Long-term Consequences of Criminal Justice System Intervention: The Impact of Young Adult Arrest on Midlife Health Behaviors.

While there is a growing literature on the relationship between incarceration and health, few studies have expanded the investigation of criminal justice system involvement and health to include the more common intervention of arrest. This study uses a quasi-experimental design to evaluate the long-term effect of arrest in young adulthood on health behaviors in midlife for African Americans. We use propensity score matching methods and gender-specific multivariate regression analyses to equate those who did and did not incur an arrest in young adulthood from a subsample (n = 683) of the Woodlawn cohort, an African American community cohort followed from childhood into midlife. The results suggest that, for men, having been arrested in young adulthood has a direct effect on smoking, daily drinking, and risky sexual behaviors into midlife while young adult arrest does not seem to impact midlife health risk behaviors for women. This study adds health risk behaviors to the growing list of detrimental outcomes, such as crime, drug use, education, and mental health that are related to criminal justice contact for African American men, in particular.

What's drugs got to do with it? Examining the relationship between drug onset and duration with criminal outcomes in an African American cohort.

BACKGROUND: The association of drug use onset and duration with criminal careers has rarely been studied over the life course among African Americans, who are disproportionately impacted by the criminal justice system. METHODS: This study uses data from a community cohort of urban African Americans, first assessed at age 6 (n = 1242) and followed into midlife. Data come from both self-reports (n = 1053 in adulthood) and official crime records (n = 1217). Regression analyses among those who used marijuana, cocaine, and/or heroin and had complete arrest data (n = 614) assess the association between adolescent vs. adult initiation, short vs. long duration of use, and their interaction with the outcomes of arrest, incarceration, and criminal career length, as well as meeting criteria for a drug use disorder. RESULTS: Findings show that onset and duration are highly related, but when independent effects of duration and onset are assessed, only duration is a statistically significant predictor of all four crime outcomes, as well as a predictor of meeting criteria for a drug use disorder in adjusted regression models. Associations of duration with arrests held for all crime types (i.e., drug, property, violence). Adolescent vs. adult drug onset only predicted meeting lifetime criteria for a drug use disorder. The interaction of onset and duration was not statistically significant in any models. No appreciable differences were observed in gender specific models. DISCUSSION: Findings suggest that shortening drug use duration may have a greater impact on reducing the association of drug use with crime for African Americans than delaying onset.

Explaining continuity in substance use: The role of criminal justice system involvement over the life course of an urban African American prospective cohort.

BACKGROUND: African Americans are disproportionately burdened by substance use consequences and criminal justice system involvement, yet their interrelationship over the life course is not well understood. This study aimed to assess how substance use, crime, and justice system involvement may influence one another from adolescence to midlife. METHODS: Data come from a community cohort of urban African Americans first assessed in childhood and followed up into midlife (n = 1242, 606 males, 636 females). We draw on interview data and local, state, and federal criminal records. Participants were assessed at ages 6, 16, 32, and 42, with additional record retrieval at age 52. Utilizing structural equation modeling, we estimate pathways between substance use, criminal behavior, and arrests over time by gender. RESULTS: For males, significant paths were found between childhood behavioral problems and adolescent substance use, delinquency, and police interactions. For females, a significant path was found between childhood behavioral problems and only adolescent delinquency. We observed continuity between substance use and between arrest constructs from adolescence through midlife for men only. Direct paths were found between substance use and later arrests for both males and females. Paths were also observed between arrests and later substance use for both genders. CONCLUSIONS: Findings of reciprocal relationships highlight the critical need to break the cycle of substance use and crime and point to specific times in the life course when intervention is necessary. Findings introduce the potential role of the criminal justice system as a key intervention agent in redirecting substance use careers.

Young Adult Victimization and Midlife Consequences: Sensitization or Steeling Effects of Childhood Adversity?

