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

Abstract

Objectives: 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.

Methods: 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).

Results: 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]).

Conclusions: 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.

FIGURE 1—

Prevalence of Substance-Use Disorder by Race/Ethnicity From Baseline (1995–1998, at Detention) Through Time 5 (12 Years Later): Cook County, Chicago, IL Note. Adjusted odds ratios (95% confidence intervals) for racial/ethnic differences over time were 1.9 (1.5, 2.3) for non-Hispanic White vs African American, 1.4 (1.1, 1.7) for non-Hispanic White vs Hispanic, and 1.4 (1.1, 1.7) for Hispanic vs African American.

FIGURE 2—

Prevalence of Alcohol-Use Disorder by Race/Ethnicity From Baseline (1995–1998, at Detention) Through Time 5 (12 Years Later): Cook County, Chicago, IL Note. Adjusted odds ratios (95% confidence intervals) for racial/ethnic differences over time were 1.7 (1.4, 2.2) for non-Hispanic White vs African American, 1.4 (1.1, 1.8) for non-Hispanic White vs Hispanic, and 1.2 (0.96, 1.5) for Hispanic vs African American.

FIGURE 3—

Prevalence of Marijuana-Use Disorder by Race/Ethnicity From Baseline (1995–1998, at Detention) Through Time 5 (12 Years Later): Cook County, Chicago, IL Note. Adjusted odds ratios (95% confidence intervals) for racial/ethnic differences over time were 1.3 (1.02, 1.6) for non-Hispanic White vs African American, 1.05 (0.8, 1.3) for non-Hispanic White vs Hispanic, and 1.2 (0.96, 1.5) for Hispanic vs African American.

FIGURE 4—

Prevalence of Cocaine-Use Disorder by Race/Ethnicity From Baseline (1995–1998, at Detention) Through Time 5 (12 Years Later): Cook County, Chicago, IL Note. Adjusted odds ratios (95% confidence intervals) for racial/ethnic differences over time were 32.1 (13.8, 74.7) for non-Hispanic White vs African American, 1.5 (1.04, 2.2) for non-Hispanic White vs Hispanic, and 21.2 (9.0, 50.1) for Hispanic vs African American.