Health Disparities in Drug- and Alcohol-Use Disorders: A 12-Year Longitudinal Study of Youths After Detention

• Published in: American journal of public health (1971) 2016-05, Vol.106 (5), p.872-880
• Main Authors: Welty, Leah J, Harrison, Anna J, Abram, Karen M, Olson, Nichole D, Aaby, David A, McCoy, Kathleen P, Washburn, Jason J, Teplin, Linda A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; African Americans; Age; AJPH Research; Alcohol; Alcohol-Related Disorders - ethnology; Alcoholism; Amphetamines; Chicago - epidemiology; Child; Cocaine; Correctional institutions; Cultural differences; Disease control; Disease prevention; Drug abuse; Drug use; Drugs; Ethnicity; European Continental Ancestry Group; Female; Gender differences; Hallucinogens; Health disparities; Health Policy; Health services; Hispanic Americans; Humans; Imprisonment; Interviews; Juvenile Delinquency - statistics & numerical data; Juvenile justice; Juvenile offenders; Longitudinal Studies; Male; Marijuana; Mental disorders; Mental Health; Minority & ethnic groups; Narcotics; Other Child and Adolescent Health; Prevalence; Prisoners - statistics & numerical data; Prospective Studies; Public health; Race; Racial differences; Review boards; Sex Factors; Studies; Substance abuse treatment; Substance-Related Disorders - classification; Substance-Related Disorders - ethnology; Time Factors; White people; Young Adult; Young adults
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2015.303032

To examine sex and racial/ethnic differences in the prevalence of 9 substance-use disorders (SUDs)--alcohol, marijuana, cocaine, hallucinogen or PCP, opiate, amphetamine, inhalant, sedative, and unspecified drug--in youths during the 12 years after detention. We used data from the Northwestern Juvenile Project, a prospective longitudinal study of 1829 youths randomly sampled from detention in Chicago, Illinois, starting in 1995 and reinterviewed up to 9 times in the community or correctional facilities through 2011. Independent interviewers assessed SUDs with Diagnostic Interview Schedule for Children 2.3 (baseline) and Diagnostic Interview Schedule version IV (follow-ups). By median age 28 years, 91.3% of males and 78.5% of females had ever had an SUD. At most follow-ups, males had greater odds of alcohol- and marijuana-use disorders. Drug-use disorders were most prevalent among non-Hispanic Whites, followed by Hispanics, then African Americans (e.g., compared with African Americans, non-Hispanic Whites had 32.1 times the odds of cocaine-use disorder [95% confidence interval = 13.8, 74.7]). After detention, SUDs differed markedly by sex, race/ethnicity, and substance abused, and, contrary to stereotypes, did not disproportionately affect African Americans. Services to treat substance abuse--during incarceration and after release--would reach many people in need, and address health disparities in a highly vulnerable population.