title: Residential segregation and injection drug use prevalence among Black adults in US metropolitan areas.
abstract: OBJECTIVE
  We analyzed the relations of two 1990 dimensions of racial residential segregation (isolation and concentration) with 1998 injection drug use prevalence among Black adult residents of 93 large US metropolitan statistical areas (MSAs).
  
  
  METHODS
  We estimated injection drug use prevalence among Black adults in each MSA by analyzing 3 databases documenting injection drug users' encounters with the health care system. Multiple linear regression methods were used to investigate the relationship of isolation and concentration to the natural logarithm of Black adult injection drug use prevalence, controlling for possible confounders.
  
  
  RESULTS
  The median injection drug use prevalence was 1983 per 100000 Black adults (interquartile range: 1422 to 2759 per 100000). The median isolation index was 0.48 (range: 0.05 to 0.84): in half the MSAs studied, the average Black resident inhabited a census tract where 48% or more of the residents were Black. The multiple regression model indicates that an increase of 0.50 in the isolation index was associated with a 23% increase in injection drug use prevalence among Black adults. Concentration was unrelated to the outcome.
  
  
  CONCLUSIONS
  Residential isolation is positively related to Black injection drug use prevalence in MSAs. Research into the pathways linking isolation to injection drug use is needed.
authors.affiliation: Medical and Health Research Association of New York City, Inc, New York, NY, USA. cooper@ndri.org
authors.forename: Hannah L F
authors.initials: HL
authors.lastname: Cooper
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
authors.forename: Barbara
authors.initials: B
authors.lastname: Tempalski
authors.forename: Risa
authors.initials: R
authors.lastname: Friedman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D019352:Censuses; D002947:Cities; D003430:Cross-Sectional Studies; D019992:Databases as Topic; D005843:Geography; D015528:HIV Seroprevalence; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011287:Prejudice; D015995:Prevalence; D012111:Residence Characteristics / Q000145:classification / Q000706:statistics & numerical data*; D012934:Social Isolation; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*