Neighborhood socioeconomic status, personal network attributes, and use of heroin and cocaine.
BACKGROUND
Drug abuse is a significant public health problem because of its association with numerous negative health and social consequences. Examining the social context of drug use represents a burgeoning avenue of research in drug abuse. This study investigates the effects of neighborhood disadvantage and network factors on current heroin and cocaine use among a predominantly African-American adult sample residing in Baltimore City.


METHODS
This study employs a cross-sectional, multilevel design using data from two sources: the SHIELD Study, a network-oriented HIV intervention in Baltimore City and the 1990 U.S. Decennial Census. The sample consisted of 1305 adults from 249 neighborhoods (census block groups) across Baltimore City. Multilevel logistic regression analysis was performed to examine personal network and neighborhood effects on current heroin and cocaine use.


RESULTS
Neighborhood poverty was significantly associated with current heroin and cocaine use (odds ratio [OR]=1.51, confidence interval [CI]=1.06-2.15). Social support (OR=0.80, CI=0.69-0.92) and having ties to employed people (OR=0.47, CI=0.24-0.92) were protective of current drug use, but did not buffer negative effects of neighborhood poverty in the face of negative drug influences in the network (OR=8.62, CI=5.81-12.79).


CONCLUSIONS
The contexts of neighborhoods and networks represent key determinants in understanding the social epidemiology of drug abuse. Network attributes have strong influences on drug use, and neighborhood poverty may increase odds of use. Further research is warranted to determine other aspects of neighborhood environments that may put individuals at risk for drug use and abuse.
Williams
Chyvette T
CT
School of Public Health, University of Illinois at Chicago, Chicago, Illinois 60612, USA. chevy@uic.edu
Latkin
Carl A
CA
D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011203:Poverty; D012111:Residence Characteristics; D012307:Risk Factors; D012923:Social Class; D012944:Social Support