Cumulative Exposure to Neighborhood Conditions and Substance Use Initiation among Low-Income Latinx and African American Adolescents

Purpose: While previous research underscores the important role that neighborhood contexts play for child and adolescent health and well-being, how these neighborhood contexts influence substance use initiation among adolescents from low-income and ethnic minority families has been understudied. Methods: This study is a secondary analysis of data from the Denver Child Study a retrospective survey that uses a natural experiment aimed at assessing neighborhood effects on developmental outcomes of Latinx and African American adolescents (N = 736). Cox cause-specific hazards models were estimated to test: (1) the effects of cumulative exposure to neighborhood social disorder, neighborhood violent and property crime rates, and neighborhood social capital during preadolescence (ages 8–11) on the likelihood of initiating alcohol, cigarette, and marijuana use during adolescence (ages 12–18), after controlling for youth, caregiver, and household factors; and (2) whether the effects of these cumulative neighborhood factors vary by Latinx and African American ethnicity. Results: 5.6% of adolescents in this study initiated cigarette use, 5.4% initiated alcohol use and 5.2% used marijuana for the first time during adolescence. The results indicate that exposure to neighborhood social disorder during preadolescence is a significant risk factor, especially for the initiation of cigarette use (HR = 1.36, 95% CI = 1.062–1.745, p = 0.015) particularly among Latinx adolescents (HR = 1.42, 95% CI = 1.031–1.966, p = 0.032). Conclusions: The findings suggest the need for further research on the relationship between exposure to neighborhood social disorder and adolescent substance use initiation in order to develop and implement community-based prevention and intervention programs to reduce substance use initiation and facilitate healthy adolescent development.