Margaret E Ensminger

• Ph.D.
• Chair at Johns Hopkins Bloomberg School of Public Health

While there is a growing literature on the relationship between incarceration and health, few studies have expanded the investigation of criminal justice system involvement and health to include the more common intervention of arrest. This study uses a quasi-experimental design to evaluate the long-term effect of arrest in young adulthood on health...

Background The association of drug use onset and duration with criminal careers has rarely been studied over the life course among African Americans, who are disproportionately impacted by the criminal justice system. Methods This study uses data from a community cohort of urban African Americans, first assessed at age 6 (n=1,242) and followed int...

Background: African Americans are disproportionately burdened by substance use consequences and criminal justice system involvement, yet their interrelationship over the life course is not well understood. This study aimed to assess how substance use, crime, and justice system involvement may influence one another from adolescence to midlife. Met...

The interrelationship between victimization, violence, and substance use/abuse has been well established, yet those who experience victimization do not necessarily respond with violence or substance use or escalate to experiencing substance abuse symptoms. Drawing on literature from both the syndemic research from medical anthropology and the resil...

Few studies have considered life course predictors of religiosity. We use the Woodlawn Study of a cohort of 1242 first-grade African American children followed over four time periods to age 42 to observe how early school behaviors, family characteristics and neighborhood and social resources relate to later religiosity. Past literature suggested se...

Objective: Prescription opioid use disorder and overdose have emerged as significant public health challenges in the past 15 years. Little is known about public attitudes toward individuals who have developed a prescription opioid use disorder and whether these attitudes affect support for policy interventions. This study examined social stigma to...

Background: In the United States, perceptions of marijuana's acceptability are at an all-time high, risk perceptions among youth are low, and rates are rising among Black youth. Thus, it is imperative to increase the understanding of long-term effects of adolescent marijuana use and ways to mitigate adverse consequences. Objectives: To identify...

Despite some stereotypes that may exist, substance use among African American adolescents is generally comparable to or somewhat less than use among White populations. However, evidence of a pattern shift emerges as they age into adulthood, when African Americans, compared to Whites, are more likely to initiate drug use and develop problem use, and...

Drawing on the life course perspective, this research addresses the direct and indirect pathways between childhood adversity and midlife psychological distress and drug use across a majority of the life span in an African American cohort (N = 1,242) followed from age 6 to 42 (1966 to 2002). Results from structural equation models highlight the impa...

Background Even though the association between cigarette smoking and later substance use has been shown in the literature, there is still no compelling evidence that demonstrates the long-term effect. Few studies have examined the mediating mechanisms of the effect of adolescent cigarette smoking on the drug progression pathway. Purpose We examin...

Background: Even though the association between cigarette smoking and later substance use has been shown, there is still no compelling evidence that demonstrates the long-term effects in a high drug using community in African Americans. Few studies have examined the mediating mechanisms of the effect of adolescent cigarette smoking on the drug prog...

Foodborne disease is a significant problem worldwide. Research exploring sources of outbreaks indicates a pronounced role for food workers' improper health and hygiene practice. To investigate food workers' perceptions of factors that impact proper food safety practice. Interviews with food service workers in Baltimore, MD, USA discussing food safe...

The life course perspective has traditionally examined prevalent adult life events, such as marriage and employment, and their potential to redirect offending trajectories. However, for African-Americans, the life events of arrest and incarceration are becoming equally prevalent in young adulthood. Therefore, it is critical to understand how these...

Purpose A major gap in the criminal career research is our understanding of offending among African Americans, especially beyond early adulthood. In light of this gap, this study describes the criminal career patterns of a cohort of African American males and females. Methods This paper uses official criminal history data spanning ages 17 to 52 fr...

Background: Life course theory emphasizes the need to examine a wide variety of distal factors along with proximal factors, longitudinally. Yet research on who obtains substance use treatment is generally cross-sectional and limited to examining developmentally proximal factors (e.g., substance use severity) and demographic factors. Methods: To...

INTRODUCTION: Certain life events, such as marriage and employment, have been demonstrated to redirect a person’s trajectory away from substance use and crime. One life event that may be particularly salient for African Americans is criminal justice system intervention as African Americans are more likely to be arrested and incarcerated than whites...

Introduction: Historically, African American adolescents have reported lower rates of marijuana use compared to Whites; however, recent national surveys have found significant increases among African American boys and girls. According to the most recent Youth Risk Behavior Surveillance System survey, African American male adolescents now have the h...

Despite known adverse causal effects of cigarette smoking on mental health, findings for the effects of adolescent cigarette smoking on later depression and socioeconomic status remain inconclusive. Previous studies have had shorter follow-up periods and did not have a representative portion of the African American population. Using an analytical m...

Introduction: Parental psychological distress, alcohol use, and child/adolescent behavior problems often occur together and can have devastating effects on families. While extant evidence suggests that parental psychological distress and alcohol use are associated with child/adolescent externalizing behavior, less is known about the longitudinal pa...

Objectives: We examined how early life conditions influence midlife overall and cause-specific mortality in a community cohort of disadvantaged African Americans. Methods: Using a prospective design, we assessed first-grade children and their teachers and families when children were 6 years old, with follow-up at ages 16, 32, and 42 years. We ob...

Objectives: Drawing on Sampson and Laub's age-graded theory of informal social control, this research tests the generalizability of the marriage effect on desistance from crime. Specifically, do urban African American men and women living in the United States benefit from marriage similarly to Whites? Methods: The authors use hierarchical linear...

Although previous studies have identified a protective effect of marriage on risky health behaviors, gaps remain in our understanding of how marriage improves health, particularly among African Americans. This study uses longitudinal data to take selection into account and examines whether marital trajectories that incorporate timing, stability, an...

Background: Religiosity and health are positively related. Studies on predictors of religiosity are few, especially among African Americans. We identify early predictors of mid adulthood religiosity in a longitudinal cohort of African Americans. Methods: The study is prospective study of a community cohort of 1242 African Americans from 1966-1967...

Depression among African Americans residing in urban communities is a complex, major public health problem; however, few studies identify early life risk factors for depression among urban African American men and women. To better inform prevention programming, this study uses data from the Woodlawn Study, a well-defined community cohort of urban A...

Marriage is a key life event that has numerous benefits. Recent research extends these benefits to include desistance from crime and drug use yet there has been little investigation regarding whether deviant behavior in adolescence impacts long-term marital patterns. Since rates of marriage are low among African Americans and rates of adolescent de...

The present study identifies risk factors for intimate partner violence (IPV) initiation and persistence over three years in a high psychosocial risk Asian American and Pacific Islander (AAPI) sample of women with children living in Hawaii. We included 378 women in a 3-year relationship with the same partner who reported IPV experiences at baseline...

Much is known about contemporaneous correlates of homelessness from studies of homeless individuals. However, few studies have prospectively examined early antecedents and prevalence of homelessness in community populations. We use data from a 35-year study of a community population of African Americans to examine relationships between homelessness...

Substance use and psychological problems are major public health issues because of their high prevalence, co-occurrence, clustering in socio-economically disadvantaged groups, and serious consequences. However, their interrelationship over time is not well understood. This study identifies and compares the developmental epidemiology from age 6 to 4...

Major depressive disorder (MDD) is one of the most common and debilitating disorders in the United States. While research suggests lower rates of MDD among African American men compared to other racial/ethnic groups and to women, evidence suggests that they may experience worse outcomes, with reduced access to and poorer quality treatment leading t...

Background Despite the known adverse causal effects of cigarette smoking on mental health, there remain inconclusive findings for the effects of adolescent cigarette smoking on later mental health, socioeconomic status, and social integration outcomes. Other studies have shorter follow-up periods and did not have a representative portion of the Afr...

Background: Understanding the relationship between substance abuse severity and time to treatment from substance abuse onset is essential to increase access to and tailor treatment services. The current study, part of a larger longitudinal study examining paths leading to substance use among a community sample of African Americans, examined the tim...

Charles R. (Bob) Schuster, an internationally recognized researcher on the psychopharmacology of drugs of abuse, passed away on February 21, 2011. Bob Schuster was a pioneer in the scientific study of addiction and one of the founders of a specialized research field called behavioral pharmacology. Bob mentored many young scientists, including 15 do...

