This study examined the association between community disadvantage and substance use among adolescents referred to child protective services (CPS) and the interaction role of race/ethnicity in the association between community disadvantage and adolescent substance use. Findings revealed that higher county-level alcohol/drug mortality rates were associated with a higher risk of substance use across non-Hispanic Black, non-Hispanic white, and Hispanic adolescents. An interaction test showed that the association between county-level alcohol/drug mortality rates and risk of substance use was particularly stronger for non-Hispanic Black adolescents compared to non-Hispanic white adolescents. However, county-level vacant housing rates and low median household income did not show a significant association with adolescent substance use across all racial/ethnic groups. Results suggest that practitioners should screen for community-level substance risk levels to prevent substance use among historically marginalized racial-ethnic adolescents involved in CPS.
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