Association of low-literacy with substance use in middle-school students

A. E. Green, T. C. Davis, C. L. Arnold, K. W. Green, P. Auinger, Robert S Byrd

Research output: Contribution to journalArticlepeer-review


Substance use among teens is a persistent threat to adolescent health. Identification of modifiable risk factors may allow for effective targeted interventions. Because of previous research by our team which found a significant relationship between low literacy and violence in adolescents, we investigated whether low literacy was also related to substance use. PURPOSE: This study investigated the relationship between substance use and below-grade read ng (≥ 2 grades below) in middle school youth. METHODS: From 1994-98, 480 young adolescents (ages 11-14) who volunteered for a summer track, field and literacy program in Shreveport, Louisiana were tested; 88% African-American, 60% male. This program, which was held in four low-income neighborhoods, assessed literacy using the SORT-R and self report of drug use using the CDC'S Youth Risk Behavior Survey. RESULTS: 45% of participants were reading below grade level. Comparing students reading on grade level with those reading below grade level, there was no significant difference in smoking and alcohol use. However, there was a significant difference in the last 30 days in binge drinking (5% vs. 12%, p=.004), marijuana use on school property (4% vs. 10%, p=.01) and cocaine use (3% vs. 8%, p = .02). Significant differences were also present in use of other illegal drugs (LSD, PCP, ecstasy, mushrooms, speed, ice, heroin, or pills without a prescription) (3% vs. 10%, p=.004), including steroids (4% vs. 11%, p=.005). When controlling for age, race and gender, below-grade readers were significantly more likely to report binge drinking (OR=2.6, 95%CI=1.3, 5.4), marijuana use (OR=3.0, CI=1.1, 8.0), cocaine use (OR=2.8, CI=1.1, 7.2), all in the last thirty days, or ever using crack (OR=3.9, CI=1.5, 10.2), steroids (OR=2.7, CI=1.2, 5.9) or other illicit drugs (OR=2.8. CI=1.2, 6.5). CONCLUSIONS: Among a largely low-income group of middle school students, low reading skills were common. Young adolescents with inadequate reading ability were much more likely to binge drink and use illicit drugs. Understanding how literacy relates to adolescent risk behavior may help develop prevention strategies for substance use.

Original languageEnglish (US)
JournalJournal of Investigative Medicine
Issue number2
StatePublished - Feb 1999

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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