Abstract
This study examined employment and sources of income for different genders and ethnic groups residing in a substance abuse recovery homes called Oxford Houses. Men compared to women reported significantly higher mean income from employment as well as total income. African Americans compared to European Americans reported significantly more work in the past 30 days; however, the rate of pay between these two ethnic groups was not significantly different. Longer length of stay in Oxford House was related to higher incomes. Implications of these findings are discussed.
Keywords: Oxford House, substance abuse recovery, economic factors, human sex difference, ethnic differences
It is estimated that over 22.5 million Americans ages 12 or older (approximately 9.4% of the population) are classified with substance dependence or abuse. These maladaptive patterns of substance use lead to clinically significant impairment [National Survey on Drug Use and Health (NSDUH), 2004] and may interfere with a person’s ability to work (Zlotnik, Robertson, & Tam, 2002). Bray et al. (2000) found that for both men and women substance use with symptoms of dependence was associated with lower employment rates and represented a barrier to leaving welfare (Legal Action Center, 1997). Studies showed that welfare recipients diagnosed with drug dependence had a lower probability of finding employment (Office of the Inspector General, 1992). Finally, individuals who abused drugs and were employed cost their employers about twice as much in medical and worker compensation claims as their drug-free coworkers (NIDA, 2004).
Employment is among the most important factors associated with alcohol and substance abuse addictions (Brady & Mathews, 2002). For instance, employment rates for those adults addicted to substances were lower than for those adults not addicted (NSDUH, 2003). The National Survey on Drug Use and Health revealed that in 2004 an estimated 19.2% of unemployed adults were substance users, whereas 8.0% of full-time and 10.3% of part-time employed adults were classified with dependence or abuse.
Furthermore, employment seems to be related to successful recovery. Sterling, Gottheil, Glassman, Weinstein, Serota, and Lundy (2001) found that employed adults were doing significantly better in their recovery process than unemployed adults. In addition, the loss of employment was associated with relapse (Fisher & Anglin, 1987). Thus, attainment and sustainability of steady employment may serve as a central mediator of positive substance use outcome (Gregoire & Snively, 2001; Platt, 1995; Sterling et al., 2001). While steady employment may facilitate and help sustain abstinence, recovering individuals may encounter multiple barriers, particularly in regards to gaining and retaining employment. Obstacles such as lack of job-searching skills, scarcity of low-level jobs, prejudice against the person in recovery, employer’s fear of applicant’s relapse, and lack of social support may prevent a person in recovery from successfully gaining employment.
The Oxford House model for recovery seems to provide a mixture of residential therapeutic community and 12-step approaches (Oxford House Inc., 2004). It is built on a democratic framework, with over 1,200 rented dwellings located across the USA (Jason, Ferrari, Davis, & Olson, 2006). No professional staff live within any residence, and house decisions are based on traditions specified in the house rules and are voted on by house members. Largely because of its self-run nature, the program is far less costly to initiate and run compared to the operational costs of the staffed therapeutic community model (Oxford House Inc., 2004). Three rules of the house are that members must: a) abstain from drinking or using drugs, b) avoid disruptive behavior, and c) pay rent through their own employment or social service benefits (Ferrari, Jason, Davis, Olson, & Alvarez, 2004).
It may be important to examine self-run recovery homes such as Oxford House because living in such settings may help with a number of barriers towards gaining and maintaining stable employment faced by individuals in recovery. Because there is a need to pay rent for residency in an Oxford House, there is an incentive to find a steady source of income. It may also be easier to find a better job while residing in an Oxford House, particularly because the employer may be assured that the person has a stable and substance free living arrangement. The residents of the house may also serve as a resource by helping new residents find and sustain employment through recommendations and referrals. Oxford House may work as a platform for persons recovering from abuse as well as an aid in gaining and retaining employment. At the same time, Oxford House creates an option for persons in recovery to stay abstinent in a substance free environment among similar others, while they are becoming a self-efficient and productive members of society. Finally, based on previous studies, living in an abstinent setting, away from high-risk environments, may facilitate addiction recovery (see Ferrari, Jason, Olson, Davis, & Alvarez, 2002; Jason, Davis, Ferrari, & Bishop 2001).
The present study explored effects of gender, ethnicity, and length of stay on the number of days worked in the past 30 and the sources of income among Oxford House members. It was predicted that men compared to women would report more days worked and higher income, especially from employment, and lower income from other sources such as unemployment compensation, pension, the Department of Public Aid (DPA), or family, friends, and partner. It also was predicted that European-Americans compared to African Americans would report more days worked and higher income, especially from employment, and lower income from other sources such as unemployment compensation, pension, DPA, or family, friends, and partner. Finally, it was predicted that those adults who stayed in Oxford House for 6 months or longer would report more days worked and higher income, especially from employment, and lower income from other sources such as unemployment compensation, pension, DPA, or family, friends, and partner, than adults who stayed in Oxford House for less than 6 months.
