Among 1,369 postpartum African American women, those perceiving their neighborhoods as most dangerous, disorderly, or lacking social cohesion had roughly twice the odds of prenatal cannabis use.
Maternal health researchers, public health planners, social determinants of health researchers
Nearly 2x odds of prenatal cannabis use in worst-perceived neighborhoods
What the researchers found
Out of 1,369 postpartum African American women in Metropolitan Detroit, 11% reported using cannabis during pregnancy. After adjusting for age, marital status, income, education, and social support, women perceiving the worst neighborhood conditions had significantly higher odds of cannabis use: social cohesion/trust OR 1.77 (95% CI: 1.04-3.03), social disorder OR 1.83 (95% CI: 1.15-2.91), and danger/safety OR 1.93 (95% CI: 1.12-3.31). Perceived stress mediated the association only for the danger/safety pathway.
Why it matters
Prenatal cannabis use does not happen in a vacuum. This study demonstrates that the neighborhood environment where pregnant women live shapes their substance use decisions, suggesting that addressing community-level factors may be more effective than individual-level messaging alone.
The numbers in context
n=1,369; 11% reported prenatal cannabis use; worst neighborhood safety: OR 1.93 (95% CI: 1.12-3.31); worst social disorder: OR 1.83 (95% CI: 1.15-2.91); worst social cohesion: OR 1.77 (95% CI: 1.04-3.03)
How the study worked
Data from the Life-Course Influences on Fetal Environments (LIFE) Study, a retrospective cohort of postpartum African American women in Metropolitan Detroit, Michigan (2009-2011). Three perceived neighborhood scales assessed: social cohesion/trust, social disorder, and danger/safety. Logistic regression with adjustment for demographics and mediation analysis for perceived stress.
What this study cannot tell us
Self-reported cannabis use likely underestimates true prevalence. Retrospective cohort design with data from 2009-2011 may not reflect current patterns. Limited to African American women in one metro area. Perceived neighborhood environment is subjective and may not match objective measures.
How to read the evidence
Moderate sample size with appropriate statistical adjustments and mediation analysis provides moderate evidence, though retrospective self-report and single-city recruitment limit generalizability.
When this study was published
2025 publication analyzing data from the LIFE Study (2009-2011)
The bigger picture
This study connects prenatal cannabis use to structural determinants of health rather than treating it solely as an individual choice. The finding that perceived stress mediates the danger/safety pathway specifically suggests that neighborhood violence and instability may drive prenatal cannabis use through stress pathways.
Questions still open
- Would neighborhood-level interventions that improve safety or social cohesion reduce prenatal cannabis use? Do these neighborhood effects on prenatal cannabis use extend to other racial/ethnic groups?
Common questions
How does neighborhood environment affect prenatal cannabis use?
Does stress explain the connection?
Read the original research
Effect of Perceived Neighborhood Environment on Cannabis Use during Pregnancy among African American Women.
Journal of urban health : bulletin of the New York Academy of Medicine, 102(1), 139-151
Citation
Al-Sahab, Ban; LaMarche, Cassandra; Liang, Xiaoyu; Dailey, Rhonda; Misra, Dawn P. (2025). Effect of Perceived Neighborhood Environment on Cannabis Use during Pregnancy among African American Women.. Journal of urban health : bulletin of the New York Academy of Medicine, 102(1), 139-151. https://doi.org/10.1007/s11524-024-00958-5
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