Youth and young adults who are injection drug users (IDU’s) often live and survive in physical and emotional environments that are associated with negative behaviors and outcomes. Past environmental and social factors, such as participation in social welfare systems or institutionalization in foster care or juvenile hall, have been found to be associated with IDU-involved young adults’ health behaviors when they become older. Social networks, which include drug, sex, or hangout networks, may influence their health outcomes and behaviors. The goals of this dissertation include an investigation of how reported past social welfare participation and institutionalization is associated with IDU-involved young adults’ health behaviors and the role of social networks and how they are associated with IDU-involved young adult behaviors have been examined. This dissertation involves analysis of 320 IDU-involved young adults who participated in a 5-year NIDA-funded social network study conducted in Los Angeles County. Participants may be involved in negative health behaviors and outcomes, such as illicit drug use, violence, risky sexual behaviors, and homelessness. In order to examine associations between social welfare participation, institutionalization, and the social networks’ possible influence on behavior, categorical-response survey items were recoded and used as dependent and independent variables in chi-square, logistic regression, or ordinal regression analyses. The results suggest that negative health behaviors and outcomes of IDU-involved young adults are positively associated with different forms of past institutionalization and several forms of social networks. Foster care and juvenile hall incarceration seem to pose similar risks of performing negative health behaviors among IDU-involved youth. Statistical interactions by gender indicate that, overall, females were protected from perpetrating and being victimized by violence, except when past histories of child abuse were experienced. Gender interactions indicated that social networks appear to influence male negative behaviors more than females. Males and females appear to be influenced by different predictor variables relating to past abuse and people with whom they associate with on the streets. Implications based on these results may guide health educators and policy makers to improve existing institutionalization services such as foster care and juvenile hall where rehabilitative or developmental care may be lacking.


School of Public Health

First Advisor

Susanne B. Montgomery

Second Advisor

Jerry W. Lee

Third Advisor

Mark Ghamsary

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Social Welfare -- psychology; Substance-Related Disorders; Adolescent; Health Behavior.



Page Count

xiii; 174

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives