Neighborhood disadvantage amplifies risk of drug problems for residents with a family history of alcohol problems

The effects of family risk factors for alcohol and drug problems may be amplified in the context of neighborhood disadvantage. Drinkers or drug users with a family history of alcohol abuse may have fewer psychological and social resources to cope with stress associated with living in disadvantaged neighborhoods and may develop alcohol or drug problems. This study examined whether the relationship between family history of alcohol abuse and current alcohol or drug problems was moderated by neighborhood disadvantage. Survey data from the 2000 and 2005 National Alcohol Surveys (N = 11,399 adults) were linked to indicators of neighborhood disadvantage from the 2000 US Decennial Census. Neighborhoods were classified into 3 groups based on a composite indicator of neighborhood disadvantage. Past-year drug and alcohol problems included interpersonal, health, legal and work-related consequences. Individuals with both first- and second-degree relatives who were problem drinkers or alcoholics were coded as positive for family history of alcohol abuse. The hypothesis was tested using logistic regression adjusting for individual SES and other demographics. Neighborhood disadvantage did modify the association between family history and drug problems: Residents of poor neighborhoods who had a positive family history were at significantly elevated risk compared to other residents. Neighborhood disadvantage did not modify the association between family history and alcohol problems. The findings suggest that living in advantaged neighborhoods may reduce risk of drug problems for people with a family history of alcohol abuse, but prevention initiatives should target both advantaged and disadvantaged areas to reduce alcohol problems.