This study focused on (1) whether disparities in timely receipt of substance use services can be explained in part by the characteristics of the community in which the clients reside and (2) whether the effect of community characteristics on timely receipt of services was similar across racial/ethnic groups. The sample was composed of adults receiving publicly funded outpatient treatment in Washington State. Treatment data were linked to data from the US census. The outcome studied was “Initiation and Engagement” in treatment (IET), a measure noting timely receipt of services at the beginning of treatment. Community characteristics studied included community level economic disadvantage and concentration of American Indian, Latino, and Black residents in the community. Black and American Indian clients were less likely to initiate or engage in treatment compared to non-Latino white clients, and American Indian clients living in economically disadvantaged communities were at even greater risk of not initiating treatment. Community economic disadvantage and racial/ethnic makeup of the community were associated with treatment initiation, but not engagement, although they did not entirely explain the disparities found in IET.
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The authors would like to thank Can Du from the Behavioral Health Administration in the Washington State Department of Social and Health Services for her comments on an earlier version of the manuscript.
This research was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under award number R03AA023390. The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or of the participating state.
Conflict of Interest
The authors have no conflict of interests to declare.
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Acevedo, A., Panas, L., Garnick, D. et al. Disparities in the Treatment of Substance Use Disorders: Does Where You Live Matter?. J Behav Health Serv Res 45, 533–549 (2018). https://doi.org/10.1007/s11414-018-9586-y