317 research outputs found
Trends in Alcohol Services Utilization from 1991–1992 to 2001–2002: Ethnic Group Differences in the U.S. Population
Background: During the early 1990s in the United States, changes to the provision and financing of alcohol treatment services included reductions in inpatient treatment services and in private sector spending for treatment. We investigated trends in alcohol services utilization over the 10‐year period from 1991–1992 to 2001–2002 among U.S. whites, blacks, and Hispanics.
Methods: Data come from 2 household surveys of the U.S. adult population. The 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey and the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions conducted face‐to‐face interviews with a multistage cluster sample of individuals 18 years of age and older in the continental United States. Treatment utilization represented both total utilization and the use of alcohol services. Data analyses were prevalence rates and multivariate logistic regressions for lifetime utilization with drinkers and individuals with alcohol use disorders (AUDs).
Results: From 1991–1992 to 2001–2002, drinking‐related emergency room and human services use increased for drinkers, while total utilization and the use of private health professional services and mutual aid decreased for individuals with AUDs. In drinkers and individuals with AUDs, blacks and Hispanics were less likely than whites to use private health professional care. Hispanics with AUDs were less likely than whites with AUDs to use alcohol or drug programs. Ethnicity interacted with alcohol severity to predict alcohol services utilization. At higher levels of alcohol severity, blacks and Hispanics were less likely than whites to ever use treatment and to use alcohol services (i.e., human services for Hispanic drinkers, mental health services for blacks with AUDs, and mutual aid for Hispanics with AUDs).
Conclusions: Our findings showed increases from 1991–1992 to 2001–2002 in alcohol services utilization for drinkers, but reductions in utilization for individuals with AUDs. Blacks and Hispanics, particularly those at higher levels of alcohol severity, underutilized treatment services compared to whites. These utilization trends for blacks and Hispanics may reflect underlying disparities in healthcare access for minority groups, and language and logistical barriers to utilizing services
Recommended from our members
Co-Occurrence of Multiple Risk Factors and Intimate Partner Violence in an Urban Emergency Department
Introduction: Urban emergency departments (ED) provide care to populations with multiple health-related and overlapping risk factors, many of which are associated with intimate partner violence (IPV). We examine the 12-month rate of physical IPV and its association with multiple joint risk factors in an urban ED.Methods: Research assistants surveyed patients regarding IPV exposure, associated risk factors, and other sociodemographic features. The joint occurrence of seven risk factors was measured by a variable scored 0–7 with the following risk factors: depression; adverse childhood experiences; drug use; impulsivity; post-traumatic stress disorder; at-risk drinking; and partner’s score on the Alcohol Use Disorders Identification Test. The survey (N = 1037) achieved an 87.5% participation rate.Results: About 23% of the sample reported an IPV event in the prior 12 months. Logistic regression showed that IPV risk increased in a stepwise fashion with the number of present risk factors, as follows: one risk factor (adjusted odds ratio [AOR] [3.09]; 95% confidence interval [CI], 1.47-6.50; p<.01); two risk factors (AOR [6.26]; 95% CI, 3.04-12.87; p<.01); three risk factors (AOR = 9.44; 95% CI, 4.44-20.08; p<.001); four to seven risk factors (AOR [18.62]; 95% CI, 9.00-38.52; p<001). Ordered logistic regression showed that IPV severity increased in a similar way, as follows: one risk factor (AOR [3.17]; 95% CI, 1.39-7.20; p<.01); two risk factors (AOR [6.73]; 95% CI, 3.04-14.90; p<.001); three risk factors (AOR [10.36]; 95%CI, 4.52-23.76; p<.001); four to seven risk factors (AOR [20.61]; 95% CI, 9.11-46.64; p<001).Conclusion: Among patients in an urban ED, IPV likelihood and IPV severity increase with the number of reported risk factors. The best approach to identify IPV and avoid false negatives is, therefore, multi-risk assessment
A 10-year Study of Factors Associated with Alcohol Treatment Use and Non-use in a U.S. Population Sample
Background This study seeks to identify changes in perceived barriers to alcohol treatment and predictors of treatment use between 1991–92 and 2001–02, to potentially help understand reported reductions in treatment use at this time. Social, economic, and health trends during these 10 years provide a context for the study.
