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The Role of Social Status during the Transition from Adolescence into Adulthood on Smoking and Alcohol Behaviors


Across the life course, substance use is highest in adolescence and young adulthood in the U.S. Although substance use declines with age, a significant number of young adults go beyond normative to problematic use. Despite the strong relationship between low social status and poor health, substance use varies by social status in inconsistent ways. Smoking is higher among lower social status groups. Alcohol use is higher among higher social status groups. Substance use is often higher among Whites compared to racial/ethnic minorities. Problematic substance use is often higher among minorities compared to Whites. These inconsistent patterns may be due to drug type (e.g., smoking vs. alcohol) or difficulty in assessing social status during the transition to adulthood and across race/ethnicity.

The goal of this dissertation is to ascertain the effects of social status on substance use behaviors across race/ethnicity during the transition to adulthood using secondary data analysis of three waves of the National Longitudinal Study of Adolescent Health. Using social stratification theories and the life course perspective, this study conceptualized social status as a life-course construct from adolescence (ages 12-17) to young adulthood (ages 18-26) and adulthood (ages 24-32). Furthermore, social status was examined across the domains of economic, human, and social capitals. Cigarette smoking and heavy episodic alcohol use served as the key outcomes.

Through a person-oriented framework, latent class analysis captured the ebb and flow of social status advantages and disadvantages with four latent groups for the domains of economic and social capitals, and five groups for the domain of human capital. These latent classes were substantively similar across Whites, Blacks, and Latinos; however, variations within subgroups differed. Regardless of domain or race/ethnicity, persistently low social status had higher smoking prevalence when compared to other groups. For heavy episodic drinking, there was no clear pattern across domains and race/ethnicity, which suggest a complex picture that may be difficult to disaggregate. Overall, these findings highlight several dimensions of social status that present opportunities to reduce substance use disparities, and reveal life-course social status groupings from adolescence to adulthood that may provide important avenues to prevent problematic substance use.

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