title: Heterogeneous Costs of Alcohol and Drug Problems Across Cities and Counties in California.
abstract: Estimates of economic and social costs related to alcohol and other drug (AOD) use and abuse are usually made at state and national levels. Ecological analyses demonstrate, however, that substantial variations exist in the incidence and prevalence of AOD use and problems including impaired driving, violence, and chronic disease between smaller geopolitical units like counties and cities. This study examines the ranges of these costs across counties and cities in California.
  
  
  
  We used estimates of the incidence and prevalence of AOD use, abuse, and related problems to calculate costs in 2010 dollars for all 58 counties and an ecological sample of 50 cities with populations between 50,000 and 500,000 persons in California. The estimates were built from archival and public-use survey data collected at state, county, and city levels over the years from 2009 to 2010.
  
  
  
  Costs related to alcohol use and related problems exceeded those related to illegal drugs across all counties and most cities in the study. Substantial heterogeneities in costs were observed between cities within counties.
  
  
  
  AOD costs are heterogeneously distributed across counties and cities, reflecting the degree to which different populations are engaged in use and abuse across the state. These findings provide a strong argument for the distribution of treatment and prevention resources proportional to need.
authors.affiliation: Pacific Institute for Research and Evaluation, Silver Spring, Maryland.|Centre for Population Health Research, Curtin University, Perth, Western Australia, Australia.
authors.forename: Ted R
authors.identifier: 0000-0002-0958-2639
authors.initials: TR
authors.lastname: Miller
authors.affiliation: Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California.
authors.forename: Peter
authors.initials: P
authors.lastname: Nygaard
authors.affiliation: Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gaidus
authors.affiliation: Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California.
authors.forename: Joel W
authors.initials: JW
authors.lastname: Grube
authors.affiliation: Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California.
authors.forename: William R
authors.initials: WR
authors.lastname: Ponicki
authors.affiliation: Pacific Institute for Research and Evaluation, Calverton, Maryland.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Lawrence
authors.affiliation: Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Gruenewald
mesh_terms: D000437:Alcoholism / Q000191:economics / Q000401:mortality / Q000628:therapy; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D002947:Cities / Q000191:economics* / Q000453:epidemiology*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends; D019966:Substance-Related Disorders / Q000191:economics* / Q000401:mortality* / Q000628:therapy
keywords: Child Maltreatment; Chronic Disease; Impaired Driving; Quality of Life; Violence