The Opioid Epidemic and Children’s Living Arrangements in the United States, 2000–2018

• DOI: http://doi.org/10.1177/00027162221142648
• Published date: 01 September 2022
• Date: 01 September 2022

162 ANNALS, AAPSS, 703, September 2022

DOI: 10.1177/00027162221142648

The Opioid

Epidemic and

Children’s

Living

Arrangements

in the United

States, 2000–

2018

By

MÓNICA L. CAUDILLO,

ANDRÉS VILLARREAL,

and

PHILIP N. COHEN

1142648ANN THE ANNALS OF THE AMERICAN ACADEMYTHE OPIOID EPIDEMIC AND CHILDREN’S LIVING ARRANGEMENTS

research-article2022

Although the detrimental effects of the opioid epi-

demic on individuals’ health and well-being have been

well documented, we know little about how it has

affected the family contexts in which children live. We

assess how the opioid epidemic, as measured by a rise

in the opioid overdose death rate, has affected the rates

at which children live in different family arrangements:

two married parents, two cohabiting parents, single

mother, single father, or another configuration. Our

local fixed-effects models show that higher local over-

dose death rates are associated with fewer children

living with two married parents and with an increase in

children living in family structures that tend to be less

stable, such as those led by cohabiting parents or a

single parent. These changes in family arrangements

have potential long-term implications for the well-

being of future generations.

Keywords: children; child well-being; family instabil-

ity; family structure; opioid epidemic

In 2017, more than eleven million people

misused some type of opioid in the United

States (Substance Abuse and Mental Health

Services Administration [SAMHSA] 2018).

Although multiple studies have shown that

opioid dependence has severe negative effects

on individuals’ lives, we know very little about

how it affects the family contexts in which

children live (Peisch etal. 2018). Indirect evi-

dence of the effect of the opioid epidemic on

family structure may be gleaned from studies

Mónica L. Caudillo is an assistant professor of

sociology at the University of Maryland and a faculty

affiliate at the Maryland Population Research Center.

Her current research projects assess how disruptions

to social contexts, such as community violence, the

opioid epidemic, and the COVID-19 pandemic, impact

fertility, family transitions, and health in the U.S. and

Mexico. Her work has appeared in journals like

Demography, Social Forces, and Journal of Marriage

and Family.

Correspondence: caudillo@umd.edu

THE OPIOID EPIDEMIC AND CHILDREN’S LIVING ARRANGEMENTS 163

examining other closely related outcomes. For example, a recent study has shown

that local opioid-overdose death rates (ODR) are associated with an increase in

nonmarital births (Caudillo and Villarreal 2021). There is also evidence of a

positive association between opioid overdose deaths and the number of children

who enter foster care (Bullinger and Ward 2021). Nonetheless, we know little

about how the opioid epidemic has shaped children's probability of living in dif-

ferent types of family arrangements. This question is fundamental to understand-

ing the long-term and intergenerational effects of the opioid crisis because the

health, behavioral, and economic outcomes of children vary across different types

of family structures (Craigie, Brooks-Gunn, and Waldfogel 2012).

In this study, we use the 5 percent sample of the 2000 Census, the 2005 to

2018 one-year samples of the American Community Survey (ACS), and restricted

national death certificate data for the same period to evaluate the relationship

between the local ODR and the rates of children living under five different fam-

ily structures: two married parents, two cohabiting parents, single mother, single

father, and adults other than parents. We distinguish between children living with

two married or two cohabiting parents because children of married parents tend

to experience better educational and social outcomes, compared to those with

cohabiting parents (Brown 2010). Children living with two married parents are

the least likely to experience poverty and housing and food insecurity, whereas

those living with single or cohabiting parents are at higher risk of experiencing

those conditions (Manning and Brown 2006). We also evaluate changes in the

rates of children living with single mothers and fathers, because this type of fam-

ily structure is the most economically vulnerable as there is usually only one adult

who works and provides income (Brady, Finnigan, and Hübgen 2017).

We examine how children’s family arrangements have changed throughout the

opioid epidemic using local area fixed-effects models, which account for any

time-invariant community-level characteristics that might affect both opioid

abuse and changes in family arrangements. We exploit variation in ODR from

Andrés Villarreal is a professor of sociology at the University of California, Los Angeles, and a

faculty affiliate at the California Center for Population Research. His current research focuses

on international migration, race and ethnicity, social stratification, and health in social context.

His work has appeared in journals like Demography, American Sociological Review, and Social

Forces.

Philip Cohen is a professor of sociology at the University of Maryland and a faculty affiliate at

the Maryland Population Research Center. His most recent book is The Family: Diversity,

Inequality, and Social Change (3rd ed., Norton 2021). He is the founding director of SocArXiv,

an open archive for the social sciences, and an advocate for open science in the research

community.

NOTE: We are grateful to Colleen Heflin, Rajeev Darolia, and the other authors in this vol-

ume for their helpful comments on a previous version of this manuscript. This study was

funded in part by a grant from the Eunice Kennedy Shriver National Center for Child Health

and Human Development grant (R03HD102516), granted to co-PIs Caudillo and Villarreal.

Additionally, we gratefully acknowledge support from the NICHD grants to the Maryland

Population Research Center (P2C-HD041041) and the California Center for Population

Research (P2C-HD041022).