Distance traveled to outpatient drug treatment and client retention

Beardsley, Kyle; Wish, Eric D.; Fitzelle, Dawn Bonanno; O’Grady, Kevin E.; Arria, Amelia M.

doi:10.1016/s0740-5472(03)00188-0

Cited by 145 publications

(139 citation statements)

References 15 publications

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“…This distribution may have several implications. Given the salience of proximity to determining injectors' use of harm reduction services and drug treatment, [32][33][34][35] the racialized distribution of ESAP access may help explain the lower rates of ESAP pharmacy utilization among black injectors in NYC if the racial/ethnic composition of injectors across districts follows that of the general population. Planned multilevel analyses that combine district-level data on spatial access to ESAP with individual-level data on ESAP use among injecting district residents will allow us to explore this possibility.…”

Section: Discussionmentioning

confidence: 99%

“…Spatial access to programs supporting users' health is a key feature of the local risk environment for injectors: travel time to service sites shapes utilization of harm reduction programs and drug treatment programs (though see Bruneau and colleagues for a possible exception 31 ). [32][33][34][35] An NYC-based study conducted in the mid-1990s, for example, found that injectors living within a 10-min travel distance of a local SEP were almost three times more likely to attend an SEP and half as likely to report receptive syringe sharing than other injectors. 32 Critical race theory describes racialized social systems as "societies that allocate differential economic, political, social, and even psychological rewards to groups along racial lines" 36 (p. 44).…”

Section: Introductionmentioning

confidence: 99%

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Temporal Trends in Spatial Access to Pharmacies that Sell Over-the-Counter Syringes in New York City Health Districts: Relationship to Local Racial/Ethnic Composition and Need

et al. 2009

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Pharmacies that sell over-the-counter (OTC) syringes are a major source of sterile syringes for injection drug users in cities and states where such sales are legal. In these cities and states, however, black injectors are markedly less likely to acquire syringes from pharmacies than white injectors. The present analysis documents spatial and temporal trends in OTC pharmacy access in New York City health districts over time (2001)(2002)(2003)(2004)(2005)(2006) and investigates whether these trends are related to district racial/ ethnic composition and to local need for OTC pharmacies. For each year of the study period, we used kernel density estimation methods to characterize spatial access to OTC pharmacies within each health district. Higher values on this measure indicate better access to these pharmacies. "Need" was operationalized using two different measures: the number of newly diagnosed injection-related AIDS cases per 10,000 residents (averaged across 1999-2001), and the number of drug-related hospital discharges per 10,000 residents (averaged across 1999-2001). District sociodemographic characteristics were assessed using 2000 US decennial census data. We used hierarchical linear models (HLM) for descriptive and inferential analyses and investigated whether the relationship between need and temporal trajectories in the Expanded Syringe Access Demonstration Program access varied by district racial/ethnic composition, controlling for district poverty rates. HLM analyses indicate that the mean spatial access to OTC pharmacies across New York City health districts was 12.71 in 2001 and increased linearly by 1.32 units annually thereafter. Temporal trajectories in spatial access to OTC pharmacies depended on both need and racial/ethnic composition. Within high-need districts, OTC pharmacy access was twice as high in 2001 and increased three times faster annually, in districts with higher proportions of non-Hispanic white residents than in districts with low proportions of these residents. In low-need districts, "whiter" districts had substantially greater baseline access to OTC pharmacies than districts with low proportions of non-Hispanic white residents. Access remained stable thereafter in low-need districts, regardless of racial/ethnic composition. Conclusions were consistent across both measures of "need" and persisted after controlling for local poverty rates. In both high-and low-need districts, spatial access to OTC pharmacies was greater in "Whiter" districts in 2001; in high-need 929districts, access also increased more rapidly over time in "whiter" districts. Ensuring equitable spatial access to OTC pharmacies may reduce injection-related HIV transmission overall and reduce racial/ethnic disparities in HIV incidence among injectors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Temporal Trends in Spatial Access to Pharmacies that Sell Over-the-Counter Syringes in New York City Health Districts: Relationship to Local Racial/Ethnic Composition and Need

et al. 2009

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“…[19][20][21][22] Associations between illicit drug use and neighborhood context 1,3 suggest that certain aspects of the neighborhood environment around the treatment site may also affect recovery. 12,13 We illustrated an assessment of neighborhood conditions at publicly financed treatment facilities in a large, metropolitan area and compared them to conditions where patients they serve live.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas an objective assessment of neighborhood conditions at treatment locations relative to where clients live can help guide facility location decisions, we recognize that it is no substitute for fair siting processes and will not necessarily satisfy concerned residents' opposition to a planned site or expansion. [17][18][19] The aims of this assessment are threefold:…”

Section: Introductionmentioning

confidence: 99%

Do Drug Treatment Facilities Increase Clients’ Exposure to Potential Neighborhood-Level Triggers for Relapse? A Small-Area Assessment of a Large, Public Treatment System

Jacobson

2006

J Urban Health

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Research on drug treatment facility locations has focused narrowly on the issue of geographic proximity to clients. We argue that neighborhood conditions should also enter into the facility location decision and illustrate a formal assessment of neighborhood conditions at facilities in a large, metropolitan area, taking into account conditions clients already face at home. We discuss choice and construction of smallarea measures relevant to the drug treatment context, including drug activity, disadvantage, and violence as well as statistical comparisons of clients`home and treatment locations with respect to these measures. Analysis of 22,707 clients discharged from 494 community-based outpatient and residential treatment facilities that received public funds during 1998-2000 in Los Angeles County revealed no significant mean differences between home and treatment neighborhoods. However, up to 20% of clients are exposed to markedly higher levels of disadvantage, violence, or drug activity where they attend treatment than where they live, suggesting that it is not uncommon for treatment locations to increase clients`exposure to potential environmental triggers for relapse. Whereas on average both home and treatment locations exhibit higher levels of these measures than the household locations of the general population, substantial variability in public treatment clients`home neighborhoods calls into question the notion that they hail exclusively from poor, high drug activity areas. Shortcomings of measures available for neighborhood assessment of treatment locations and implications of the findings for other areas of treatment research are also discussed.

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“…1 More specifically, research has identified a lack of awareness of substance abuse treatment options and stigma associated with seeking treatment as barriers that restrict clients from seeking treatment. 9 Although evidence suggests that outreach to improve knowledge around substance use disorders and awareness of treatment options significantly reduces stigma of treatment for under-served groups 10 , only a small proportion of facilities in Cape Town and Gauteng conduct activities that target these barriers among black South Africans.…”

Section: Discussionmentioning

confidence: 99%

Access to substance abuse treatment services for black South Africans: findings from audits of specialist treatment facilities in Cape Town and Gauteng: original article

Myers¹,

Parry²

2005

Afr. J. Psych

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Distance traveled to outpatient drug treatment and client retention

Cited by 145 publications

References 15 publications

Temporal Trends in Spatial Access to Pharmacies that Sell Over-the-Counter Syringes in New York City Health Districts: Relationship to Local Racial/Ethnic Composition and Need

Temporal Trends in Spatial Access to Pharmacies that Sell Over-the-Counter Syringes in New York City Health Districts: Relationship to Local Racial/Ethnic Composition and Need

Do Drug Treatment Facilities Increase Clients’ Exposure to Potential Neighborhood-Level Triggers for Relapse? A Small-Area Assessment of a Large, Public Treatment System

Access to substance abuse treatment services for black South Africans: findings from audits of specialist treatment facilities in Cape Town and Gauteng: original article

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