Patterns and social determinants of substance use among Arizona Youth: A latent class analysis approach

Background: Substance use among youth often involves multiple types of substances. Little is known about how the use of common, lower-risk substances (e.g., alcohol, cigarettes, marijuana) co-occur with the less common and higher-risk substances (e.g., opioids and methamphetamine). Objectives: This study aims to identify distinctive substances use patterns and investigate the multi-level factors associated with substance use patterns under the social determinants of health framework. Methods: This study used data from the 2016 Arizona Youth Survey (n = .30,187). Latent class analysis (LCA) was used to identify the patterns based on 15 types of substances. We used multinomial logistical regression to explore the correlates of substance use classification. Results: We identified a five-group model: (1) Serious Users, (2) Moderate Users, (3) Non-progressive Users, (4) Common Substance Users, (5) Abstainers. We found that variables at the individual, peers, family, school, and community levels were associated with the group membership. Conclusions/Importance: The findings advanced knowledge about key eco-systemic factors and their role as predictors of substance use patterns. Examining the predictors at multi-levels also provided a strong foundation for the design of future interventions.