Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115383

Barbara Allen¹, Geneva Bell-Sanford², Matthew R. Facer, PhD³, Dennis V. Ferrero, MPH², Barbara Green-Ajufo¹, Jeffrey D. Klausner, MD, MPH⁴, George Lemp, DrPH⁵, Martin Lynch⁶, Willi McFarland, MD, PhD⁷, Fred Molitor⁸, Scott Morrow⁹, Kim Page-Shafer, PhD, MPH¹⁰, Juan Ruiz, MD, MPH³, and Jennifer K. Baham, MPH¹¹. (1) Alameda County, 1000 Broadway, Suite 500, Oakland, CA 94607, (2) San Joaquin County, P.O. Box 2009/1601 E. Hazelton Ave., Stockton, CA 95201, (3) California Department of Health Services, Office of AIDS, 1616 Capitol Avenue, Sacramento, CA 95814, (4) STD Prevention and Control Services, San Francisco Department of Public Health, 1360 Mission Street, Suite 401, San Francisco, CA 94103, (5) University of California Office of the President, Universitywide AIDS Research Program, 300 Lakeside Drive, 6th Floor, Oakland, CA 94612, (6) Contra Costa County, 597 Center Avenue, Suite 200, Martinez, CA 94553, (7) HIV Seroepidemiology Unit, San Francisco Department of Public Health, 25 Van Ness, Suite 500, San Francisco, CA 94102, (8) ETR Associates, 2210 21st Street, Sacramento, CA 95818, (9) San Mateo County, 225 W. 37th Avenue, San Mateo, CA 94403, (10) Department of Medicine, University of California Center for AIDS Prevention Studies, 74 New Montgomery Street, Suite 600, San Francisco, CA 94105, (11) HIV/AIDS Epidemiology Branch, Office of AIDS, California Department of Health Services, MS 7700, P.O. Box 997426, Sacramento, CA 95899-7426, 916-449-5853, JBaham@dhs.ca.gov

Objectives: Assess the relation between lacking medical insurance and drug using behaviors within a population-based sample of young men from low-income neighborhoods.

Methods: Census data and maps were used to identify blocks within which the median income fell below the 10th percentile within five northern California counties. Outreach teams enumerated randomly selected blocks and went door-to-door to recruit men aged 18 to 35 from all residences within these blocks. Those who agreed to participate were interviewed from a standardized questionnaire that obtained information on demographics and risk behaviors, including drug use, within the last six months. Multivariate logistic regressions quantified how medical insurance relates to the use of specific drugs while correcting for race/ethnicity, age, and if born outside the U.S..

Results: Among the 1,293 participants, 49.0% were Hispanic/Latino, 20.3% African American, 12.6% white, and 9.2% multiracial; 48.6% were born outside the U.S., and 57.0% reported not having any form of medical insurance (including Medicare/MediCal). Lacking medical insurance showed a slight but significant association to currently smoking cigarettes (OR=1.6; 95% CI 1.2-2.0) and recent marijuana use (OR=1.4; 1.1-1.8). It was strongly associated with recent use of methamphetamine (OR=3.9; 2.3-6.4), crack cocaine (OR=4.4; 1.8-10.6), and powdered cocaine (OR=2.1; 1.4-3.1), but not significantly associated with recent ecstasy use.

Discussion: Absent medical coverage showed a significant association with recent substance use, particularly stimulants, among low-income young men from selected areas of California. Without current prevention efforts, long-term health outcomes from such usage may further strain publicly funded health systems in the future.

Learning Objectives: At the completion of the presentation, the attendee will be able to

• Recognize the importance of knowing whether or not having medical insurance is associated with high-risk behavior, particularly within low-income populations.
• Discuss the relevance of using population-based sampling methods in public health-related studies, particularly within populations containing great demographic diversity.
• Identify some specific drug-using behaviors to which lacking medical insurance is significantly associated.

Keywords: Access to Health Care, Drug Use

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.