1997 National Household Survey on Drug Abuse
Drug Use, by Family Income, Health Insurance Status, and Welfare Assistance (Tables 13.1 and 13.2)
Table 13.1 shows past year rates of illicit drug use, marijuana use, and cocaine use by total yearly family income and health insurance status for each age group and for the total population. For the total population, the rates of any past year illicit drug use and marijuana use were similar across income levels, with the exception that people at the lowest level of total family income (less than $9,000) were significantly more likely than those in the other income categories to have used any illicit drug or marijuana in the past year. Among youths aged 12 to 17, rates of drug use were generally unrelated to family income level.
In the total population, people without health insurance were more than twice as likely as those with insurance to have used any illicit drug (20% vs. 10%), marijuana (16% vs. 8%), or cocaine (4% vs. 2%) in the past year. Drug use was not significantly related, however, to health insurance status for youths. For each of the drug use measures, the gap between the insured and uninsured adults increased as age increased.
For the total population aged 12 or older, the estimates of drug use were nearly twice as high among people who reported that they or someone in their household received welfare assistance during the past year (Table 13.2). For example, about 18% of people in households where someone had received welfare reported past year illicit drug use compared with about 11% of people in households without a family member receiving welfare. Among adults aged 35 or older, those who received welfare were three times more likely than those who did not to have used marijuana or cocaine in the past year.
Because significant relationships between drug use and receipt of welfare assistance were not observed for most age groups, the previous findings of significant relationships in the total population, and specifically in the older adult population, should be interpreted with caution. In particular, the prevalences of past year use of any illicit drug and marijuana in 1997 were highest among young adults and youths (Tables 2.10 and 3.2). Further analysis of these NHSDA data also indicate that people aged 12 to 25 comprised about 40% of the people in households where someone received welfare assistance (data not shown in Table 13.3), even though these two age groups comprised less than one-fourth of the total population aged 12 or older in 1997 (Table 1.2). These NHSDA estimates are consistent with U.S. Bureau of the Census data, which show that more than three-fourths of people receiving Aid to Families with Dependent Children (AFDC) or General Assistance benefits were under the age of 18, and that more than three-fourths of mothers receiving AFDC were under the age of 35 (U.S. Bureau of the Census, 1996).28 Therefore, the relationships between drug use and welfare assistance in the total population may be due in part to a disproportionate representation of youths and young adults in the "do receive" welfare assistance category. Multivariate analyses could help establish whether receipt of welfare assistance is an independent predictor of drug use, or whether the observed relationship between drug use and welfare assistance in the total population is an artifact due to the confounding influence of age.
27 For example, the Contract with America Advancement Act of 1996 (Public Law 104-121, enacted March 29, 1996) stipulates that alcoholism and drug addiction may no longer be considered disabilities under the Federal Social Security Act (42 U.S.C. 423(d)(2)). For a cost-benefit analysis of drug treatment for welfare recipients, see Gerstein, Johnson, Larison, Harwood, and Fountain (1996).
28 The NHSDA estimates presented above for the percentage of youths and young adults among people in households receiving welfare assistance are lower than the Census population data because the latter are restricted to actual recipients of benefits. In comparison, NHSDA respondents would still be included in the "do receive" welfare assistance category even if they were not the direct recipients of assistance-as long as someone in the household was a recipient. Thus, for example, a respondent over the age of 35 who was living in the same household with a grandchild receiving AFDC would be included in the "do receive" welfare assistance category.
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