The interrelationship between victimization, violence, and substance use/abuse has been well established, yet those who experience victimization do not necessarily respond with violence or substance use or escalate to experiencing substance abuse symptoms. Drawing on literature from both the syndemic research from medical anthropology and the resilience research from psychology, this study examines the interaction between early childhood adversity and young adult violent victimization on later substance use/abuse and violent offending to provide insight into conditional effects. Data are derived from the Woodlawn Study, an African American cohort of men and women from a socioeconomically heterogeneous community in the South Side of Chicago, who were followed from first grade through age 42. Results indicate that those with lower levels of childhood adversity are more likely to suffer the negative consequences of violent victimization than those with higher childhood adversity, providing support for a "steeling" effect.

Social Stigma Toward Persons With Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health-Oriented Policies.

OBJECTIVE: Prescription opioid use disorder and overdose have emerged as significant public health challenges in the past 15 years. Little is known about public attitudes toward individuals who have developed a prescription opioid use disorder and whether these attitudes affect support for policy interventions. This study examined social stigma toward individuals with prescription opioid use disorder and tested whether stigma was associated with support for various policy interventions. METHODS: A nationally representative Web-based survey was conducted from January 31 to February 28, 2014. The 1,071 respondents reported on their beliefs about and attitudes toward persons affected by prescription opioid use disorder and rated their support for various policy interventions. Ordered logistic regression models estimated the association between stigma and public support for punitive and public health-oriented policies. RESULTS: Most respondents viewed this disorder as affecting all groups-racial and ethnic, income, and geographic area of residence groups-fairly equally, despite epidemiological data demonstrating that certain populations have been disproportionately burdened. Respondents expressed high levels of stigma toward individuals with prescription opioid use disorder. Levels of stigma were generally similar among those with and without experience with prescription opioid use disorder, either one's own or that of a relative or close friend. Higher levels of stigma were associated with greater support for punitive policies and lower support for public health-oriented policies. CONCLUSIONS: Reframing the issue to emphasize the structural factors contributing to prescription opioid use disorder and the barriers to accessing evidence-based treatment might improve support for policies that benefit affected individuals.

Long-term consequences of adolescent cannabis use: Examining intermediary processes.

BACKGROUND: In the United States, perceptions of marijuana's acceptability are at an all-time high, risk perceptions among youth are low, and rates are rising among Black youth. Thus, it is imperative to increase the understanding of long-term effects of adolescent marijuana use and ways to mitigate adverse consequences. OBJECTIVES: To identify the midlife consequences of heavy adolescent marijuana use and the mechanisms driving effects among a Black, urban population. METHODS: This study analyzed the propensity score-matched prospective data from the Woodlawn Study, a community cohort study of urban Black youth followed from ages 6-42. After matching the 165 adolescents who used marijuana heavily to 165 non-heavy/nonusers on background confounders to reduce selection effects (64.5% male), we tested the association of heavy marijuana use by age 16 with social, economic, and physical and psychological health outcomes in midlife and the ability of adult drug trajectories (marijuana, cocaine, and heroin use from ages 17-42) and school dropout to mediate effects. RESULTS: Heavy adolescent marijuana use was associated with an increased risk of being poor and of being unmarried in midlife. Marijuana use also predicted lower income and greater anxious mood in midlife. Both adult drug use trajectories and school dropout significantly mediated socioeconomic effects but not marital or anxious mood outcomes. CONCLUSION: Heavy adolescent marijuana use seems to set Black, urban youth on a long-term trajectory of disadvantage that persists into midlife. It is critical to interrupt this long-term disadvantage through the prevention of heavy adolescent marijuana use, long-term marijuana and other drug use, and school dropout.

Examining the Consequences of the "Prevalent Life Events" of Arrest and Incarceration among an Urban African-American Cohort.

