Suntai Zainab D, Lee Lewis H, Leeper James D
School of Social Work, University of Alabama, Tuscaloosa, USA.
College of Community Health Sciences, University of Alabama, Tuscaloosa, USA.
Innov Aging. 2020 Oct 26;4(6):igaa051. doi: 10.1093/geroni/igaa051. eCollection 2020.
Racial disparities in substance use among young adults have been well documented in the substance use literature, but little attention has been paid to older adults. While being an older adult is positively associated with substance use treatment completion, racial disparities in treatment completion have yet to be examined. The purpose of this study was to determine to what extent racial disparities exist in substance use treatment completion among older adults (65 and older).
This cross-sectional study utilized data from the most recent Treatment Episode Data from the Substance Abuse and Mental Health Services Administration, which documents discharges from a publicly funded substance use treatment program in the United States. A total of 17,942 older adults reported to a substance use treatment program in 2017 and 6,653 met the criteria for the study. Chi-squared tests were used to analyze group differences and a binary logistic regression was used to predict substance use treatment completion.
Results show that Black older adults were 37% less likely to complete a substance use treatment program than Whites (OR = 0.630) while Hispanic older adults were 26% more likely to complete a substance use treatment program than Whites (OR = 1.26).
These results support the findings from similar studies with younger adults and support the theory that racial disparities are prevalent across the life span. Although Hispanics had a higher treatment completion rate than Whites, this is likely a reflection of , where decisions about health treatments is a group process and a steady network of family members are available to provide advice and encouragement. The significant disparity observed between Black and White older adults suggest a need to consider cultural, historical, and systemic factors that affect voluntary termination of substance use treatment among Black older adults.
年轻人物质使用方面的种族差异在物质使用文献中已有充分记载，但老年人方面却很少受到关注。虽然老年人与物质使用治疗的完成呈正相关，但治疗完成方面的种族差异尚未得到研究。本研究的目的是确定老年人（65岁及以上）在物质使用治疗完成方面存在多大程度的种族差异。
这项横断面研究利用了物质滥用和精神健康服务管理局最新的治疗事件数据，该数据记录了美国一个由公共资金资助的物质使用治疗项目的出院情况。2017年共有17942名老年人向一个物质使用治疗项目报到，其中6653人符合研究标准。使用卡方检验分析组间差异，并使用二元逻辑回归预测物质使用治疗的完成情况。
结果显示，黑人老年人完成物质使用治疗项目的可能性比白人低37%（OR = 0.630），而西班牙裔老年人完成物质使用治疗项目的可能性比白人高26%（OR = 1.26）。
这些结果支持了对年轻人的类似研究结果，并支持了种族差异在整个生命周期中普遍存在的理论。尽管西班牙裔的治疗完成率高于白人，但这可能反映了 ，在那里关于健康治疗的决策是一个群体过程，并且有稳定的家庭成员网络提供建议和鼓励。黑人和白人老年人之间观察到的显著差异表明，需要考虑影响黑人老年人自愿终止物质使用治疗的文化、历史和系统因素。
