Life stage, substance use and health decline in a community cohort of urban African Americans.

This longitudinal study analyzed chronic health effects, predominantly somatic, resulting from substance use in a homogeneously urban African American community cohort (n = 411). Individual and collective effects of eight licit and illicit substances on change in perceived health (index of reported health conditions formulated as regressed change scores) were tested as the cohort matured into young adulthood. Ten additional measures of health behavior, social attainment and social networks were introduced to control against spurious causal attribution. Gender differences in direct and intercorrelated drug effects and their timing processes were observed. Substance use explained a larger share of the variance in men's health than in women's. In absolute numbers of health problems, however, substance use had a greater effect on women's health.