National data indicate that both substance use and psychological problems become more pronounced for African Americans in midlife, but few studies have examined the development of risk for these problems in African American communities, particularly into mid adulthood. Moreover, high rates of co-occurrence demand an approach that explores both unique and shared risk factors;however, these problems rarely have been studied together. Applying a developmental perspective, we aim to examine specific risk, protective, mediating, and moderating factors that influence later substance use and psychological problems among a community- based African American population followed longitudinally. In addition, there is a great need to determine how substance use and psychological problems contribute to physical health decline in mid adulthood. Spanning more than 35 years of life, the Woodlawn Study, an epidemiological, prospective study of an African American community cohort, provides extensive data for understanding risk and protective factors and the short- and long-term consequences of substance use and psychological problems outside the context of treatment. With data extending into midlife - a neglected dimension of the life course - early risk factors and key mediating and moderating influences can be identified in an understudied population. This cohort was assessed initially as first graders in 1966-67 (N=1242), and followed up in adolescence (age 15-16), early adulthood (age 32-33), and mid-adulthood (age 42-43), creating an unprecedented chronicle of individual, family, and environmental characteristics, diverse life-course experiences, and their ultimate consequences. Guided by the Life Course Social Field Theory, the study focuses on: the developmental epidemiology of substance use and disorders and psychological problems through midlife, identifying onset, persistence, remission, co-occurrence, and reciprocal effects;childhood and adolescent risk factors for adult substance use and disorders and psychological problems;mediating and moderating influences on early risk factors;and physical health consequences in adulthood. Analytic methods include structural equation modeling, propensity score matching, general growth mixture modeling, and latent class, survival, and cluster analyses. Improved understanding of the timing and mechanisms for development of risk for substance use and psychological problems will provide essential guidance in designing effective prevention and intervention programs.
PROJECT NARRATIVE/PUBLIC HEALTH SIGNIFICANCE The public health relevance of this project is to inform the design of prevention and intervention programs for substance use and psychological problems among African Americans into midlife. The project will also provide critical insight into physical health problems of urban African Americans during mid-adulthood, identifying the contribution of psychopathology to specific health problems.
|Dagher, Rada K; Green, Kerry M (2015) Does depression and substance abuse co-morbidity affect socioeconomic status? Evidence from a prospective study of urban African Americans. Psychiatry Res 225:115-21|
|Assini-Meytin, Luciana C; Green, Kerry M (2015) Long-term consequences of adolescent parenthood among African-American urban youth: a propensity score matching approach. J Adolesc Health 56:529-35|
|Green, Kerry M; Stuart, Elizabeth A (2014) Examining moderation analyses in propensity score methods: application to depression and substance use. J Consult Clin Psychol 82:773-83|
|Juon, Hee-Soon; Evans-Polce, Rebecca J; Ensminger, Margaret (2014) Early life conditions of overall and cause-specific mortality among inner-city African Americans. Am J Public Health 104:548-54|
|Green, Kerry M; Fothergill, Kate E; Robertson, Judith A et al. (2013) Early life predictors of adult depression in a community cohort of urban African Americans. J Urban Health 90:101-15|
|Doherty, Elaine Eggleston; Robertson, Judith A; Green, Kerry M et al. (2012) A longitudinal study of substance use and violent victimization in adulthood among a cohort of urban African Americans. Addiction 107:339-48|
|Green, Kerry M; Doherty, Elaine E; Fothergill, Kate E et al. (2012) Marriage Trajectories and Health Risk Behaviors Throughout Adulthood Among Urban African Americans. J Fam Issues 33:1595-1618|
|Green, Kerry M; Zebrak, Katarzyna A; Robertson, Judith A et al. (2012) Interrelationship of substance use and psychological distress over the life course among a cohort of urban African Americans. Drug Alcohol Depend 123:239-48|
|Green, Kerry M; Zebrak, Katarzyna A; Fothergill, Kate E et al. (2012) Childhood and adolescent risk factors for comorbid depression and substance use disorders in adulthood. Addict Behav 37:1240-7|
|Fothergill, Kate E; Doherty, Elaine E; Robertson, Judith A et al. (2012) A prospective study of childhood and adolescent antecedents of homelessness among a community population of African Americans. J Urban Health 89:432-46|
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