This paper examines the effects of experiencing violent victimization in young adulthood on pathways of substance use from adolescence to mid-adulthood. Data come from four assessments of an African American community cohort followed longitudinally from age 6 to 42 years. The cohort lived in the urban, disadvantaged Woodlawn neighborhood of Chicago...

This study examined the relationship between adolescent alcohol use and adult violence from a developmental perspective, specifically whether frequent adolescent drinking predicts adult violence once shared risk factors are taken into account through propensity score matching. The research considered multiple types of violence, including assault, r...

We examined developmental trajectories of marijuana use among a cohort of urban African Americans followed from first grade to mid adulthood. We compared risk factors in childhood and adolescence and consequences in mid adulthood across trajectory groups. Using semiparametric group-based mixture modeling, five marijuana trajectories for men (n=455)...

Previous research suggests that experiencing intimate partner violence (IPV) may negatively affect employment outcomes. This study explores the relationship between IPV and employment stability both concurrently and longitudinally among a sample of 512 predominantly Asian American and Pacific Islander young women living in Hawaii. Women in this stu...

Research indicates that engagement in community organizations is positively associated with health, particularly among aging populations, yet few studies have examined in detail the influence of community engagement (CE) on later health among African Americans. This study provides a longitudinal assessment of the effects of CE over a 22-year period...

While marijuana use is common during adolescence, it can have adverse long-term consequences, with serious criminal involvement being one of them. In this study, we utilize longitudinal data from the Woodlawn Study of a community cohort of urban African Americans (N=702) to examine the effects of heavy adolescent marijuana use (20 or more times) on...

This paper examines the association between social integration in young adulthood and the later onset of substance use and disorders through mid-adulthood. Design Data come from a community cohort of African Americans followed longitudinally from age 6-42 years with four assessment periods. The cohort all lived in the Woodlawn neighborhood of Chica...

Although there has been much discussion about the persistence of poverty and welfare receipt among child-rearing women in the US, little is known about long-term patterns of poverty and welfare receipt or what differentiates those who remain on welfare from those who do not. Furthermore, are there distinctions between child-rearing women who are po...

Using longitudinal data from the Woodlawn Project (N=680), this study examined how patterns of living arrangements among a community cohort of African American mothers were associated with later physical and emotional health. We identified eight patterns of stability and transition in living arrangements during the childrearing years. Health outcom...

We compare life course characteristics of a cohort of African American women (N=457) by their smoking status at age 42: never smoker (34.1%), former smoker (27.8%), or current smoker (38.1%). The Woodlawn population from which our sample is drawn has been followed from first grade (1966-67) to mid adulthood (2002-3) and is a cohort of children from...

Social connectedness has been shown to be related to health and well-being, yet there is little knowledge about its developmental and intergenerational origins. We examine the childhood, family, and neighbourhood origins of social connectedness in young adulthood in a cohort of African American children (N=1242) from Chicago followed since 1966. Th...

This study examines pathways to adult marijuana and cocaine use in a cohort of African Americans from Woodlawn, an inner city community in Chicago. Assessments were conducted in first grade (age 6), adolescence (age 16), early adulthood (age 32), and in mid-adulthood (age 42). The "social adaptation life course "framework guided the focus on social...

Suicides rates are increasing in African-Americans, and epidemiologic review reveals midlife as a period of high risk for emerging suicidal behavior. Driven by studies suggesting older adults' psychosocial health is jeopardized by negative bonds, this study explores the role of maternal affect on suicidal behavior among middle-aged African-American...

The purpose of this study was to investigate the cumulative effects of poverty and family stressors to the later life functional status of African American women. We used longitudinal data covering a 30-year period for a cohort of 553 African American women with common life experiences. Interviews were conducted with these women as young mothers, a...

Cross-sectional analyses and the little existing longitudinal analyses on substance use over the life course have been integral in providing information about the epidemiology of substance use in the United States. However, it is unclear whether these estimates provide an accurate portrayal of long-term substance use patterns among African-American...

