Contextual Predictors of Injection Drug Use among Black Adolescents and Adults in US Metropolitan Areas, 1993-2007

OBJECTIVES:

We sought to determine whether contextual factors shape injection drug use among Black adolescents and adults.

METHODS:

For this longitudinal study of 95 US metropolitan statistical areas (MSAs), we drew annual MSA-specific estimates of the prevalence of injection drug use (IDU) among Black adolescents and adults in 1993 through 2007 from 3 surveillance databases. We used existing administrative data to measure MSA-level socioeconomic status; criminal justice activities; expenditures on social welfare, health, and policing; and histories of Black uprisings (1960-1969) and urban renewal funding (1949-1974). We regressed Black IDU prevalence on these predictors by using hierarchical linear models.

RESULTS:

Black IDU prevalence was lower in MSAs with declining Black high-school dropout rates, a history of Black uprisings, higher percentages of Black residents, and, in MSAs where 1992 White income was high, higher 1992 Black income. Incarceration rates were unrelated.

CONCLUSIONS:

Contextual factors shape patterns of drug use among Black individuals. Structural interventions, especially those that improve Black socioeconomic security and political strength, may help reduce IDU among Black adolescents and adults. 

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By:   Cooper HL1, West B1, Linton S1, Hunter-Jones J1, Zlotorzynska M1, Stall R1, Wolfe ME1, Williams L1, Hall HI1, Cleland C1, Tempalski B1, Friedman SR1.

1Hannah L. F. Cooper, Sabriya Linton, Josalin Hunter-Jones, Maria Zlotorzynska, and Mary E. Wolfe are with the Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Brooke West is with the Division of Global Public Health, University of California at San Diego, La Jolla. Leslie Williams, Barbara Tempalski, and Samuel R. Friedman are with National Development and Research Institutes Inc, New York, NY. Ron Stall is with the Department of Behavioral and Community Health Sciences and Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. H. Irene Hall is with the HIV Incidence and Case Surveillance Branch, Centers for Disease Control and Prevention, Atlanta. Charles Cleland is at the School of Nursing, New York University, New York, NY.

 

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