Evaluating racial disparity in referral source and successful completion of substance abuse treatment.
Health disparity is a significant problem in the United States, and particularly for substance abuse treatment programs. A better understanding of racial differences in treatment pathways associated with successful treatment completion is needed to reduce the existing health disparities. Referral source is a strong predictor of treatment success and most research on health disparities has focused on the criminal justice referrals. However, little research has examined other types of referral sources, and the interaction with race. The current study sought to compare the effect of referral sources on national substance abuse successful treatment completion rates between Black clients (n=324,625) and White clients (n=1,060,444) by examining the interaction of race on referral source and successful treatment completion. Race significantly moderated the difference between referral source and successful treatment completion (Wald χ(2)=1477.73, df=6, p<0.0001). Employment referral was associated with the greatest percentage of successful treatment completion for Black clients. Criminal justice referral was associated with the greatest percentage of successful treatment completion for White clients. Results from the present study support a reevaluation of incentives leading to successful treatment completion with a multicultural perspective.
Iowa Consortium for Substance Abuse Research and Evaluation, 100 MTP4, University of Iowa, Iowa City, IA 52245-5000, USA; Department of Psychological and Quantitative Foundations, Counseling Psychology Program, College of Education, University of Iowa, 361 Lindquist Center, Iowa City, IA 52242, USA.
Ethan
E
Sahker
Department of Epidemiology, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, USA.
Maisha N
MN
Toussaint
Department of Occupational and Environmental Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, 100 CPHB, Iowa City, IA 52242, USA.
Marizen
M
Ramirez
Department of Psychological and Quantitative Foundations, Counseling Psychology Program, College of Education, University of Iowa, 361 Lindquist Center, Iowa City, IA 52242, USA.
Saba R
SR
Ali
Iowa Consortium for Substance Abuse Research and Evaluation, 100 MTP4, University of Iowa, Iowa City, IA 52245-5000, USA; Department of Psychiatry, Carver College of Medicine, University of Iowa, 451 Newton Road, 200 Medicine Administration Building, Iowa City, IA 52242, USA; Department of Biostatistics, College of Public Health, University of Iowa, 145 N. Riverside Drive, 100 CPHB, Iowa City, IA 52242, USA. Electronic address: stephan-arndt@uiowa.edu.
Stephan
S
Arndt
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D057566:Self Report; D019966:Substance-Related Disorders / Q000208:ethnology* / Q000628:therapy; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
Health disparity; Race; Referral source; Substance abuse; Treatment outcomes