Prior research has found a positive relationship between delinquency and early onset of drug use. However, little is known about the influence of delinquency on drug initiation through mid-adulthood. This paper investigates the long-term relationship between serious adolescent delinquency and the onset of marijuana and cocaine use among an epidemio...

This research examines adolescent perceptions of neighborhood disorganization and social capital to determine if they are associated with adolescent alcohol or drug (AOD) use, AOD dependence, and access to AOD treatment. This is a secondary analysis of data from the 1999 and 2000 National Survey on Drug Use and Health (NSDUH). The NSDUH is a cross-...

Few longitudinal studies have examined the effects of education on drug use disorders among community populations of African Americans. This study explores the impact of multiple early education indicators on later problem drug use in an African American population followed for more than 35 years. The initial cohort comprised all 1st graders (N=124...

Drawing from social disorganization theory, this study examined how perceived neighborhood conditions modified associations between parenting and delinquency, depressive symptoms, and school problem behavior among more than 800 African American and Latino 10- to 14-year-olds participating in Welfare, Children, and Families: A Three-City Study. Perm...

Drug use trends are typically monitored by surveys of retrospective self-reports of drug use; yet we know little about the consistency of reports made across the life course. This study examines the consistency of marijuana self-reports from adolescence and adulthood and what characterizes inconsistent reporting among a cohort of African American f...

The authors examined the effects of heavy adolescent marijuana use on employment, marriage, and family formation and tested both dropping out of high school and adult marijuana use as potential mediators of these associations among a community sample of African Americans followed longitudinally from age 6 to age 32–33. They used propensity score ma...

Adult criminality has important roots in childhood. While many studies have established that multiple problem behaviors in childhood increase the likelihood of future crime and deviance, the current study extends this “established” relationship by asking three questions: (1) Do different combinations of childhood behavioral risk factors affect adul...

Using longitudinal data spanning early elementary through middle school, aggression behavior trajectory groups were identified for boys and girls. Early elementary school predictors of trajectory group membership were examined as well as whether trajectory group predicted physical aggression, covert delinquency, and substance use in 9th grade. Semi...

This longitudinal study examines the effect of sons’ incarceration on their mothers’ psychological distress. Interviews were conducted over the life course with a community cohort of African American mothers who had children in first grade in 1966 – 1967 when the study began (N =615). Thirty years later, their sons had significant rates of incarcer...

Despite the serious health and economic consequences of drug and alcohol abuse and dependence, few studies have prospectively examined the etiology of this problem in non-clinical populations. This longitudinal study examines childhood and adolescent antecedents of drug and alcohol problems in adulthood among an African American cohort (n = 1242; 5...

Problems with alcohol remain a serious public health concern despite decreased use among some populations. Here we examine the relationship between alcohol problems and religiosity, hypothesizing that social resources may mediate this relationship. Using data from a longitudinal cohort study of a black community population (N=1242) followed from ag...

Using prospectively gathered data across a 35-year follow-up interval, we assessed the association of educational achievement and school behaviors with risk for the development of an alcohol-use disorder in adulthood. The baseline population consisted of 1242 first-grade students in 1966-1967 residing in the Woodlawn community of Chicago, Illinois....

This article examines diversity among 542 African-American grandmothers from the Woodlawn Longitudinal Study. Women were categorized on the basis of their household composition, degree of care provided to grandchildren, and status of primary caregiver to grandchildren during lifetime. Overall, 67.7% of the sample engaged in parenting and exchange b...

Building on social ecological research, this study considers whether neighborhood socioeconomic advantage modifies the relationship between parenting practices and sex initiation among young adolescents. Using data on a national sample of 2,559 middle school students, the authors examined two-way interactions between neighborhood socioeconomic stat...

Largely absent in the congressional debate regarding U.S. welfare reform reauthorization are policy discussions aimed at preventing long-term welfare use for families at risk. This study examines three social science perspectives explaining the relationship between early poverty and health as a means to understand long-term welfare receipt. Using l...