Methods Subjects were Whites, Blacks, and Hispanics. The data were from the National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We conducted two analyses that compared the surveys on: 1) perceived treatment barriers for subjects who thought they should get help for their drinking, and 2) variables predicting past-year treatment use in an alcohol use disorder subsample using a multi-group multivariate regression model.
Results In the first analysis, those barriers that reflected negative beliefs and fears about seeking treatment as well as perceptions about the lack of need for treatment were more prevalent in 2001–02. The second analysis showed that survey year moderated the relationship between public insurance coverage and treatment use. This relationship was not statistically significant in 1991–92 but was significant and positive in 2001–02, although the effect of this change on treatment use was small.
Conclusions Use of alcohol treatment in the U.S. may be affected by a number of factors, such as trends in public knowledge about treatment, social pressures to reduce drinking, and changes in the public financing of treatment
Intimate Partner Violence and Alcohol Problems in Interethnic and Intra-ethnic Couples
Despite the growing number of interethnic marriages in the U.S., few studies have examined intimate partner violence (IPV) in interethnic couples. This article examined past-year occurrences of IPV across interethnic and intra-ethnic couples and tested correlates of IPV specifically in interethnic couples. Data were from a national survey of couples 18 years of age and older from the 48 contiguous states. Interethnic couples (n = 116) included partners from different ethnic backgrounds, including black-white, Hispanic-white, and black-Hispanic couples. White (n = 555), black (n = 358), and Hispanic (n = 527) intra-ethnic couples included partners with the same ethnicity. Data analyses were prevalence rates and logistic regressions. The analyses showed that interethnic couples were comparatively younger and had shorter relationships than intra-ethnic white, black, and Hispanic couples. Male partners in interethnic couples had higher rates of binge drinking and alcohol problems compared to male partners in intra-ethnic couples. Past year prevalence rates for any occurrence of IPV and acts of severe IPV were higher for interethnic couples relative to intra-ethnic couples. Most occurrences of IPV for interethnic couples were mutual. Factors predicting IPV among interethnic couples included marital status, couples’ age, male alcohol problems, and female impulsivity. Mounting evidence points to interethnic couples as a high risk group for IPV. Interethnic couples may be at greater risk for IPV because of their younger age, binge drinking and alcohol problems. Future research could build on this study by examining cohort effects and regional differences in IPV for interethnic couples, and the risk for IPV across interethnic couples of different ethnic compositions
Ethnicity and Health Disparities in Alcohol Research
Recent advances in alcohol research continue to build our understanding of alcohol consumption and related consequences for U.S. ethnic minority groups. National surveys show variations across ethnicities in drinking, alcohol use disorders, alcohol problems, and treatment use. Higher rates of high-risk drinking among ethnic minorities are reported for Native Americans and Hispanics, although within-ethnic group differences (e.g., gender, age-group, and other subpopulations) also are evident for ethnicities. Whites and Native Americans have a greater risk for alcohol use disorders relative to other ethnic groups. However, once alcohol dependence occurs, Blacks and Hispanics experience higher rates than Whites of recurrent or persistent dependence. Furthermore, the consequences of drinking appear to be more profound for Native Americans, Hispanics, and Blacks. Disparities in alcohol treatment utilization are most apparent for Hispanics. Explanations for these differences are complex, likely affected by risky drinking behaviors, immigration experiences, racial/ethnic discrimination, economic and neighborhood disadvantage, and variations in alcohol-metabolizing genes. Research must maintain a systematic, strong, and growing focus on ethnic minorities. A more complete understanding of these effects for ethnic minority groups is needed to enable researchers to face the challenges of reducing and ultimately eliminating health disparities in the alcohol field
Recommended from our members
Gender Differences in Smoking Among an Urban Emergency Department Sample.
