Community distress and substance misuse are often conjoined social problems. In Newark, NJ, the state’s largest city and the seat of Essex County, the average annual household income is $13,009. Forty-two percent of residents age 24 and older have not completed high school. Fifty-four percent of all residents are African-American. They consistently show poorer health and socio-economic outcomes when compared to African Americans in more affluent neighboring areas. Newark has the highest prevalence of substance use and HIV/AIDS in the State of New Jersey. HIV and hepatitis infection rates among injection drug users (IDUs) is substantially greater in Newark than in nearby New York City.
Goal of the Study
The current study aimed to engage individuals from low-income African American communities in Newark (henceforth, “Newark’s distressed neighborhoods”) to develop a framework for substance abuse treatment and HIV-prevention programs that would be relevant to low-income African Americans.
We applied community-based participatory research (CBPR) principles to the implementation of concept mapping with a sample of 100 service providers, individuals with substance use disorders, and community residents in Newark, NJ. Concept mapping is a structured method for translating complex qualitative data into a pictorial form that displays interrelationships among ideas. Concept mapping and focus groups were used to develop a framework interpreting the role of drugs and alcohol in Newark’s distressed neighborhoods. In implementing concept mapping, we followed the five steps shown in Figure 1.
Figure 1: Research process and individuals involved in each stage.
Findings were collapsed into three themes that best represented participants’ perspectives: (1) Impact of specific substance use on individuals and communities; (2) Impact of the drug trade and its players; and (3) Impact of substance use and the drug trade on the community. Below, we summarize each theme.
(1) Impact of specific substances on individuals and communities: This theme reflected dimensions of the map showing the interconnectedness of the impact of substance use on individuals and the impact of substance use on the community. For instance, participants discussed how the availability and cost of certain substances in the community impacted individual substance use. Prescription drugs were typically preferred by users over illegal drugs because they are safer (e.g., pharmaceutical companies are regulated and use standard formulas, while street dealers may use a variety of chemicals to dilute street drugs), and because withdrawal from prescription drugs is less likely to produce severe symptoms. However, heroin and other illegal drugs were cheaper than prescription drugs in Newark. Participants contended that substance users often turn to illegal drugs if they cannot afford to purchase prescription drugs in the illegal market.
(2) Impact of the drug trade and its players: This theme referred to the individuals and organizations involved in the drug trade in Newark’s distressed neighborhoods. This includes drug dealers, neighborhood youth, the police, politicians, and business owners. Study participants explained that all these groups benefit from the drug trade, at the expense of impoverished youth. For example, politicians develop punitive policies that serve their political interests. The police, including some corrupt officers, implement these policies in the community, creating suspicion and fear among residents. Drug possession typically carries a heavy sentence. To protect themselves, higher-level drug dealers need protection, and, as they are unwilling to risk heavy prison sentences, they employ neighborhood youth and street drug sellers as lookouts. Businesses also benefit from the trade, as many bodegas serve as storage locations for drugs, and other kinds of retail businesses, such as clothing stores, sell products popular with the “flashy drug-dealer lifestyle.”
(3) Impact of substance use and drug trade on the community: This theme reflected the relationships between substance use, drug trade, and crime. Participants talked about being exposed to drug-related violence, including witnessing shootings, being interrogated by the police about crimes they did not commit, being afraid to visit different parts of the neighborhood, and being scared that their children would be victims of violence and/or would become addicted to drugs. Participants discussed the disadvantages that impoverished families face when living in neighborhoods by substance use and the drug trade, along with the racism, discrimination, and lack of opportunity that are already a part of residing in low-income communities. Participants also discussed a major change in neighborhood culture—the community no longer watches out for the welfare of its children. They explained that, in the past, people felt comfortable disciplining their neighbors’ children, but currently people are disconnected from one another and afraid of experiencing violence.
To see a more complete description of the findings and the pictorial map we created, click here