Adverse childhood experiences and substance use across diverse neighborhoods
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Adverse childhood experiences (e.g., abuse, substance abuse or mental illness in the household, incarceration of a family member) have gained prominence in the medical and epidemiological literature in recent years due in part to the implications these experiences have for later adult health. One pathway by which adverse childhood experiences influence later health is through the development of problematic health behaviors that serve as coping mechanisms, such as drinking alcohol and smoking. Individuals typically initiate these behaviors in one form or another during adolescence, a time of experimentation and increased autonomy. Accordingly, the first aim of this study analyzes the extent to which adverse childhood experiences are linked with later substance use during adolescence and the transition to adulthood. In addition to the household environment, neighborhood context may also play a role in adolescents’ substance use behaviors. Protective resources in youth’s neighborhood, such as collective efficacy, might buffer the effects of growing up in a troubled household, although other neighborhood environments may contribute to youth’s substance use. The second aim of this study explores how the neighborhood social context moderates the association between adverse childhood experiences and later substance use. Lastly, as substance use shows systematic age-related patterns, the third aim of this study tests if the foregoing relationships vary by age. This study uses the Project on Human Development in Chicago Neighborhoods data to estimate multi-level models predicting three health behaviors during adolescence: drinking, cigarette smoking, and drug use. Results showed consistent associations between adverse childhood experiences and the amount of cigarettes smoked and the likelihood of illicit drug use, although not the amount of days drunk in the past year. Second, neighborhood interaction effects operated unexpectedly so that some neighborhood resources increased substance use among youth with adverse childhood experiences. Third, adverse childhood experiences and neighborhood resources were the most salient for substance use at the older ages. This examination of how childhood experiences relates to substance use behaviors in adolescence provides additional insight into the family and neighborhood contexts of adolescent substance use as well as how adverse childhood experiences matter across the life course.