This research explores area-level social influences on prostate cancer, to test whether area-level influences explain disparities in U.S. prostate cancer burden. The authors geocoded 23,993 1992-1997 Maryland prostate cancer cases, and linked cases to 1990 census data. The authors examined the effect of 17 area-level social variables, measured at b...

A key issue that came to the forefront during the welfare reform debate in the United States during the 1990s concerned the relationship between welfare receipt and drug use and abuse. This paper examines the relationship between persistent welfare assistance, welfare background, and marijuana and cocaine use among African-American women. We hypoth...

Although adolescents in poor urban areas often assume independent, adult-like roles, relatively little is known about the relationship between these roles and other adolescent behaviors. This research examines the association between independent roles occurring within different contexts (e.g. family, peer, work) and aggressive behavior among 516 lo...

The Woodlawn Project is a longitudinal study of the development of psychological well-being and social adaptation in an epidemiologically defined cohort of African American first graders interviewed as adolescents and again as adults. The identification of childhood factors predictive of mortality has clear public health importance. Family and chil...

Offspring of depressed women have high rates of depressive symptoms and other psychopathology. The authors examined the relationship of mothers' symptoms of depression and anxiety reported during their offspring's childhood and adolescence on depressive disorder and educational achievement of their adult children. The data come from a longitudinal...

A century ago, W. E. B. Du Bois wrote: “Crime is a phenomenon of organized social life, and is the open rebellion of an individual against his social environment” (1899/1996: 235). Explaining crime among blacks in Philadelphia between 1835 and 1895, Du Bois noted their overrepresentation in the courts as well as prisons and was acknowledging the da...

To examine childhood antecedents of marijuana and cocaine use in adulthood. Epidemiological, longitudinal cohort study of African American first graders (age 6) followed to age 32. Children (N=1242) and families in the 57 first grade classrooms from Woodlawn, an inner-city community in Chicago. First grade teachers, mothers and children provided as...

This study examined smoking trajectories between adolescence and adulthood in an African American cohort followed prospectively from first grade to age 32. We classified non-smokers, former smokers, current smokers/late adopters (initiated after age 18), and current smokers/early adopters (initiated before age 17). Results show that almost half of...

This study examined predictors of longevity in a cohort of inner-city African American women. Data were derived from a cohort study of inner-city African American mothers whose median age in 1966 was 31 years. Analyses involved single-decrement life tables and pooled logistic regression. Giving birth for the first time before age 25 and having at l...

Effects of changes in physical health status and drug use, and prior social support on depressive symptoms were assessed in low income injection drug users. Data are from participants (n = 503) enrolled at baseline (1994-1995) who remained at one-year follow-up (79%), of whom 37% were HIV-positive and 36% female. Physical health was measured by HIV...

This study examined interrelations among welfare receipt, social integration, and later physical and mental health in a cohort of African American mothers from the Woodlawn neighborhood on the south side of Chicago. These women (N = 681) have been followed prospectively from 1966-67 to 1997-98. Findings indicate that receiving welfare during the ch...

The study sought to assess the associations of HIV status, physical health status, current drug use, and gender with depressive symptoms in former and current illicit drug users. In 1994–1995, 503 individuals (188 HIV-infected; 191 females; 279 current drug users) were interviewed. Of HIV-infected participants, 70 were women and 96 were current dru...

It is important to consider sources of job stress that affect worker populations, however a focus should be placed on assessing the association between particular workplace stressors within genders. Customer service workers are a growing occupational group in the United States. As technology evolves, these predominantly female workers are increasin...

This article reports on a study of the schooling careers of a recent cohort of African Americans that found that 44 percent of the women and 34 percent of the men reentered school at least once. There were few differences in educational credentials at age 27 between those who attained their education in one spell or two spells of enrollment, althou...

This study examines the validity of measures of socioeconomic status (SES) as reported by adolescents. Adolescents completed a self-administered questionnaire that included eight measures of SES. Mothers also reported on selected measures of SES. Supporting criterion validity, adolescents and mothers had relatively high agreement on the SES measure...

To identify the health needs of adolescent males incarcerated in a juvenile justice facility and to compare their health profiles with those of male adolescents in the community. Cross-sectional surveys were conducted of incarcerated (N = 202) and school (N = 379) samples of male youths. Questionnaires were self-administered and completed before ad...