Method
Participants
This study was a part of a larger National Institute on Drug Abuse (NIDA) funded national study of Oxford Houses (see Jason, Davis, Ferrari, & Anderson, 2007 for details) from 2001 to 2006. There were 897 participants involved in the study (604 males, 293 females), with a mean age of 38.4 years old. Participants were recruited from five cluster areas across the United States: Washington/Oregon, Texas, Illinois, Pennsylvania/New Jersey, and North Carolina. These clusters indicated locations of the majority of Oxford Houses across the USA. On average, participants spent 10.85 months (SD = 15.04) residing in an Oxford House.
The present sample was ethnically diverse, with 58.4% being European American, 34.0% African American, 3.5% Latino, and 4% other. Marital status of the sample included 49% single/never married, 46.2% divorced/widowed or separated, and 4.8% married. The average education level reported by participants was 12.6 years. With respect to employment, 69.3% reported being employed full-time, 13.9% part-time, 11.6% reported being unemployed, and 3.8% were retired or disabled at the time of the survey. The average monthly income across participants was $981.80.
Based on the preliminary review of the data, the majority of the present sample was diagnosed with alcohol and drug abuse or dependence, as well as significant histories of co-morbid mental health and behavioral problems. This sample reflected the overall socio-demographic makeup and substance use disorders of individuals from the national sample of Oxford House residents from which the sample was drawn.
Materials
Participants completed the Addiction Severity Index, LITE (ASI; McLellan, Kushner, & Metzger, 1992), a semi-structured interview protocol widely used throughout the United States and other countries to assess a number of substance-abuse related behaviors. It is an intake assessment instrument used to develop a treatment plan and is designed to obtain information about lifetime problem behaviors as well as those in the past 30 days prior to assessment. The survey covered seven areas of a person’s life, namely: medical, employment/support, drug and alcohol use, legal, family/social, and psychiatric. The ASI has often been used in substance abuse related studies and has shown to have excellent test-retest reliability of (0.83) or higher with the coefficient alpha ≥ 0.80 (McLellan et al., 1992). Sample questions included: “How long was your longest full-time job?” and “How many days were you paid for working in the past 30 days?”
Employment information
Sociodemographic and other pertinent information were gathered via specific portions of the ASI 5th Edition. Because of the nature of this study, the employment section of the ASI scale was a major focus. For the present study, demographic and background information from the ASI included, age, sex, ethnicity, months of education/technical education completed, distribution of financial support, pay rates, and length of residence.
Results
A 2 × 2 × 2 (gender by ethnicity by length of stay) analysis of covariance (ANCOVA) was conducted for each of the six dependent measures (i.e., income from employment and the total income, number of days paid for work, income from unemployment compensation, income from DPA, and income from partner, family, and friends). Because of the possible confounding differences due to age or education level, analyses controlled for these variables.
Table 1 presents findings regarding gender and ethnic differences in education and financial variables. Males reported significantly more months of formal education completed compared to females [M = 153.77, SD = 23.95 versus M = 148.61, SD = 27.59 months, F(1,804) = 6.97, p < .05]. European Americans reported significantly more months of formal education completed compared to African Americans [M = 153.95, SD = 23.08 versus M = 148.74, SD = 27.01 months, F(1,804) = 7.07, p < .005]. There was no significant difference in the number of days worked between the two genders. There was, however, a significant difference in the number of days worked between the two ethnic groups with African Americans reporting higher number of days paid for work [M = 17.76, SE = .75 versus M = 15.32, SE = .56 days, F(1,732) = 6.6, p <.01, partial η2 = .009]. There was a significant difference in the amount of money from employment and the total amount of income between the two genders with men reporting higher amounts compared to women [M = $948.01, SE = 47.32 versus M = $646.42, SE = 69.15, F(1,732) = 12.80, p < .001, partial η2 = .945 and M = $1123.50, SE = 40.03 versus M = $811.33, SE = 58.50, F(1,732) = 19.17, p < .001, partial η2 = .026].
Table 1.
