The Social Environment: Definitions, Measures, Challenges

1. The Social Environment: Definitions, Measures, Challenges Yonette F. Thomas, Ph.D. Chief, Epidemiology Research Branch Division of Epidemiology, Services and Prevention Research National Institute on Drug Abuse NIH/DHHS NIDA COUNCIL PRESENTATION February 7, 2007

2. Biology/Genes Environment DRUG Neurobiology Behavior Addiction

5. November 1-2, 2006 Meeting • Definition of the social environment; • Best measures or different elements of the social environment; • Methodological challenges, and • Leading constructs for drug abuse research.

6. Outline of Presentation • Thinking About the Social Environment • Definitions • Key Examples 2. Developing Social Environment Metrics for Drug Abuse Research • Common Elements and Measures • Methodological Challenges 3. Conclusions

7. Thinking About the Social Environment ►What is the Social Environment? ●Definitions ● Dimensions ● How applied in Epidemiologic Research

8. A person’s social environment includes their human relationships, living and working conditions, income level, educational background and the communities they are a part of. All of these are shown to have a powerful effect on health.

10. Epidemiological Triad

11. Social Environment Influences Health • For example, the coexistence of neighborhood disadvantage, drug use, and stress: • increases the number of stressors individuals are exposed to • may undermine individual psychosocial resources • decreases social resources available to individuals Boardman JD, Finch BK, Ellison CG, Williams DR, Jackson JS. Neighborhood disadvantage, stress, and drug use among adults. Journal of Health and Social Behavior. 2001;42(2):151-6

12. Social Environment Influences Health: Conceptual Model of Neighborhood Disadvantage, Life Stress and Drug Use Paradigm Psychological Resources Social Resources Neighborhood Disadvantage Drug Use Stressors Psychological Distress Boardman JD, Finch BK, Ellison CG, Williams DR, Jackson JS. Neighborhood disadvantage, stress, and drug use among adults. Journal of Health and Social Behavior. 2001;42(2):151-6

13. Thinking About the Social Environment ►Key Examples: ● Neighborhood Disadvantage ● Built Environment ● Multiple Levels of the Environment ● Social Environment and Behavior Genetics

15. Neighborhood Environment Influences Opportunity to Use Drugs in Late Childhood/Early Adolescence * * * * * * *p<0.05 Crum, et al., DAD 43 (1996) 155-161.

17. The Built Environment Influences Children’s School Conduct/Grades • A child living in a residential block was 74 times more likely to exhibit problem behavior, conduct/grades in the lowest 10%, than a child living in a mixed-use block. (Szapocznik et al., 2006, AJCP)

19. Association with Delinquent Peers Good FamilyManagement Neighborhood Disorganization Multiple Levels of Environment Influence the Etiology of Drug Problems • Monitoring • Clear Rules • Calmly Discuss • Praise school achievements • Reward Good Job • Don’t put me down • Get in trouble • Alcohol • Marijuana • Illegal • Arrest • Crime • Poverty • Drug Selling • Gangs • Rowdy or Undesirable Neighbors +.15 -.15 Alcohol Dependence +.25 Age 21 Hawkins, et al. Personal Communication

20. Gene and Environment Influences on Antisocial Behavior Depend on Developmental Stage Source: Virginia Twin Study, Kendler & Prescott, 2006 E3 E2 E1 A3 A2 C1 A1

21. Specific Interaction of Social Environment With Genotype Source: Caspi, et al. Science 2000, 297, 851-854.

22. Outline of Presentation • Thinking About the Social Environment • Definitions • Key Examples 2. Developing Social Environment Metrics for Drug Abuse Research • Common Elements and Measures • Methodological Challenges 3. Conclusions

23. Developing Social Environment Metrics for Drug Abuse Research • Common Elements and Measures • Methodological Challenges/Solutions

24. Family* Peers* School Neighborhood Community/Culture Domains *domains that have an individual element also have a genetic component; this probably also pertains (perhaps to a lesser extent) to neighborhoods and community/culture

25. Cross-cutting Themes Within Domains Time/Development

26. Developing Social Environment Metrics for Drug Abuse Research • Common Elements and Measures • Methodological Challenges/Solutions

27. Challenges Conceptual • The challenge of ubiquity • Identifying key associations among multiple levels of the social environment • Determining causes • Studying populations vs. individuals

28. Challenges Methodological • Specificity of construct and group definition • Selection vs. causation • Calculating statistical power for multilevel interactions • Differentiating between proximal mediators vs. confounders

29. Solutions Collect social environment data: • Survey data • Independent samples of community observers • Direct observation • Video surveys of neighborhoods • Observation methods of parent-child, romantic, and peer interactions, etc.

30. Solutions • Administrative/Archival data • Police department • School data • Public health surveillance • U.S. Census • Real estate data • City agencies • GIS

31. Conclusions • The social environment needs to be considered as a fundamental cause of drug-related behaviors. • Characteristics of the social environment can make communities particularly vulnerable to elevated rates of substance abuse. • Built environment changes need to be evaluated; statistical model must allow for changes over time

32. Conclusions • Each of these factors directly contribute to rates of drug use and can also exacerbate propensities to use or abuse drugs among certain individuals. • For use in gene-environment studies, the social environment must be measured just as thoroughly and rigorously as the human genome.

33. Division of Epidemiology, Services and Prevention Research Providing a foundation for NIDA’s public health mission.