Decline In Public Substance Use Disorder Treatment Centers Most Serious In Counties With High Shares Of Black Residents.
Previous research has associated declines in health care resources such as hospitals and trauma centers with communities' racial composition. However, little is known about changes in the substance use disorder treatment infrastructure in recent years and the implications for black communities. We used data for the period 2002-10 from the National Survey of Substance Abuse Treatment Services to describe changes in the supply of public and private outpatient facilities for substance use disorder treatment, and to determine whether these trends had implications for the geographical availability of these facilities in counties with high percentages of black residents. During the study period the number of publicly owned facilities declined 17.2 percent, whereas the number of private for-profit facilities grew 19.1 percent. At baseline, counties with very high percentages of black residents (that is, more than one standard deviation above the mean) were more likely than counties with less than the mean percentage of black residents to be served by public facilities and were thus disproportionately affected by the overall decline in public facilities. Future research should examine the effect of expanding eligibility for Medicaid on the supply of substance use disorder treatment facilities across diverse communities.
Janet R. Cummings (jrcummi@emory.edu) is an associate professor in the Department of Health Policy and Management, Rollins School of Public Health, at Emory University, in Atlanta, Georgia.
Janet R
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Hefei Wen is an assistant professor of health management and policy at the University of Kentucky, in Lexington.
Hefei
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Michelle Ko is a research scientist at the Center for Health Policy Research, at the University of California, Los Angeles.
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D001741:Black or African American / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006269:Health Facilities, Proprietary / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data; D010067:Ownership; D017150:Public Sector; D044469:Racial Groups; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000208:ethnology / Q000628:therapy*; D011795:Surveys and Questionnaires; D014481:United States
Disparities; Mental Health/Substance Abuse; Nonprofit/For-Profit Status; Safety-Net Systems