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Original Article |

Macroeconomic Environment During Infancy as a Possible Risk Factor for Adolescent Behavioral Problems

Seethalakshmi Ramanathan, MBBS, DPM; Natarajan Balasubramanian, PhD; Rajeev Krishnadas, MBBS, MRCPsych
JAMA Psychiatry. 2013;70(2):218-225. doi:10.1001/jamapsychiatry.2013.280.
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Context  Economic difficulties at the individual level can lead to a number of behavioral problems, including substance abuse and delinquent behaviors.

Objective  To examine the influence of a nationwide adverse economic environment during infancy, specifically, the high unemployment rates during and after the 1980 and 1981-1982 recessions, on rates of subsequent adolescent substance use and delinquent behaviors.

Design  We used data from the National Longitudinal Survey of Youth 1997 and estimated logit regressions to examine the effect of changes in unemployment rates during infancy on the incidence of adolescent behavioral problems, controlling for known youth, family, and environmental risk factors.

Setting  Adolescents living in the United States in 1997.

Participants  Nationally representative sample of 8984 adolescents born from January 1, 1980, through December 31, 1984.

Main Outcome Measures  Probability of engaging in substance use (marijuana, smoking, alcohol, and hard [ie, illegal] drugs) and delinquent behaviors (arrest, handgun use, gang affiliation, petty and major theft, property destruction, and assaultive behavior).

Results  Exposure to a 1% deviation from mean regional unemployment rates at the age of 1 year was associated with an increase in the odds ratios of engaging in marijuana use (1.09 [95% CI, 1.04-1.14]), smoking (1.07 [1.03-1.11]), alcohol use (1.06 [1.02-1.10]), arrest (1.17 [1.09-1.25]), gang affiliation (1.09 [1.00-1.19]), and petty (1.06 [1.01-1.10]) and major theft (1.11 [1.05-1.18]). No significant associations were noted with use of hard drugs, property destruction, and assaultive behavior.

Conclusions  The macroeconomic environment during infancy can have serious long-term effects on substance use and delinquent behavior. These potential long-term effects can play an important role in policy making for adolescent mental health care.

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Figures

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Figure 1. Residuals and unemployment rates. A visual comparison of the national unemployment rate at 12 months of age with the predicted probability to engage in select behavioral problems. The behavioral problems are measured as the residuals from logistic regressions of the problem on all confounding variables. A, Marijuana use. B, Smoking. C, Alcohol use. D, Arrest.

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Figure 2. Macroeconomic unemployment rates at infancy and problem behavior. The predicted propensity of engaging in various behavioral problems during adolescence for youth who turned 1 year of age in a period of low unemployment (<7.25%) and who turned 1 year of age in a period of high unemployment (>9.25%). These 2 rates were approximately the 25th and 75th percentiles of unemployment rates during the study period. The lines for higher unemployment rate start at a later age than the line for lower unemployment rate because the periods of higher unemployment occurred in the earlier part of the study period. A, Marijuana use. B, Smoking. C, Alcohol use. D, Arrest. E, Petty theft. F, Major theft. The predicted probability of a problem behavior was calculated as a fractional polynomial fit of logit residuals (scales differ across graphs). Shaded areas indicate 95% confidence intervals.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

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