Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 650, Atlanta, GA 30322, USA.
J Am Acad Child Adolesc Psychiatry. 2011 Dec;50(12):1265-74. doi: 10.1016/j.jaac.2011.09.006. Epub 2011 Oct 22.
This study examined differences in treatment rates for substance use disorders (SUD) among adolescents of white, black, Hispanic, Asian, Native American/Alaska Native, and Native Hawaiian/Pacific Islander race/ethnicity.
Eight years of cross-sectional data (2001-2008) were pooled from the National Survey on Drug Use and Health to derive a nationally representative sample of 144,197 adolescents (aged 12-17 years); 12,634 adolescents were identified with SUD in the previous year. Weighted probit regressions were estimated with year fixed effects to examine whether racial/ethnic minorities had lower rates of treatment in any setting, in medical settings (i.e., hospital, rehabilitation facility, mental health clinic, and/or doctor's office), and in self-help programs. Initial models controlled for demographics and health status. Additional models further adjusted for family income and health insurance status.
Among adolescents with SUD, unadjusted treatment rates ranged from 8.4% among blacks to 23.5% among Native Hawaiian/Pacific Islanders. After adjusting for demographics and health status, blacks (RD = -3.9%, 95% CI = -6.4%, -1.3%) and Hispanics (RD = -2.3%, 95% CI = -4.1%, -0.4%) were significantly less likely to receive SUD treatment than whites (adjusted treatment rate 10.7%). These differences were exacerbated after adjusting for family income and insurance status. Lower treatment rates for black and Hispanic adolescents persisted when examining SUD treatment rates in medical settings and self-help programs. Treatment rates for other racial/ethnic groups did not generally differ from whites.
Results highlight exceptionally low treatment rates for SUD among all adolescents, with blacks and Hispanics experiencing the lowest treatment rates across all racial/ethnic groups.
本研究考察了白种人、黑种人、西班牙裔、亚洲人、美洲原住民/阿拉斯加原住民和夏威夷原住民/太平洋岛民等不同种族/族裔的青少年在物质使用障碍（SUD）治疗率方面的差异。
利用国家药物使用与健康调查（National Survey on Drug Use and Health）的八年横断面数据（2001-2008 年），对 144197 名年龄在 12-17 岁的青少年进行了全国代表性抽样调查；其中 12634 名青少年在过去一年被诊断为 SUD。采用加权概率回归分析（weighted probit regressions），并结合年度固定效应，以检验少数民族在任何治疗环境中（如医院、康复机构、心理健康诊所和/或医生办公室）和自助项目中的治疗率是否较低。初始模型控制了人口统计学和健康状况。进一步的模型还调整了家庭收入和健康保险状况。
在患有 SUD 的青少年中，未经调整的治疗率从黑人的 8.4%到夏威夷原住民/太平洋岛民的 23.5%不等。在调整了人口统计学和健康状况后，黑人和西班牙裔（RD = -3.9%，95%CI = -6.4%，-1.3%）比白人（调整后的治疗率为 10.7%）更不可能接受 SUD 治疗。这些差异在进一步调整家庭收入和保险状况后更加明显。在调整了家庭收入和保险状况后，黑人和西班牙裔青少年在医疗场所和自助项目中接受 SUD 治疗的比例仍然较低。其他种族/族裔群体的治疗率通常与白人没有差异。
结果突出表明，所有青少年的 SUD 治疗率都非常低，黑人及西班牙裔青少年在所有种族/族裔群体中的治疗率最低。
