Welcome to the second edition of the OASAS County Risk Profiles. The purpose of this 1999 County Risk Profile is to provide New York State (NYS) counties with updated information on risk factors for youth alcohol and other substance abuse (ASA) at the county level. These research based risk factors or ?risk constructs? were tested in an earlier study and found to predict greater youth ASA related problems. While longitudinal research studies are needed to identify the causative risk factors for individuals, this county level risk information can alert local governments, prevention coalitions, and service planners to those domains where alcohol and other substance abuse associated risks are highest.
To promote factors that protect against and reduce the risks of alcohol and substance abuse, a range of strategies at varying intensity levels must be provided within an integrated and community supported network. Improved knowledge of a community's unique ASA risks can guide the development of a responsive and optimal balance of universal, selected, and indicated prevention services, early intervention, treatment, and drug control strategies. The risk indicator rates and county rankings described below are one tool to assist New York state in targeting prevention strategies across service systems. Local surveys, sub-county indicators and other community level data are also needed to get beneath the surface of community substance abuse problems.
PRISMS County Risk Profile Development
Research and practitioner experience have documented that the roots of alcohol and other substance abuse are related to a host of other social problems and health compromising behaviors. Gaining a greater understanding of the interaction between ASA and problems such as poverty, family dysfunction, school failure, violence and adolescent pregnancy, is a first step toward improving the planning of effective prevention strategies. To guide the ongoing development of the OASAS Prevention Risk and Protective Framework, a 1996 OASAS study tested archival social indicators as county level measures of these economic, social, and behavioral ASA risk factors.
The indicators were organized within an ecological risk framework based on the Social Development Risk and Protective Factor research model (Hawkins, Catalano, & Miller, 1992). The Social Development model focuses on the influence of social bonding within the domains of the individual, family, school, peers, and community. This model hypothesizes that positive social bonds will protect against the development of substance abuse, and that ASA risk factors operate by inhibiting social bonding during child and adolescent development. This model has been embraced by many in the ASA and juvenile delinquency prevention fields because it identifies and organizes causative risk and protective factors that are amenable to change, and then prescribes specific prevention strategies. The OASAS ecological risk framework for prevention needs assessment has three conceptual indices:
Community Risk Index (CRI)
The CRI was calculated from risk constructs measuring social indicators of community disorganization and community ASA exposure. Community-level risks are believed to be present for all individuals living within a community, and counties with more or larger distressed communities are considered to be at higher risk. This index can help to estimate alcohol and substance abuse risks that can be addressed through universal, state, county, and community-wide environmental prevention strategies and systems improvement efforts. The risk constructs used to compute the index are:
Community Disorganization |
Community ASA Exposure |
Urbanicity |
Alcohol Accessibility |
Poverty |
Adult Alcohol Health/Treatment |
Violence |
Adult Probation - Alcohol |
Crime |
Adult Drug Indicators |
Youth Risk Index (YRI)
The YRI is computed from risk indicators reflecting youth whose family environments, behavior, or psychosocial development place them at higher risk for alcohol and substance abuse. Selected and Indicated prevention strategies to reduce these risks are targeted to schools, families, peer groups and individual youth.
Intrapersonal Problems |
Academic Failure |
Family Dysfunction |
School Conduct |
Problem Behavior - Delinquency |
School Separation |
Problem Behavior - Sexuality |
Youth ASA Consequences Index
The Youth ASA Consequences Index was developed to help analyze the predictive ability of the other risk indices; past levels of alcohol and other substance abuse related problems are useful in predicting future problem intensity. The ASA consequences were computed from indicators that represent direct consequences for youth (e.g., DWI, drug arrest, treatment admission) resulting from their use or abuse of alcohol or other drugs. This risk index may help estimate need for indicated prevention strategies, early intervention, and adolescent treatment. The indicators used to compute these indices are:
Youth Alcohol Consequences |
Youth Other Drug Consequences |
DWI Arrests |
Drug Arrests |
Intoxicated Youth in Auto Accidents |
Drug-Related Hospital Diagnoses |
Probation Cases: Use at Offense |
Probation Cases: Use at Offense |
Probation Cases: Court Mandates |
Probation Cases: Court Mandates |
OASAS Treatment Admissions |
Statistical Methods
The risk indicators were standardized and combined into 17 risk constructs through factor analyses. The risk constructs were then combined into the three risk indices based on their predictive ability. The Community Risk and Youth Risk constructs were tested for their relationships to county levels of youth alcohol and other substance abuse related consequences. All of the risk constructs were significantly related to the Youth ASA Consequences Risk Indices; levels of risk successfully predicted 84% of the variation in Youth Alcohol Consequences and 72% of variation in Youth Drug Consequences over a three year time period. Detailed study methods are available in an OASAS technical report: County Level Social Indicator Study, 1997.
