304885
Individual and neighborhood level correlates of substance abuse and treatment among opioid dependent urban inner-city residents
The three major methodological steps were: 1) Based on clients’ self-reported neighborhood of residence, we calculated geographic access (distance, walking and transit time) to places that would elevate risk of substance abuse or facilitate treatment for substance use disorders and comorbid outcomes (HIV and mental illness). 2) Using data from US Census Bureau and factor and geographic analysis, we measured constructs of social disorganization at the neighborhood level. 3) Building a 2-level multilevel regression model, we identified significant correlates of substance abuse (measured by Addiction Severity Index composite score) from the interaction of individual (sociodemographic, drug and criminal risk behavior, housing) and neighborhood (accessibility and social disorganization measures) level factors. All geographic and statistical analyses were conducted in ArcGIS 10.2 and R software packages.
Preliminary results highlight the varying effects of interplay of individual predisposing risky behavior, geographic accessibility to risky places and treatment facilitators, and overall social disorganization of neighborhoods on substance abuse. The study will inform policies and intervention for reducing the risk of substance abuse and contribute to the growing literature of multidimensional effects of geography and place on social-ecological models.
Learning Areas:
Administer health education strategies, interventions and programsImplementation of health education strategies, interventions and programs
Provision of health care to the public
Social and behavioral sciences
Learning Objectives:
Identify significant interaction effects of individual and neighborhood level correlates of substance abuse.
Explain specifically the effect of geographic or place measures on the risk and treatment of substance abuse.
List possible intervention strategies at the neighborhood level to reduce the risk and improve access to treatment of substance abuse.
Keyword(s): Drug Abuse, Geographic Information Systems (GIS)
Qualified on the content I am responsible for because: As a trained health geographer, I have substantial research experience in examining effects of geography and neighborhood characteristics on health outcomes and reciprocal causality between place and health. Central to these interests, I have developed regression, neural network, and space-time Geographic Information Systems models to understand the complex interplay of social-environmental-individual level risk factors of infectious disease, accessibility to health care facilities, and interface of substance abuse and HIV/AIDS using health geography system science techniques.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.