Background

The assessment and tracking of social indicators in a statewide prevention needs assessment project is important since these "environmental" variables can potentially be utilized to predict risk for substance abuse in specific geographical areas of the state. When used in conjunction with other methods of assessing need, the effectiveness of the overall community needs assessment is enhanced (Fiorentine, 1994). These indicators can serve as relatively accessible measures of protective and risk factors that are available to be examined over time and to provide evidence for the need to focus on specific prevention message content and/or geographical areas for intervention.

The level of need for prevention services cannot be determined through simple counts of the number of current substance users within a given population. Rather methods for assessing the probability (or risk) of future substance use among those not currently using are needed, along with an assessment of the resources currently available within the population or community (Arthur & Blitz, 2000). These assessments can help a community reduce the probability of future drug abuse by providing them with tools needed to prioritize specific intervention targets and populations. A general model suggests that effective preventive programming requires: (1) information on the incidence and prevalence of substance abuse within a population, (2) information on the risk and protective factors for substance abuse to and finally (3) community-specific, multi-component strategies that focus on the risk and protective factors identified and prioritized in the population (Hawkins, et al, 1995).

The theoretical underpinnings of this Social Development Model (Hawkins, Catalano, & Miller, 1992) provide guidance in program planning based on a risk reduction approach and support the utility of epidemiological data, such as archival social indicators, to inform prevention policy. In essence, this model recognizes that several different, and frequently co-occurring, sociological variables are associated with substance abuse. It acknowledges that protective processes may reduce the negative effects of the presence of risk factors. This model also recognizes there are potential ecological or community factors that can interact with substance abuse or other problem behaviors. Thus, it becomes essential to identify geographical areas or subpopulations where protective factors are low or risk exposure is high. Especially when resources are limited, it is mandatory to prioritize risk factors and intervene in regions or with populations where higher risk factors exist.

Epidemiological data provide an empirical foundation for substance abuse prevention policy and programming by establishing the prevalence and intensity of risk and protective factors over time within communities, counties, regions, and states. With the assistance of a data-based monitoring system, policy and resource allocation can be targeted to preventive interventions that more effectively match needs.

Although there are archival, population-based data that have appeared relevant to the ecological assessment of substance abuse risk, only recently have they been systematically assembled and assessed for their validity and sensitivity as indicators of the risk for substance abuse in specific geographical areas. Given the relatively low cost associated with the collection of social indicators, in contrast to the collection of survey data, it should be a primary method in establishing an efficient risk monitoring system. However, there are problems associated with their use (Cagle & Banks, 1986; Gruenewald, 1997). To achieve a valid risk monitoring system, systematic assessment of the indicators’ validity and sensitivity to change over time and their utility for replacing or supplementing survey measures of risk and protective factors as a basis for prevention policy and planning is needed.

Social indicators do not always capture precisely the concepts they are intended to measure. They can, however, serve as useful surrogates when a more precise measure is unavailable. For example, the rate of juvenile arrests for violent crimes is an indicator of violent acts among juveniles, but it is not an ideal measure because it does not capture those violent acts that do not result in an arrest. Thus, the ‘events’ that make up the indicator rates may overestimate or underestimate the true prevalence of the outcome of interest. However, as long as the indicators represent a constant proportion of the true prevalence of the problem behavior, trends in the outcome indicators are meaningful.

The benefits of collecting ecological or social indicators include increased data comparability and availability across geographic areas of the state and for multiple years, and low cost and ease of data collection. When data are standardized, organized according to risk factors, and presented in comparable units (such as percentages or rates per thousand individuals in the population), relative risk across regions, counties, and communities can be assessed and compared for planning purposes. Comparisons of indicators of specific risk factors allow a means for planners to identify and prioritize risk factors to be targeted with focused prevention efforts in identified geographical areas or population groups.

The Six-State Consortium (a SAMHSA-funded prevention needs assessment project) completed a three year project to study the validity and utility of a set of social indicators as measures of specific, empirically established risk factors. While further analyses need to be done on the social indicator approach to monitoring individual risk factors, the results were encouraging. Thirteen risk factors and 40 indicators were identified that showed a strong correlation with rates of substance abuse in adolescents and risk factors measured through surveys. In addition, many of the indicators had strong face validity and would provide useful information to program planners to determine what specific types of prevention services were needed (such as family-focused, school-focused, or community-focused).