The life course perspective has traditionally examined prevalent adult life events, such as marriage and employment, and their potential to redirect offending trajectories. However, for African Americans, the life events of arrest and incarceration are becoming equally prevalent in young adulthood. Therefore, it is critical to understand how these "standard" criminal justice practices, which are designed to deter as well as punish, affect deviance among this population. This study evaluates the long-term consequences of criminal justice intervention on substance use and offending into midlife among an African American community cohort using propensity score matching and multivariate regression analyses. The results largely point to a criminogenic effect of criminal justice intervention on midlife deviance with a particularly strong effect of young adult arrest on rates of violent and property arrest counts into midlife. The theoretical and policy implications of the findings are discussed.

Pathways from Early Childhood Adversity to Later Adult Drug Use and Psychological Distress: A Prospective Study of a Cohort of African Americans.

Drawing on the life course perspective, this research addresses the direct and indirect pathways between childhood adversity and midlife psychological distress and drug use across a majority of the life span in an African American cohort (N = 1,242) followed from age 6 to 42 (1966 to 2002). Results from structural equation models highlight the impact of low childhood socioeconomic status (SES), poor maternal mental health, and the role of first-grade maladaptation in launching a trajectory of social maladaptation from age 6 to 42. Specifically, for men, we found a direct pathway from early low SES to drug use in mid adulthood and an indirect pathway to psychological distress through first-grade maladaptation and adolescent poor mental health. For females, early SES affected first-grade maladaptation and low school bonds, which then predicted later drug use.

Effect of Adolescent Cigarette Smoking on Adulthood Substance Use and Abuse: The Mediating Role of Educational Attainment.

BACKGROUND: Even though the association between cigarette smoking and later substance use has been shown, there is still no compelling evidence that demonstrates the long-term effects in a high drug using community in African Americans. Few studies have examined the mediating mechanisms of the effect of adolescent cigarette smoking on the drug progression pathway. OBJECTIVES: We examined the long-term influence of adolescent smoking on later illegal drug use in a cohort of urban African Americans, and the mediating role of educational attainment in the drug progression pathway. METHODS: The study used a longitudinal dataset from the Woodlawn Project that followed 1,242 African Americans from 1966-1967 (at age 6-7) through 2002-2003 (at age 42-43). We used the propensity score matching method to find a regular and a nonregular adolescent smoking group that had similar childhood characteristics; we used the matched sample to assess the association between adolescent smoking and drug progression, and the mediating role of educational attainment. RESULTS: Adolescent regular smokers showed significantly higher odds of using marijuana, cocaine, and heroin, having alcohol abuse problems and any drug dependence, and abuse problems in adulthood. We found that educational attainment mediated most of the drug progression pathway, including cigarette smoking, marijuana, cocaine and heroin use, and drug dependence or abuse problems in adulthood, but not alcohol abuse. CONCLUSIONS: More focus needs to be put on high school dropout and development of interventions in community settings for African Americans to alter the pathway for drug progression for adolescents who use cigarettes regularly.

Taking a life course approach to studying substance use treatment among a community cohort of African American substance users.

BACKGROUND: Life course theory emphasizes the need to examine a wide variety of distal factors along with proximal factors, longitudinally. Yet research on who obtains substance use treatment is generally cross-sectional and limited to examining developmentally proximal factors (e.g., substance use severity) and demographic factors. METHODS: To investigate treatment within a life-course framework, we studied 522 drug and/or alcohol users from a community cohort of African Americans followed prospectively from age 6. Developmentally distal factors of childhood and adolescent social behavior, family environment, academic achievement, mental health, and substance use along with the key proximal factors of substance use severity and socioeconomic status were examined using regression analyses to assess their impact on obtaining adult substance use treatment. RESULTS: One-fifth of the study population obtained treatment for substance use by age 32 (20.5%). Although adult socioeconomic status was not associated with substance use treatment in adulthood in the multivariable model, the proximal factor of substance use severity was a strong predictor of obtaining substance use treatment, as expected. After including several developmentally distal factors in the model, childhood aggression also had an independent effect on adult substance use treatment, above and beyond substance use severity. CONCLUSIONS: These findings emphasize the importance of using a life course framework when exploring predictors of treatment; early life characteristics are important influences beyond the more proximal factors in adulthood. Research should continue to take a life course approach to better understand pathways to substance use treatment.