BackgroundUrban emergency department (ED) patients have elevated smoking and substance use compared with the general population. We analyzed gender differences in smoking among an urban ED sample and assessed the contribution of substance use, demographic, and couple factors.MethodsWe conducted a secondary analysis of data obtained from a cross-sectional, observational survey (N = 1037 participants) on drinking, drug use, and intimate partner violence (IPV). Gender-specific logistic regression models for current (past 30-day) smoking and multinomial regression models for smoking intensity (light: ⩽5 cigarettes per day [CPD]; moderate: 6 to 10 CPD; heavier: >10 CPD) were estimated.ResultsSmoking prevalence was higher among men than women (35.5% vs 18.9%; P < .001). Substance use (frequency of intoxication, marijuana, amphetamine, and cocaine use), demographic (food insufficiency, unemployment), and couple-related factors (having a spouse/partner who smoked, IPV involvement, being in a same-gender couple) were differentially associated with current smoking and level of intensity among men and women.ConclusionsEmergency department staff should consider the impact of polysubstance use, food insufficiency, unemployment, and whether both partners in the couple smoke when screening patients for smoking and formulating cessation treatment plans. Women in same-gender relationships and those who have experienced IPV involvement may require additional referral
Ten Year Trends (1992 to 2002) in Sociodemographic Predictors and Indicators of Alcohol Abuse and Dependence among Whites, Blacks, and Hispanics in the U.S
Background
The objective of this paper is to examine 10-year trends (1992–2002) in the number and type of indicators of DSM-IV abuse and dependence among Whites, Blacks and Hispanics in the U.S.
Methods
Data are from the 1991–1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001–2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population.
Results
Increases in the prevalence of alcohol abuse between 1992 and 2002seem associated to a rise in the prevalence of the indicator for “hazardous use”, which usually means reports of driving after drinking. The decrease in dependence was not associated with changes in a particular indicator. In addition, both in 1992 and 2002, 12.3% to 15.4% of the men and 5.2% to 7.9% of the women were diagnostic “orphans”. These respondents reported 1 or 2 indicators of alcohol dependence as present.
Conclusion
The observed trends in number and types of indicators of DSM-IV alcohol abuse and dependence were probably triggered by a complex interplay between individuals’ volume and pattern of drinking and reactions from the drinkers’ social environment. The close association between hazardous use of alcohol and the prevalence of abuse deserves further discussion. A medical diagnostic category should not be so dependent on a criterion that may be influenced by social situations. It is necessary to understand more about diagnostic “orphans” to better design interventions to address their problems
Formação na PSP: definição de prioridades
O sentimento de segurança da população é um fator extremamente importante para a
definição da atuação policial.
É essencial perceber o contexto social relativamente à criminalidade, sendo este
ambiente fundamental para que a Polícia adapte o seu dispositivo e os seus procedimentos
para fazer face aos crimes que criam sentimento de insegurança nos cidadãos, numa
determinada área geográfica. Estes crimes podem ser os mais frequentes, os mais graves ou
até aqueles que, pela sua rápida evolução, criam maior alarme social.
A formação profissional é importante, não só para a obtenção de conhecimentos, mas
também para a adoção de novos procedimentos e sensibilização para o problema, pelo que é
fundamental para um combate eficiente à criminalidade. A formação específica em
determinados crimes poderá capacitar os profissionais de polícia a enfrentar os desafios
impostos por estas atividades ilícitas.
Importa, assim, criar critérios que permitam definir as matérias a incluir na formação
profissional da Polícia. Pretende-se com este trabalho desenvolver um método que permita
a inclusão do fator estatístico da criminalidade na definição destes critérios, através da
análise estatística e dos Planos Anuais de Formação.The feeling of security of the population is an extremely important factor for the
definition of police action.
It is essential to understand the social context in relation to crime, and this is a key
environment for the police to adapt their force and procedures to deal with crimes that create
a sense of insecurity in citizens in a given geographical area. These crimes may be the most
frequent, the most serious or even those that, due to their rapid evolution, create greater
social alarm.
Vocational training is important not only for obtaining knowledge, but also for the
adoption of new procedures and awareness of the problem, and it is essential to efficiently
combat crime. Specific training in certain crimes may empower police professionals to face
the challenges posed by these illicit activities.
It is therefore necessary to create criteria for defining the subjects to be included in the
professional training of the Police. The aim of this work is to develop a method that allow
the inclusion of the statistical factor of crime in the definition of these criteria, through
statistical analysis and the Annual Training Plans.N/
- …