Access to substance abuse treatment by adolescents in Medicaid: Differences by race, gender and level of rurality

Adolescent substance abuse continues to be a public health concern. Vulnerable populations are the focus of particular attention because despite efforts to improve the overall health of the nation, these populations still contend with increasing disparities in health status and health outcomes. The purpose of this study is to examine disparities in utilization of substance abuse treatment among minority, female and rural adolescents enrolled in one southern state's Medicaid program. This secondary data analysis used eligibility and claims data from adolescents aged 12-17 years enrolled in Mississippi Medicaid from 2001-2005. Utilization of substance abuse services was examined in two ways. The first considered annual utilization rates and probability of substance abuse treatment. For these analyses, the sample was the statewide population of adolescent Medicaid enrollees during the study period (n °Ö 200,000). The second utilization measure examined the age at which the first substance abuse service was received. For the first-use analyses, the sample consisted of adolescents who had their first substance abuse service paid for by Medicaid during the study period (n °Ö 15,000). Preliminary results indicate that after controlling for other demographics, minority adolescents, female adolescents and rural adolescents were less likely to have a substance abuse service in MS Medicaid during the study period. This study is exploratory in nature and can inform policymakers and providers about best practices in substance abuse treatment settings. Further investigation is necessary to determine causal pathways of racial, gender and rural disparities documented in this study.