Financial Characteristics of the OH residents
Gender | Ethnicity | |||
---|---|---|---|---|
Female | Male | White | Black | |
Education (months) | 148.61 | 153.77* | 153.95* | 148.74 |
Days paid for work (number of days) | 15.80 | 16.56 | 15.64 | 17.54* |
Money from ($) | ||||
employment | 615.74 | 941.56** | 820.10 | 869.99 |
unemployment compensation | 23.2 | 47.23 | 40.8 | 29.63 |
DPA | 10.96 | 8.34 | 9.68 | 9.62 |
pension, benefits or social security | 97.57 | 72.32 | 106.97 | 62.918 |
partner, family or friends | 70.18 | 45.2 | 66.06 | 49.31 |
Total monthly income ($) | 814.8 | 1120.95** | 943.16 | 992.58 |
Note
p<.05
p<.001
Table 2 indicates that the number of days paid for work increased significantly for those who stayed in OH for 6 months or more compared to those who stayed in OH for less than 6 months [M = 18.42, SE = .58 versus M = 14.20, SE = .59, F(1,729),= 25.57, p < .001, partial η2 = .034]. At the same time, those who stayed in OH for 6 months or longer reported significantly higher amounts of both income from employment and the overall income compared to those who stayed in OH for less than 6 months [M = $1,035.27, SE = 52.35 versus M = $635.13, SE = 53.46, F(1,729) = 27.81, partial η2 = .037, p < .001 and M = $1,171.42, SE = 44.74 versus M = $861.77, SE = 45.69, F(1,729) = 22.80, p < .001, partial η2 = .30 respectively].
Table 2.
Lengths of Stay in OH
Length of Stay | ||
---|---|---|
< 6 months | >= 6 months | |
Days paid for work (number of days) | 14.20 | 18.42** |
Money from ($) | ||
employment | 635.13 | 1,035.27** |
unemployment compensation | 55.00 | 28.09 |
DPA | 6.70 | 12.78 |
pension, benefits or social security | 87.00 | 88.95 |
partner, family or friends | 73.92 | 38.56 |
Total monthly income ($) | 861.77 | 1171.42** |
Note
p<.001
Discussion
The current study suggested that Oxford House may help provide a setting that increases economic opportunities for residents, as financial characteristics improved with length of stay. Adults who continued residence for 6 months or more reported a higher number of days working, higher income from employment, and higher overall income, compared to adults who stayed in OH for less than 6 months. Apparently, with longer time since entering a recovery setting such as Oxford House, income and number of days worked per month improve.
In terms of months of education, income from employment, and the total income, men did significantly better than women. Both men and women, however, did not significantly differ on number of days paid for work, income from unemployment compensation, income from DPA, and income from partner, family, and friends. Perhaps, a gender pay gap existed as reported in U.S. society such that men earn significantly more money for the same amount of work than women (Lips, 2003). According to Bem (2005), organized society is a better fit for men, automatically placing women at certain disadvantages, including financial obstacles such as income. Based on the present study, these disadvantages were mirrored in substance abuse recovery populations in the United States. Women compared to men might be disadvantaged at the beginning of the recovery process and might require additional assistance, particularly in gaining financial independence.
European Americans also reported a significantly higher mean number of months of formal education compared to African-Americans. There was no significant difference, however, between these two ethnic groups in regards to income from employment. Furthermore, African Americans reported working significantly longer on average than European-Americans. Thus, while African American’s employment rates were significantly higher, their income from employment was not - suggesting that African-Americans were getting paid less for the same amount of work as their European-American counterparts.
An explanation for this outcome may be that a gap favoring the latter group exists between African Americans and European Americans on financial characteristics such as employment-population ration, unemployment-population ration, and income, among others [Current Population Survey (CPS), 2007]. According to the U.S. Bureau of Labor Statistics (2007), in 2000 African Americans earned 71.6 percent of what European Americans earned. This trend can still be seen in the current years, as based on the CPS, in 2006, median weekly earnings of European Americans were $690, while median weekly earning of African Americans were $554 (CPS, 2007).
Limitations and Future Directions
Of course, there are several limitations in the present study. For instance, despite the seeming overall ethnic diversity of the sample (i.e., 58.5% being European American, 34.1% African American, 3.5% Latino, 2% American Indian, and 2% other), only the two largest groups (i.e., European Americans and African Americans) were included in the analyses due to the small sample size of the other subgroups. The authors chose not to collapse the minority subgroups into an “other” category as such would have not provided enough information regarding each of the separate ethnic groups. Inclusion of other ethnic sub-groups within the recovery population is necessary for gaining a better understanding of ethnic difference in regard to financial status. Over-sampling certain ethnic groups might be of benefit to future research.
Despite the limitations, our prospective analysis suggested that programs like Oxford House may provide not only an abstinent environment that promotes recovery from substance abuse, but also work as a stepping stone toward a more stable financial status among adults in recovery. Despite overall improvement on a number of financial characteristics, certain subgroups (e.g., African-Americans) may have greater or lesser economic obstacles to overcome. Future research might identify specific barriers toward financial independence sub-groups may face. Furthermore, qualitative data may provide even greater insight into the potential barriers and resilience factors in overcoming such barriers toward financial independence among the recovering population.
Acknowledgments
Portions of this paper reflected the Masters Thesis of the first author under the supervision of the second and third authors. The authors appreciate financial support from the National Institute on Drug Abuse (grant number DA13231).
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