School of Social Work, University of Southern California, Los Angeles, CA 90089, United States.
Int J Drug Policy. 2013 Jan;24(1):38-45. doi: 10.1016/j.drugpo.2012.04.004. Epub 2012 Jun 16.
Travel distance and English proficiency skills are widely recognized factors associated with service access and treatment engagement. As Latino populations represent one of the most rapidly growing populations in the United States, methods are needed to better understand availability of linguistically appropriate services in Latino communities. Given regional variability in the density of Latino communities, the current study examines treatment access as travel distance to outpatient substance use disorder treatment facilities in one of the largest and most rapidly changing Latino communities in the United States - Los Angeles County, CA.
Data from the 2010 U.S. Census and the National Survey of Substance Abuse Treatment Services were analyzed using a geographic information system approach to determine the street-level distance between treatment facilities with services in Spanish and Latino communities throughout L.A. County. This study used an innovative approach that included network analysis and spatial autocorrelation to identify "hot spots," i.e. clusters of census tracts with high-density Latino populations that were relatively far from treatment services in Spanish.
The analysis identified several key hot spots with significantly large Latino populations and far street distances to the closest facility offering Spanish-language services. The average distance between these hot spots and the closest facilities was 2.74 miles (SD=0.38), compared to a county average of 2.28 miles (SD=2.60). In several key hot spots, the distance was greater than 3 miles.
Despite the growing presence of Latinos in L.A. County in 2010, constrained access to services in Spanish was found in geographic locations highly represented by Latinos. The distances identified in this study are almost triple the 1-mile threshold representing reduced access to treatment as determined by other studies. Geographic information systems represent an innovative and user-friendly approach for effectively and efficiently identifying areas with the greatest service needs. This approach can inform policies to increase the capacity of ethnic minority communities to develop linguistically responsive social services.
旅行距离和英语熟练程度是广泛认可的与服务获取和治疗参与相关的因素。随着拉丁裔人口成为美国增长最快的人口之一，需要有方法来更好地了解拉丁裔社区提供语言适当服务的情况。鉴于拉丁裔社区的密度存在地区差异，本研究在美国最大和变化最快的拉丁裔社区之一——加利福尼亚州洛杉矶县，检查了前往门诊物质使用障碍治疗设施的治疗可及性与旅行距离的关系。
利用地理信息系统方法，对 2010 年美国人口普查和国家药物滥用治疗服务调查的数据进行了分析，以确定治疗设施与整个洛杉矶县讲西班牙语和拉丁裔社区之间的街道级距离。本研究采用了一种创新方法，包括网络分析和空间自相关，以确定“热点”，即高人口密度的拉丁裔社区的普查区集群，这些社区与提供西班牙语服务的治疗设施之间的距离相对较远。
分析确定了几个关键的热点地区，这些地区的拉丁裔人口密度非常大，与最近提供西班牙语服务的设施之间的街道距离非常远。这些热点地区与最近设施之间的平均距离为 2.74 英里（SD=0.38），而全县平均距离为 2.28 英里（SD=2.60）。在几个关键的热点地区，距离超过 3 英里。
尽管 2010 年洛杉矶县的拉丁裔人口不断增加，但在拉丁裔人口高度集中的地理位置上，西班牙语服务的获取受到限制。本研究确定的距离几乎是其他研究确定的治疗可及性降低的 1 英里阈值的三倍。地理信息系统代表了一种创新和用户友好的方法，可以有效地确定服务需求最大的地区。这种方法可以为增加少数民族社区发展语言响应社会服务的能力提供政策信息。
