Long-Term Morbidity and Mortality among a Sample of Cocaine-Dependent Black and White Veterans

Abstract

Racial minorities generally exhibit worse health status than do whites. To assess the presence of similar phenomena among long-term cocaine-using veterans, this study examined racial variations in mortality and health status among cocaine-dependent men who were originally recruited at their admissions to cocaine treatment in 1988-1989 and were interviewed approximately 12 years later in 2002-2003. Mortality was higher among whites (15%) than blacks (6%), particularly due to drug overdose. Controlling for socioeconomic factors, cocaine severity, and depression, the racial difference was still significant in the survival analysis. Racial differences were examined in the health status of those interviewed in the 12-year follow-up study (178 blacks and 65 whites), after confirmation of their comparable socioeconomic backgrounds and levels of healthcare access and utilization. Contrary to expectations, few racial differences were found on most health indicators, although the level of cocaine use was higher among blacks. Furthermore, fewer blacks reported having hepatitis or sexually transmitted diseases than did whites. The study results suggest that black cocaine-dependent veterans do not have worse health status when compared with white veterans on most health indicators.

Mortality, Causes of Death, and Health Status Among Methamphetamine Users

“…12,30–32 The standardized mortality ratio for females was similar to that in Kuo and colleagues 31 but greater than that reported in Hser and colleagues for female methamphetamine users 30 ; for males in the current study, the SMR was greater than that reported by Kuo and colleagues. 31 …”

Need-service matching in substance abuse treatment: Racial/ethnic differences

“…While some studies indicate Latinos and African Americans have greater or equal access to substance abuse treatment compared to Whites (Daley, 2005; Niv & Hser, 2006; Yan, Huan, & Hser, 2006), still other studies indicate they are less likely to seek and complete treatment (Agosti, Nunes, & Ocepek-Welikson, 1996; Kleinman et al, 1992; Rebach, 1992; Wickizer et al, 1994). Additionally, other research indicates that African American and Latino clients report that they have less access to drug treatment (Robles et al, 2003; Wu, El-Bassel, Gilbert, Piff, & Sanders, 2004; Wu, Kouzis, & Schlenger, 2003), receive fewer services (Jerrell & Wilson, 1997; Wells et al, 2001), and are less like to report overall satisfaction with treatment (Wells et al, 2001; Tonigan, 2003).…”

Ethnic differences in utilization of drug treatment services and outcomes among Proposition 36 offenders in California

“…Some studies indicate that minority groups, compared to Whites, experience better or equal access to and utilization of treatment services (Daley, 2005;Niv & Hser, 2006;Yang, Huang, & Hser, 2006), with an overrepresentation of minorities in some substance abuse treatment programs (De La Rosa, Khalsa, & Rouse, 1990;Desmond & Maddux, 1984;Hanson, 1985;Jung, 2000;Kopstein & Roth, 1998;SAMHSA, 2002;Schmidt & Weisner, 1993;Yang et al, 2006). Other evidence indicates that ethnic disparities do occur, with minorities experiencing reduced access to drug treatment (Little, 1981;Lundgren, Amodeo, Gerguson, & Davis, 2001;Rhodes et al, 1990;Robles et al, 2003;Rounsaville & Kleber, 1985;Wu, ElBassel, Gilbert, Piff, & Sanders, 2004;Wu, Kouzis, & Schlenger, 2003), fewer services (Wells, Klap, Koike, & Sherbourne, 2001), shorter treatment stays (Agosti, Nunes, & Ocepeck-Welikson, 1996;Evans, Spear, Huang, & Hser, 2006;Longshore et al, 2004;McCaul, Svikis, & Moore, 2001;Milligan, Nich, & Carroll, 2004), or complete absence of substance abuse treatment services (Longshore, Hsieh, Anglin, & Annon, 1992).…”