Understanding Disparities in the Treatment of Alcohol and Other Drug Disorders

描述（由申请人提供）：酒精和其他药物（AOD）障碍对少数群体的健康有不成比例的影响，包括更严重的酒精问题和更高的药物过量死亡率。然而，需要治疗的少数种族/族裔群体成员获得治疗的可能性较小，一旦接受治疗，参与或完成治疗的可能性较小，就业和刑事司法治疗结果比白色同行更差。个体因素（例如，社会经济地位）也有影响，但不能完全解释治疗中的种族/民族差异。一个有希望的方向是增加对社区特征的关注，这些特征已被证明会广泛影响健康和一般保健服务方面的差距。拟议的研究探讨了社区特征的影响，种族/民族差异在治疗AOD疾病。这项研究将是一项二次分析，使用来自华盛顿公共资助的专业AOD治疗系统的数据，与来自州就业和刑事司法机构的数据以及来自美国人口普查的社区层面数据相关联，以了解差异的驱动因素。拟议的分析将测试种族/民族和社区特征在多大程度上影响接受符合既定质量指标的AOD护理，参与门诊治疗以及就业和逮捕结果。本研究旨在：1.确定社区特征是否介导治疗参与中的种族/民族差异。2.测试治疗后就业，DUI逮捕和与毒品有关的逮捕是否存在种族/民族差异，以及社区特征是否调解任何差异。3.探索社区特征是否调节种族/民族与治疗参与、就业和刑事司法结果之间的关系，这项研究有可能解释AOD治疗中种族/民族差异如何发生的途径。这项研究的结果将为在客户或社区一级制定适当的干预措施提供信息，以消除AOD治疗中的差异，并最终消除健康结果。

DESCRIPTION (provided by applicant): Alcohol and other drug (AOD) disorders have disproportionate impact on the health of minority groups, including more severe alcohol problems and higher rates of drug overdose mortality. Yet, members of racial/ethnic minority groups who need treatment are less likely to access treatment, and once entering treatment are less likely to become engaged in or complete treatment, and to have worse employment and criminal justice treatment outcomes than their white counterparts. Individual factors (e.g., socioeconomic status) have been shown to contribute, but not completely explain racial/ethnic disparities in treatment. One promising direction is to add a focus on community characteristics which have been shown to influence disparities broadly in health and general health care services. The proposed research examines the influence of community characteristics on racial/ethnic disparities in the treatment of AOD disorders. This study will be a secondary analysis using data from Washington's publicly funded specialty AOD treatment system linked to data from state employment and criminal justice agencies, as well as community level data from the U.S. Census, to understand drivers of disparities. The proposed analysis will test to what degree race/ethnicity and community characteristics influence receiving AOD care that conforms to a well-established quality indicator, engagement in outpatient treatment, as well as employment and arrest outcomes. The current study aims to: 1. Determine whether community characteristics mediate racial/ethnic disparities in treatment engagement. 2. Test whether racial/ethnic disparities in post-treatment employment, DUI arrests, and drug-related arrests exist and whether community characteristics mediate any disparities. 3. Explore whether community characteristics' moderate the relationship between race/ethnicity and treatment engagement, employment, and criminal justice outcomes this study has the potential to explain the pathways of how racial/ethnic disparities in AOD treatment occur. Findings from this study will inform the development of appropriate interventions, at the client or community- level, needed to eliminate disparities in AOD treatment, and ultimately in health outcomes.