Disparties in substance abuse (SA treatment)

本研究的目标是为服务规划者和政策制定者提供有关 药物滥用治疗服务中种族/族裔差距的大小和来源，以及 以及美国少数族裔人群中物质障碍的社会后果。在前三个目标中，我们 应用医学研究所健康差距框架，该框架强调差距包括所有 通过健康以外的因素调节的种族/民族群体之间的待遇差异 状态和首选项。第一个目标是评估和比较未得到满足的药物滥用治疗需求。 按种族/民族(亚裔、拉丁裔、非裔美国人和非拉丁裔白人)分列的服务。第二个目标 计算每个种族/少数族裔群体在药物滥用治疗利用方面的差异 非拉丁裔白人。第三个目标是确定和评估各种机制的相对贡献 保险、社会保障、语言和地理等方面的差异。第四个目的是估计协会 年少数民族人群物质障碍与劳动力市场和公共援助结果之间的关系 以强调有可能通过缩小差距来防止的经济负担。最后， 第五个目标的目标是将前四个目标产生的与政策相关的结果传播给 健康差距和药物滥用领域的利益攸关方。 数据来自四个新的具有全国代表性的大型数据集，全国拉丁裔和亚洲人 美国研究(NLAAS)、国家共病调查复制研究(NCS-R)、国家 酒精及相关疾病流行病学调查(NESARC)和全国吸毒情况调查 和健康(NSDUH)。这些调查提供了有关物质和其他精神障碍的诊断信息， 治疗利用信息，劳动力市场结果、公共援助收据等丰富数据 社会人口因素。为了估计差距，我们最近应用了服务使用的非线性模型 介绍了卫生服务方面的研究文献。为了研究机制，我们使用了基于回归的方法 分解方法，以了解不同来源可以解释的差异比例。 我们测试了我们的发现对需求和治疗的几种不同定义的敏感性。 我们的发现将提供一些关于大小和来源的最佳和最新数据 各国在利用药物滥用治疗方面的种族/族裔差异。这项研究还将产生 关于潜在可预防的劳动力市场和公共援助的一些首批可用信息 少数民族人群物质障碍状况分析。这些信息是非常需要开发的 有效的政策，以纠正差距，并最终通过减少以下方面的负担来改善公共卫生 少数族裔人群中的物质障碍。

The goal of this study is to supply service planners and policy makers with the best available data on the magnitude and sources of racial/ethnic disparities in substance abuse treatment services, and the economic and social consequences of substance disorders in minority populations in the US. In the first three aims, we apply the Institute of Medicine health disparity framework, which emphasizes that a disparity includes all differences in treatment between racial/ethnic groups that are mediated through factors other than health status and preferences. The first aim estimates and compares unmet need for substance abuse treatment services by racial/ethnic group (Asians, Latinos, African-Americans, and non-Latino whites). The second aim calculates disparities in substance abuse treatment utilization for each racial/ethnic minority group relative to non-Latino whites. The third aim identifies and assesses the relative contribution of various mechanisms of disparities such as insurance, SES, language, and geography. The fourth aim estimates the association between substance disorders and labor market and public assistance outcomes in minority populations in order to highlight the economic burden that potentially could be prevented by reducing disparities. Finally, the goal of the fifth aim is to disseminate policy-relevant findings generated from the prior four aims to key stakeholders in the health disparities and substance abuse field. Data come from four new, large, nationally representative data sets, the National Latino and Asian American Study (NLAAS), the National Comorbidity Survey Replication study (NCS-R), the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the National Survey on Drug Use and Health (NSDUH). These surveys offer diagnostic information on substance and other mental disorders, treatment utilization information, and rich data on labor market outcomes, public assistance receipt and other sociodemographic factors. To estimate disparities, we apply non-linear models of service use recently introduced in the health services research literature. To study mechanisms, we apply regression-based decomposition methods to understand what proportion of disparities can be explained by different sources. We test the sensitivity of our findings to several alternate definitions of need and treatment. Our findings will offer some of the best and most recent data available on the magnitude and sources of national racial/ethnic disparities in the utilization of substance abuse treatment. The study also will generate some of the first information available about the potentially preventable labor market and public assistance consquences of substance disorders in minority populations. This information is critically needed to develop effective policies to remediate disparities, and, ultimately, to improve public health by reducing the burden of substance disorders in racial/ethnic minority populations.