Housing instability, race/ethnicity, and sexual identity as intersectional factors in adolescent cannabis use

This study examines the association between cannabis use and the intersection of housing instability with sexual identity and race/ethnicity among U.S. high school students.

We utilized nationally representative survey data from high school students in 2021 and 2023 (n = 24,885), analyzed in 2024. The dependent variable was past 30-day cannabis use, and the primary independent variables were the intersection of housing instability with sexual identity and race/ethnicity. Propensity score weighting was used to balance characteristics between the intersectional variable groups, followed by logistic regression in the outcome model.

Results showed significantly higher odds of cannabis use among students with housing instability who identified as heterosexual (OR = 3.38, 95 %CI = 2.69-4.23), gay or lesbian (OR = 4.71, 95 %CI = 2.55-8.68), bisexual (OR = 3.89, 95 %CI = 1.90-7.96), and other sexual identities (OR = 7.73, 95 %CI = 4.24-14.08) compared to heterosexual students with stable housing. We also found higher odds of cannabis use for those with housing instability among non-Hispanic white students (OR = 3.59, 95 %CI = 2.78-4.63), non-Hispanic black students (OR = 3.24, 95 %CI = 2.10-5.00), non-Hispanic other students (OR = 3.08, 95 %CI = 2.13-4.45), and Hispanic students (OR = 5.24, 95 %CI = 3.59-7.65) compared to non-Hispanic white students with stable housing.

The findings indicate a significant association between housing instability and cannabis use, particularly among sexual and racial/ethnic minorities. The intersectional analysis underscores the compounded challenges faced by these groups.