Among 743 urban adolescents, latent class analysis identified three profiles (No Neighborhood Risk Exposure/Low or No Use, High Exposure/Low or No Use, High Exposure/Polysubstance Use), and the authors conclude that low substance use should not be interpreted as low need among adolescents exposed to neighborhood risk.
Key Findings
Results
A three-class latent class solution best described patterns of neighborhood risk exposure and substance use among urban adolescents.
Cross-sectional survey of 743 adolescents aged 13-21 in a large Northeastern U.S. city.
Five dichotomous indicators were used: witnessed neighborhood violence, seen drugs sold in the neighborhood, and lifetime vaping, alcohol, and marijuana use.
Classes were: No Neighborhood Risk Exposure/Low or No Substance Use (34%), High Exposure/Low or No Use (40%), High Exposure/Polysubstance Use (26%).
Results
The largest class consisted of adolescents with high neighborhood risk exposure but low or no substance use.
The High Exposure/Low or No Use class comprised 40% of the sample.
Together with the polysubstance class, 66% of adolescents were in a high-exposure class.
Some adolescents report low to no substance use despite shared exposure to environmental risk.
Results
Compared with the High Exposure/Low or No Use class, the No Neighborhood Risk Exposure/Low or No Use class reported more neighborhood support and less racial discrimination.
Higher neighborhood support in the no-exposure class.
Lower racial discrimination in the no-exposure class.
Derived from multinomial logistic regression with the High Exposure/Low or No Use class as the reference.
Results
Compared with the High Exposure/Low or No Use class, the No Neighborhood Risk Exposure/Low or No Use class reported lower school absence and fewer suicidal thoughts.
Lower missing school in the no-exposure class.
Lower suicidal thoughts in the no-exposure class.
This suggests adolescents with high exposure but low use still carry greater behavioral and emotional burden than unexposed peers.
Results
The High Exposure/Polysubstance Use class differed from the High Exposure/Low or No Use class primarily by higher depressive symptoms.
Depressive symptoms were the main differentiating factor between the two high-exposure classes.
Both classes shared high exposure to neighborhood violence and visible drug activity.
Conclusions
The authors conclude that low substance use should not be interpreted as low need among adolescents exposed to neighborhood risk.
Adolescent health and well-being efforts should assess mental health distress, suicidal ideation, racial discrimination-related experiences, and school disengagement alongside substance use.
The study was guided by the adverse community experiences and resilience framework.
What This Means
This study surveyed 743 teens and young adults (ages 13-21) in a large Northeastern U.S. city about violence and drug selling they had seen in their neighborhoods, and whether they had ever vaped or used alcohol or marijuana. Statistical grouping found three types of young people: about one-third had little neighborhood exposure and low or no substance use, 40% had high exposure but low or no substance use, and about one-quarter had high exposure and used multiple substances.
Young people with high exposure but low substance use were not doing as well as those with no exposure. Compared with them, the unexposed group reported more neighborhood support and less racial discrimination, missed less school, and had fewer suicidal thoughts. Those with high exposure who used multiple substances differed from the high-exposure, low-use group mainly in having more depressive symptoms.
This research suggests that not using substances does not necessarily mean a young person in a high-risk neighborhood is doing well. The authors suggest that programs for youth should look at mental health, suicidal thoughts, experiences of racial discrimination, and school disengagement, not only substance use. Because the data were collected at one point in time, the study cannot show what causes what.
Weerakoon S, Opara-Mezue I. (2026). Neighborhood violence, visible drug activity, and substance use among urban youth: Mental health and community factors.. Drug and alcohol dependence. https://doi.org/10.1016/j.drugalcdep.2026.113400