George Pro, Jonathan Cantor, Mance Buttram, Clare C Brown, Mofan Gu, Michael Mancino, Nickolas Zaller
{"title":"2021 年美国在获得甲基苯丙胺戒毒服务方面的地域和种族/族裔差异。","authors":"George Pro, Jonathan Cantor, Mance Buttram, Clare C Brown, Mofan Gu, Michael Mancino, Nickolas Zaller","doi":"10.1097/MLR.0000000000002013","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Methamphetamine detoxification before entering formal and longer term treatment may have a positive impact on treatment retention and success. Understanding geographic distribution of methamphetamine specialty detox services and differential access by race/ethnicity is critical for establishing policies that ensure equitable access across populations.</p><p><strong>Methods: </strong>We used the Mental health and Addiction Treatment Tracking Repository to identify treatment facilities that offered any substance use detoxification in 2021 (N=2346) as well as the census block group in which they were located. We sourced data from the US Census Bureau to identify the percentage of a census block group that was White, Black, and Hispanic. We used logistic regression to model the availability of methamphetamine-specific detox, predicted by the percentage of a block group that was Black and Hispanic. We adjusted for relevant covariates and defined state as a random effect. We calculated model-based predicted probabilities.</p><p><strong>Results: </strong>Over half (60%) of detox facilities offered additional detox services specifically for methamphetamine. Sixteen states had <10 methamphetamine-specific detox facilities. The predicted probability of methamphetamine-specific detox availability was 60% in census block groups with 0%-9% Black residents versus only 46% in census block groups with 90%-100% Black residents, and was 61% in census block groups with 0%-9% Hispanic residents versus 30% in census block groups with 90%-100% Hispanic residents.</p><p><strong>Conclusions: </strong>During an unprecedented national methamphetamine crisis, access to a critical health care service was disproportionately lower in communities that were predominately Black and Hispanic. We orient our findings around a discussion of health disparities, residential segregation, and the upstream causes of the systematic exclusion of minoritized communities from health care.</p>","PeriodicalId":18364,"journal":{"name":"Medical Care","volume":" ","pages":"464-472"},"PeriodicalIF":3.3000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834168/pdf/","citationCount":"0","resultStr":"{\"title\":\"Geographic and Racial/Ethnic Differences in Access to Methamphetamine Detoxification Services, United States, 2021.\",\"authors\":\"George Pro, Jonathan Cantor, Mance Buttram, Clare C Brown, Mofan Gu, Michael Mancino, Nickolas Zaller\",\"doi\":\"10.1097/MLR.0000000000002013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Methamphetamine detoxification before entering formal and longer term treatment may have a positive impact on treatment retention and success. Understanding geographic distribution of methamphetamine specialty detox services and differential access by race/ethnicity is critical for establishing policies that ensure equitable access across populations.</p><p><strong>Methods: </strong>We used the Mental health and Addiction Treatment Tracking Repository to identify treatment facilities that offered any substance use detoxification in 2021 (N=2346) as well as the census block group in which they were located. We sourced data from the US Census Bureau to identify the percentage of a census block group that was White, Black, and Hispanic. We used logistic regression to model the availability of methamphetamine-specific detox, predicted by the percentage of a block group that was Black and Hispanic. We adjusted for relevant covariates and defined state as a random effect. We calculated model-based predicted probabilities.</p><p><strong>Results: </strong>Over half (60%) of detox facilities offered additional detox services specifically for methamphetamine. Sixteen states had <10 methamphetamine-specific detox facilities. The predicted probability of methamphetamine-specific detox availability was 60% in census block groups with 0%-9% Black residents versus only 46% in census block groups with 90%-100% Black residents, and was 61% in census block groups with 0%-9% Hispanic residents versus 30% in census block groups with 90%-100% Hispanic residents.</p><p><strong>Conclusions: </strong>During an unprecedented national methamphetamine crisis, access to a critical health care service was disproportionately lower in communities that were predominately Black and Hispanic. 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引用次数: 0
摘要
导言:在接受正式和长期治疗前进行甲基苯丙胺戒毒可能会对治疗的持续性和成功率产生积极影响。了解甲基苯丙胺专业戒毒服务的地理分布以及不同种族/人种获得服务的差异,对于制定确保不同人群公平获得服务的政策至关重要:我们使用精神健康和成瘾治疗跟踪库(Mental health and Addiction Treatment Tracking Repository)来确定 2021 年提供任何药物使用戒毒服务的治疗机构(N=2346)以及这些机构所在的人口普查区组。我们从美国人口普查局获取数据,以确定白人、黑人和西班牙裔在人口普查区组中所占的比例。我们使用逻辑回归法建立了一个模型,根据街区组中黑人和西班牙裔所占的比例来预测甲基苯丙胺专用戒毒所的可用性。我们对相关协变量进行了调整,并将州定义为随机效应。我们计算了基于模型的预测概率:超过一半(60%)的戒毒机构提供了专门针对甲基苯丙胺的额外戒毒服务。16个州得出了结论:在史无前例的全国甲基苯丙胺危机期间,黑人和西班牙裔占多数的社区获得关键医疗服务的比例过低。我们围绕健康差异、居住隔离以及系统性地将少数群体排除在医疗服务之外的上游原因展开讨论,从而得出结论。
Geographic and Racial/Ethnic Differences in Access to Methamphetamine Detoxification Services, United States, 2021.
Introduction: Methamphetamine detoxification before entering formal and longer term treatment may have a positive impact on treatment retention and success. Understanding geographic distribution of methamphetamine specialty detox services and differential access by race/ethnicity is critical for establishing policies that ensure equitable access across populations.
Methods: We used the Mental health and Addiction Treatment Tracking Repository to identify treatment facilities that offered any substance use detoxification in 2021 (N=2346) as well as the census block group in which they were located. We sourced data from the US Census Bureau to identify the percentage of a census block group that was White, Black, and Hispanic. We used logistic regression to model the availability of methamphetamine-specific detox, predicted by the percentage of a block group that was Black and Hispanic. We adjusted for relevant covariates and defined state as a random effect. We calculated model-based predicted probabilities.
Results: Over half (60%) of detox facilities offered additional detox services specifically for methamphetamine. Sixteen states had <10 methamphetamine-specific detox facilities. The predicted probability of methamphetamine-specific detox availability was 60% in census block groups with 0%-9% Black residents versus only 46% in census block groups with 90%-100% Black residents, and was 61% in census block groups with 0%-9% Hispanic residents versus 30% in census block groups with 90%-100% Hispanic residents.
Conclusions: During an unprecedented national methamphetamine crisis, access to a critical health care service was disproportionately lower in communities that were predominately Black and Hispanic. We orient our findings around a discussion of health disparities, residential segregation, and the upstream causes of the systematic exclusion of minoritized communities from health care.
期刊介绍:
Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.