Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th Street, Los Angeles, CA 90089-0411, USA.
Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Suite 401, Seattle, WA 98115, USA.
Public Health. 2018 Dec;165:58-66. doi: 10.1016/j.puhe.2018.09.011. Epub 2018 Oct 25.
To examine whether the (a) childhood neighborhood context predicts alcohol use disorder, nicotine dependence, and cannabis use disorder symptoms at the age of 39 years; and (b) socio-economic status during young adulthood mediates these relationships. Gender differences were also examined.
The Seattle Social Development Project is a prospective longitudinal study of 808 individuals followed up from ages 10 to 39 years in Seattle, Washington, United States. The sample was gender balanced (51% were men).
Alcohol, nicotine, and cannabis use disorder symptoms were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV-based Diagnostic Interview Schedule. Childhood neighborhood data consisted of 10 neighborhood-level variables from the 1990 national census, which were consolidated using principal component analyses. Two components with eigenvalues greater than 1 were extracted-neighborhood disadvantage and neighborhood stability. Educational attainment and employment status represented socio-economic status during young adulthood. Covariates included baseline symptoms of psychopathology, baseline substance use, gender, ethnicity, and childhood socio-economic status at the family level. Negative binomial regression was used as the primary modeling strategy. Six models for each outcome measure were estimated. The first three models examined associations between two neighborhood components and each substance use outcome measure. Next, we tested the second research question by adding unemployment and college graduate indicators at the age of 30 years as potential mediators underlying the link between the childhood neighborhood context and three substance use measures.
Study findings revealed that childhood neighborhood stability significantly reduced alcohol and cannabis use disorder symptoms nearly 3 decades later. Path analyses suggested that socio-economic status during the transition to adulthood did not influence these relationships but rather had independent effects on problematic nicotine and cannabis use. Furthermore, the effects of childhood neighborhood factors on problematic nicotine use were stronger for men.
Neighborhood characteristics during childhood may be important factors for alcohol and cannabis use disorder symptoms among adults and nicotine dependence disorder symptoms among men. Prevention efforts that address community stability and disadvantage can and should start in childhood, with a focus on intervention targets that might gain salience later in life to discourage the development and persistence of problematic substance use in adulthood.
研究童年时期的邻里环境是否会预测 39 岁时的酒精使用障碍、尼古丁依赖和大麻使用障碍症状；以及（b）成年早期的社会经济地位是否会影响这些关系。还检查了性别差异。
西雅图社会发展项目是一项对美国华盛顿州西雅图 808 名参与者进行的前瞻性纵向研究，从 10 岁到 39 岁进行了跟踪。样本在性别上是平衡的（51%是男性）。
使用基于《精神障碍诊断与统计手册第四版》的诊断访谈表评估酒精、尼古丁和大麻使用障碍症状。童年时期的邻里数据包括 1990 年全国人口普查的 10 个邻里层面的变量，这些变量使用主成分分析进行了合并。提取了两个特征值大于 1 的成分-邻里劣势和邻里稳定性。教育程度和就业状况代表了成年早期的社会经济地位。协变量包括基线精神病理学症状、基线物质使用、性别、族裔以及家庭层面的童年社会经济地位。使用负二项回归作为主要建模策略。为每个结果测量指标估计了六个模型。前三个模型研究了两个邻里成分与每种物质使用结果测量之间的关系。接下来，我们通过将 30 岁时的失业和大学毕业生指标作为童年邻里环境与三种物质使用措施之间联系的潜在中介因素，检验了第二个研究问题。
研究结果表明，童年时期的邻里稳定性显著降低了近 30 年后的酒精和大麻使用障碍症状。路径分析表明，成年过渡期的社会经济地位并没有影响这些关系，而是对尼古丁和大麻使用问题有独立的影响。此外，童年邻里因素对男性尼古丁使用问题的影响更大。
童年时期的邻里特征可能是成年人中酒精和大麻使用障碍症状以及男性尼古丁依赖障碍症状的重要因素。解决社区稳定和劣势的预防措施可以而且应该从儿童时期开始，重点关注可能在以后的生活中变得更为重要的干预目标，以阻止成年期出现和持续存在的问题性物质使用。
