeconomic disadvantage index, and a measure of tract ethnic heterogeneity (percent of Whites in tracts). We estimated multivariate Poisson models for number of drugs used.
Of all subjects, 37% reported using illicit drugs. In the adjusted model, white ethnicity (vs. Black) (Coeff.=0.54, 95%CI=0.18,0.92), a larger number of sexual partners (0.01, CI=0.003,0.02), and a larger number of friends who used drugs (0.07, CI.=0.05, 0.08) were associated with increased drug use. Neighborhood disadvantage was associated with less drug use (-0.34, CI=-0.58,-0.10). Within each stratum of tract economic disadvantage, higher percentages of Whites in the tract were associated with decreased drug use (-0.97, CI=-1.74,-0.19).
The finding that neighborhood disadvantage is associated with lower drug use contradicts reports from some studies. Our results may differ because within a low income population, those in better-off (but still poor) neighborhoods may be more able to afford drug use. The racial composition effect is compatible with models linking decreased neighborhood cohesion with increased drug use. Strategies to reduce polydrug use should target both contextual and individual risks.
Learning Objectives:
Keywords: Drug Use, Underserved Populations
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.