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The Great Smoky Mountains Study — a longitudinal study of psychiatric and substance use disorders in rural and urban youth — followed a representative sample of children in North Carolina from ages 9 to 13 years to age 21. Three years after the study's inception, a casino opened on an American Indian reservation in the area, and families on the reservation received a percentage of the profits. This allowed investigators to examine the long-term effects of family income supplements on risk for psychiatric and substance-use disorders in 349 American Indian children from families with supplements (range, US$500–$9000 per year) and 991 non–American Indian white children from families without supplements. By age 21, participants had undergone an…