Long-term effects of adolescent smoking on depression and socioeconomic status in adulthood in an urban African American cohort.

Despite known adverse causal effects of cigarette smoking on mental health, findings for the effects of adolescent cigarette smoking on later depression and socioeconomic status remain inconclusive. Previous studies have had shorter follow-up periods and did not have a representative portion of the African American population. Using an analytical method that matches adolescent smokers with nonsmokers on childhood and background variables, this study aims to provide evidence on the effects of adolescent regular smoking on adult depression and socioeconomic status. Our longitudinal study is from the Woodlawn Study that followed 1,242 African Americans in Chicago from 1966-1967 (at age 6-7) through 2002-2003 (at age 42-43). We used a propensity score matching method to find a regular and a non-regular adolescent smoking group with similar childhood socioeconomic and family background and first grade academic and behavioral performance. We compared the matched samples to assess the longitudinal effects of adolescent smoking on adult outcomes. Comparing the matched 199 adolescent regular smokers and 199 non-regular smokers, we found statistical support for the effects of adolescent cigarette smoking on later educational attainment (OR, 2.13; 95 % CI, 1.34, 3.39) and long-term unemployment (OR, 1.74; 95 % CI, 1.11, 2.75), but did not find support for the effects on adulthood major depressive disorders. With a community population of urban African Americans followed for 40 years, our study contributes to the understanding of the relationships between adolescent smoking and later educational attainment and employment.

Do the adult criminal careers of African Americans fit the "facts"?

PURPOSE: A major gap in the criminal career research is our understanding of offending among African Americans, especially beyond early adulthood. In light of this gap, this study describes the criminal career patterns of a cohort of African American males and females. METHODS: This paper uses official criminal history data spanning ages 17 to 52 from the Woodlawn Study, a community cohort of 1,242 urban African American males and females. We use basic descriptive statistics as well as group-based modeling to provide a detailed description of the various dimensions of their adult criminal careers. RESULTS: We find cumulative prevalence rates similar to those for African Americans from national probability sample estimates, yet participation in offending extends farther into midlife than expected with a substantial proportion of the cohort still engaged in offending into their 30s. CONCLUSIONS: The descriptive analyses contribute to the larger body of knowledge regarding the relationship between age and crime and the unfolding of the criminal career for African American males and females. The applicability of existing life course and developmental theories is discussed in light of the findings.

Marriage and Offending among a Cohort of Disadvantaged African Americans.

OBJECTIVES: Drawing on Sampson and Laub's age-graded theory of informal social control, this research tests the generalizability of the marriage effect on desistance from crime. Specifically, do urban African American men and women living in the United States benefit from marriage similarly to Whites? METHODS: The authors use hierarchical linear modeling (HLM) to analyze the relationship between marriage and official arrest counts among African American male and female first graders from Woodlawn, an inner-city community in Chicago, first assessed in 1966 and followed up at three time points (ages 16, 32, and 42). RESULTS: The authors find strong evidence of a marriage effect for the males across crime type, with a reduction in offending between 21 percent and 36 percent when in a state of marriage. The findings for females were less consistent across crime type, a 10 percent reduction in the odds of a property arrest and a 9 percent increase in the odds of a drug arrest when in a state of marriage. CONCLUSIONS: Their findings provide evidence in favor of the generality of Sampson and Laub's theory, at least for males. However, the authors were not able to evaluate the mechanisms of desistance and identify this as an area of future research.

Early life predictors of adult depression in a community cohort of urban African Americans.

Depression among African Americans residing in urban communities is a complex, major public health problem; however, few studies identify early life risk factors for depression among urban African American men and women. To better inform prevention programming, this study uses data from the Woodlawn Study, a well-defined community cohort of urban African Americans followed from age 6 to 42 years, to determine depression prevalence through midlife and identify childhood and adolescent risk factors for adult depression separately by gender. Results indicate that lifetime depression rates do not differ significantly by gender (16.2 % of men, 18.8 % of women) in contrast to findings of a higher prevalence for women in national studies. Furthermore, rates of depression in this urban African American population are higher than those found in national samples of African Americans and more comparable to the higher rates found nationally among Whites. Regarding early predictors, for both men and women, family conflict in adolescence is a risk factor for adult depression in multivariate regression models. For women, vulnerability to depression has roots in early life, specifically, low maternal aspirations for school attainment. Females displaying more aggressive and delinquent behavior and those growing up in a female-headed household and a household with low maternal education have elevated rates of depression. Males growing up in persistent poverty, those engaging in greater delinquent behavior, and those with low parental supervision in adolescence also have elevated rates of depression. Effective prevention programming for urban African Americans must consider both individual characteristics and the family dynamic.

Childhood and adolescent risk factors for comorbid depression and substance use disorders in adulthood.

The comorbidity of major depression and substance use disorders is well documented. However, thorough understanding of prevalence and early risk factors for comorbidity in adulthood is lacking, particularly among urban African Americans. With data from the Woodlawn Study, which follows a community cohort of urban African Americans from ages 6 to 42, we identify the prevalence of comorbidity and childhood and adolescent risk factors of comorbid depression and substance use disorders, depression alone, and substance use disorders alone. Prevalence of comorbid substance use disorders and major depression in adulthood is 8.3% overall. Comorbidity in cohort men is twice that for women (11.1% vs. 5.7%). Adjusted multinomial regression models found few differences in risk factors for comorbidity compared to either major depression or a substance use disorder on its own. However, results do suggest distinct risk factors for depression without a substance use disorder in adulthood compared to a substance use disorder without depression in adulthood. In particular, low socioeconomic status and family conflict was related to increased risk of developing major depression in adulthood, while dropping out of high school was a statistically significant predictor of adult-onset substance use disorders. Early onset of marijuana use differentiated those with a substance use disorder with or without depression from those with depression without a substance use disorder in adjusted models. In conclusion, comorbid substance use disorders and depression are highly prevalent among these urban African Americans. Insight into the unique childhood and adolescent risk factors for depression compared to substance use disorders is critical to intervention development in urban communities. Results suggest that these programs must consider individual behaviors, as well as the early family dynamic.

A prospective study of childhood and adolescent antecedents of homelessness among a community population of African Americans.

Much is known about contemporaneous correlates of homelessness from studies of homeless individuals. However, few studies have prospectively examined early antecedents and prevalence of homelessness in community populations. We use data from a 35-year study of a community population of African Americans to examine relationships between homelessness and prior structural, family, school, and behavioral influences. Nearly 22% of males and 16% of females reported homelessness between ages 15 and 42, providing a rare estimate within an African American urban community population. In bivariate analyses, lower school bonds, depressed mood, violent behavior, and running away in adolescence are predictive for both males and females. Teen parenting and angry mood are unique influences for females, while for males, poor first grade classroom conduct and adolescent substance use are unique risks. In multivariate analyses, poor classroom conduct and weaker school bonds predict homelessness among males, while teen parenting does so for females. Running away before age 15 is strongly predictive of later homelessness for both males and females. These results reveal the relative influence of multiple, interrelated early risks on homelessness and confirm our hypothesis that factors linked to other poor outcomes also relate to homelessness, underscoring another benefit to early prevention efforts.

Interrelationship of substance use and psychological distress over the life course among a cohort of urban African Americans.