In this collection of chapters, leading scholars of adolescent risk behavior present the most recent ideas and findings about the variety of behaviors that can compromise adolescent development, including drug use, risky driving, early sexual activity, depression, and school disengagement. In particular, the volume emphasizes new perspectives on de...

The aim of this study was to develop a taxonomy of health profile-types that describe adolescents' patterns of health as self-reported on a health status questionnaire. The intent was to be able to assign individuals to mutually exclusive and exhaustive groups that characterize the important aspects of their health and need for health services. Clu...

The purpose of this study was to demonstrate the preliminary reliability and validity of a set 13 profiles of adolescent health that describe distinct patterns of health and health service requirements on four domains of health. Reliability and validity were tested in four ethnically diverse population samples of urban and rural youths aged 11 to 1...

To identify aspects of social role functioning that are impaired in adolescents with specific psychiatric disorders in order to improve the psychiatric taxonomy and clinical knowledge base. Adolescents in four urban public schools were screened for mental health problems. Structured psychiatric interviews (National Institute of Mental Health Diagno...

This prospective study is focused on the characteristics leading to alcohol use disorders in early adulthood among a cohort of black children. The principal aim of this work is to examine the impact of educational attainment, school dropout and early school adaptation on the development of alcohol abuse and dependence in adulthood. From a populatio...

To determine the accuracy of adolescents' self-report of health insurance coverage, using parents' report as a comparison standard. Two separate samples of urban, school-based adolescents and their parents completed self-administered questionnaires about type of health insurance coverage. Sample 1 included 123 and Sample 2 included 93 adolescent-pa...

Although scientific and policy statements regarding drugs often suggest that there are grave problems of drug use within America's inner cities, the evidence that supports these statements is often based on anecdotal or incomplete data. This study of African-American adults from the Woodlawn study followed longitudinally partially fills that gap, a...

Social problems tend to cluster, developing in similar areas, seemingly produced in similar families, and menacing similar individuals. This fact gives rise to questions about whether the same or different conditions predict violence, depression and alcoholism, whether co-occurrences of morbidity are attributable to similar risk conditions creating...

This study examined the lifetime prevalence of suicidal behaviors and their relation to social integration, depression, and aggression/substance use in a cohort of African Americans followed prospectively from first grade to age 32. Lifetime depressive moods in adulthood, lifetime use of cocaine, and frequent mobility were associated with suicidal...

Some inner-city infants grow to be successful, self-sufficient adults. This study is designed to identify characteristics from early childhood that foster or impede favorable outcomes and are useful for formulation of public policy. Population: 2694 children (G-2s), born 1960 through 1965, to 2307 inner-city women (G-1s) enrolled in the Johns Hopki...

This study investigates the consistency of factors associated with adolescent injury in separate urban and rural samples. Adolescents, 11-17 years old, in public schools in urban and rural Maryland (n = 2,712). Separate bivariate and logistic regression analyses were conducted for each sample to determine individual and environmental factors associ...

Accountability of health services in meeting needs and assessing outcomes is hampered by the absence of tools to assess health, especially in children and youth. Because it is no longer adequate to assess health by a narrow focus on biological and physiological measures, instruments that assess functional status, person-focused general health statu...

Using 1970 and 1980 census data from 202 tracts in the Chicago metropolitan region, we examine whether neighborhoods influence the likelihood of high school graduation for a cohort of African-American children followed from 1966 to 1993. Neighborhood-level variables included percent living below poverty and percent in white collar occupations. We t...

Using 1970 and 1980 census data from 202 tracts in the Chicago metropolitan region, we examine whether neighborhoods influence the likelihood of high school graduation for a cohort of African-American children followed from 1966 to 1993. Neighborhood-level variables included percent living below poverty and percent in white-collar occupations. We t...

Recent cross-sectional studies have indicated that inhalant use might be a vulnerability marker for the development of heroin use. This study is the first prospective investigation of the hypothesized association between early inhalant use and later heroin use. Analyses were conducted using longitudinal data from a community sample of Woodlawn (an...