Access to Substance Abuse Treatment for Latinos

Background and Purpose:

Latinos have a higher risk of substance abuse and live in low-income communities with high prevalence of substance abuse. However, Latinos have lower service use and more unmet needs compared to other racial/ethnic groups. Evidence suggests Latinos are less likely to seek substance abuse treatment services, more likely to receive delayed and inadequate treatment, have higher attrition rates, and low satisfaction with treatment.  Spatial accessibility and limited English proficiency have restricted the admission and retention of Latinos in substance abuse treatment.

The aims of this study are: 1) to explore the spatial accessibility to Spanish-speaking substance abuse treatment facilities for Latinos in New Jersey; and 2) to identify current facilities in New Jersey with the highest potential to serve more Latinos if Spanish-speaking services are provided. The research question was: how accessible are substance abuse treatment facilities for Latinos in New Jersey?

 Methods:

Locations of substance abuse treatment facilities in New Jersey in 2016 with Spanish-speaking staff (n=88) were obtained from the NJ Division of Mental Health and Addiction services, then geocoded in ArcGIS (100% match).  Data on percent Hispanic per census tract were taken from the 2014 American Community Survey (U.S. Census Bureau). 

Hot spots representing high-density Latino communities were identified using four methods: Anselin Local Morans I (inverse distance), Anselin Local Moran’s I (squared), Anselin Local Morans I (continuity edges corners), and percent of Hispanics in each census tract of 50% or more.  These hot spots were examined to ascertain the spatial accessibility of Latino communities to Spanish-speaking facilities. Spatial accessibility was measured in two ways: linear distance and street-network distance (Clary & Huang, 2014; Guerrero, Kao, & Perron, 2013), and results were compared to explore the pattern and spatial variations of accessibility. We then used location allocation to identify existing facilities in optimal locations to reduce average distance traveled.

 Results:

The study found that Spanish-Speaking treatment facilities are clustered in census tracts with high proportions of Hispanics.  Tracts with the highest proportions of Hispanics are in the northeastern (highly urbanized) portion of the State and in southern agricultural areas. All four methods show similar results. Mean linear distances vary from .87 to 1.18 miles. Street network distances are greater in each case. However, the more rural portions of the state are under-served with respect to accessibility (up to 32 miles to travel in a congested transportation network). 

Conclusions and Implications:

It appears that Hispanics in New Jersey are generally well-served by substance abuse treatment facilities with respect to accessibility (low mean distance to travel).  This study found that although most Latinos communities have adequate access to Spanish-speaking substance abuse treatment facilities in New Jersey, providing Spanish-speaking services in a few existing non-Spanish-speaking facilities would significantly increase the coverage of services for Latino communities.  A major limitation of this study is that we did not have access to data showing the capacity of these facilities (with respect to number of clients, number of Spanish-speaking staff).  Future research will include some capacity measures.