Geography, Sociodemographic Factors, and the Risk of Substance Use Disorders
Few
studies have compared the sociodemographic factors associated
with drug use among people in urban, rural, and metropolitan
areas. To examine whether residence in these areas modifies the
relationship between sociodemographic factors and substance use
disorders, researchers employed a nationally representative survey
of 8098 adults in the United States aged 15–54 years.
- African
Americans were significantly protected against substance use
disorders in rural (odds ratios, OR, from 0.2 to 0.3) and urban
(ORs from 0.2 to 0.3), but not metropolitan, areas. - Workers
in services (ORs from 2.2 to 4.4) and craft (ORs from 2.3 to
3.7) occupations, compared with those not in the labor force,
were significantly more likely to have a substance use disorder
in most geographic areas (borderline significant increased
odds of drug abuse and dependence for rural service workers). - Metropolitan
residents in all occupations (compared with those not in the labor
force) and people with no health insurance in all geographic areas
(compared with those with private insurance) were also significantly
more likely to have a substance use disorder.
Comments:
This study suggests
that geographic context and occupation type may impact risk of substance
use disorders for some people. The relationship between these two
variables is complex (certain occupations increased odds regardless
of geographic context, while residents in one geographic area had
higher odds regardless of occupation). However, the relationship between
geography, insurance status, and the likelihood of a substance use
disorder appears clear—those without health insurance had higher
odds no matter where they lived.
Peter
D. Friedmann, MD, MPH
Reference:
Diala CC, Muntaner
C, Walrath C. Gender, occupational, and socioeconomic correlates of
alcohol and drug abuse among U.S. rural, metropolitan, and urban residents.
Am J Drug Alcohol Abuse. 2004;30(2):409–428.
(view
abstract)