1995-96 County Risk Profile Description
The county risk indices and construct data are provided for the years 1995-96. Individual 1996 risk indicator rates are provided in tables. To enable the assessment of trends over time, the indicators and statistical methods were not changed from the original 1993-94 profiles. Ten NYS agencies and the Census Bureau provide the public archival data that was analyzed according to our risk and protective framework and ecological risk methodology. Most indicators are rated per 10,000 of the relevant county population (e.g., teenage pregnancy per 10,000 females aged 10-19). Those indicators not rated per 10,000 population are defined in the Technical Notes.
The state ranks on the risk indices appear on the first page along with demographic data from the U.S. Census. The Total Youth Alcohol and Drug Problem Risk ranks in the top right box are based on the analyses described above. A relative risk score of "55" represents the highest risk county (outside NYC) and a score of "1" the lowest risk. To assist counties in focusing on their highest risk areas, the risk construct bar charts on the following two pages show the relative levels of Community and Youth Risk compared to the NYS average risk level. Finally, 1996 county, similar county group, and state rates for each of the 74 risk indicators are provided in data tables. The individual indicator rates can help detail why a county ranked higher or lower on a given risk construct.
What's New
By popular demand, the OASAS regional rates were replaced with a similar counties rate. These county groupings were made based on county population size and density, and the presence of urban centers with 50,000 or more residents. They range from the NYC Suburban Ring to a Rural group. This change should make comparisons more meaningful, given the wide diversity of county demographics in our state.County groupings are listed in the Technical Notes.
Needs assessment in NYC, as with all large metropolitan areas, must be conducted at a sub-county level. The OASAS study that developed the County Risk Profiles analyzed the 62 geographically defined counties of New York State, but due to large statistical differences, NYC was not included. With the cooperation of NYC agencies, a NYC alcohol and other substance abuse risk indicator study is currently underway using zip code level data. This study will be completed next year (Spring 2000). A second phase of PRISMS development, the addition of data measuring ASA prevention services, other prevention resources and protective factors is required for state and local planning. Prevention resource assessment will be advanced by the new OASAS prevention activity reporting system to be started this year. Prevention resource assessment will be further advanced by new community evaluation efforts supported by the federal Center for Substance Abuse Prevention. As this Risk Profile cannot identify high risk communities or neighborhoods within counties, PRISMS must be used in conjunction with local needs assessment studies as well as with the other OASAS needs assessment studies (ethnographic street studies, student, household, and special population surveys; and ASA treatment needs estimates). The Issues and Caveats section of the Technical Notes detail the major limitations of this social indicator method that should be considered when applying these findings. OASAS Planning and Applied Studies staff are continuing to refine the County Risk Profiles with new indicators to improve state and local needs assessment capabilities. The results of this work will be presented in the year 2000 profiles.
Important Limitations to Indicator Based Needs Assessment
The county-level results reported here must not be applied to individual-level functioning. This means that factors related at the county level, such as family dysfunction and youth alcohol consequences, may not be related at the individual level. Most indicator data is produced by social service and social control agencies and reflect societal responses to youth behavior, not the behavior itself. Resource fluctuations, data reporting practices and service delivery policies can all affect indicator rates. Local service system data should also be included in local needs assessments. Many (but not all) of these indicators are generated by institutions that serve the most troubled youth in the population (i.e., official responses to the most deviant behaviors). Surveys of the general population are needed to learn about risk and protective factors that do not result in institutional intervention. The previous version of the County Risk Profiles contained a printing error. In the Youth Risk Construct scores (p. 3), the NYS average scores for A school conduct and A school separation were reversed. The county scores for these two constructs were correct.