BACKGROUND: Substance use and psychological problems are major public health issues because of their high prevalence, co-occurrence, clustering in socio-economically disadvantaged groups, and serious consequences. However, their interrelationship over time is not well understood. METHODS: This study identifies and compares the developmental epidemiology from age 6 to 42 of substance use and psychological distress in a population of African American men and women. Data come from the Woodlawn study, a longitudinal study of an urban community cohort followed since 1966. We use structural equation modeling to examine pathways between substance use (i.e., alcohol, marijuana, and cocaine) and psychological distress over time by gender. RESULTS: We find significant continuity from adolescence to midlife for substance use and for psychological distress, as well as significant correlations within time periods between substance use and psychological distress, particularly among women. We also find greater adolescent substance use predicts psychological distress in young adulthood for men, but no cross-lag associations for women. Women's adolescent psychological distress and substance use are linked uniquely to that of their mothers. Findings show additional gender differences in the developmental etiology of substance use and psychological distress. CONCLUSIONS: Findings demonstrate the continuity of substance use and psychological distress over time; the contemporaneous relationships between psychological distress and substance use within time periods, and minimal cross-lagged relationships. Findings also show that adolescent substance use may set boys on a pathway of long-term psychological distress, thus adding to evidence of negative consequences of frequent use.

The Impact of Adolescent Deviance on Marital Trajectories.

Marriage is a key life event that has numerous benefits. Recent research extends these benefits to include desistance from crime and drug use yet there has been little investigation regarding whether deviant behavior in adolescence impacts long-term marital patterns. Since rates of marriage are low among African Americans and rates of adolescent deviance and crime are high, we investigate the long-term relationship between the two drawing on longitudinal data from the Woodlawn cohort of urban African Americans. This article investigates whether serious adolescent delinquency and marijuana use predict marital trajectories, controlling for known correlates. Multivariate findings indicate that within this African-American population, deviance predicts the probability of marriage, stability of marriage, and timing of marriage for men yet deviance relates solely to the probability of marriage for women.

A longitudinal study of substance use and violent victimization in adulthood among a cohort of urban African Americans.

AIMS: This paper examines the effects of experiencing violent victimization in young adulthood on pathways of substance use from adolescence to mid-adulthood. DESIGN: Data come from four assessments of an African American community cohort followed longitudinally from age 6 to 42 years. SETTING: The cohort lived in the urban, disadvantaged Woodlawn neighborhood of Chicago in 1966. PARTICIPANTS: All first graders from the public and parochial schools were asked to participate (n = 1242). MEASUREMENT: Dependent variables-alcohol, marijuana and cocaine use-came from self-reports at age 42. Young adult violent victimization was reported at age 32, as were acts of violence, substance use, social integration and socio-economic resources. First grade risk factors came from mothers' and teachers' reports; adolescent substance use was self-reported. FINDINGS: Structural equation models indicate a pathway from adolescent substance use to young adult violent victimization for females and those who did not grow up in extreme poverty (betas ranging from 0.15 to 0.20, P < 0.05). In turn, experiencing violent victimization in young adulthood increased alcohol, marijuana and cocaine use, yet results varied by gender and early poverty status (betas ranging from 0.12 to 0.15, P < 0.05). CONCLUSIONS: Violent victimization appears to play an important role in perpetuating substance use among the African American population. However, within-group variations are evident, identifying those who are not raised in extreme poverty as the most negatively affected by violence.

Marriage Trajectories and Health Risk Behaviors Throughout Adulthood Among Urban African Americans.

Although previous studies have identified a protective effect of marriage on risky health behaviors, gaps remain in our understanding of how marriage improves health, particularly among African Americans. This study uses longitudinal data to take selection into account and examines whether marital trajectories that incorporate timing, stability, and duration of marriage affect health risk behaviors among a community cohort of urban African Americans followed for 35 years (N = 1,049). For both men and women, we find six marital trajectories. Men and women in consistently married trajectories are less likely to smoke, drink heavily (women only), and use illegal drugs than those in unmarried or previously married trajectories. Late marrying men do not fare worse in midlife than men in earlier marrying trajectories, but late marrying women show increased risk of midlife drug use. Results suggest policies supporting marriage may have an impact on health but only if stable unions are achieved.