More than one-third of the approximately two million people entering publicly funded substance abuse treatment in the United States do not complete treatment. Additionally, racial and ethnic minorities with addiction disorders, who constitute approximately 40 percent of the admissions in publicly funded substance abuse treatment programs, may be particularly at risk for poor outcomes. Using national data, we found that blacks and Hispanics were 3.5-8.1 percentage points less likely than whites to complete treatment for alcohol and drugs, and Native Americans were 4.7 percentage points less likely to complete alcohol treatment. Only Asian Americans fared better than whites for both types of treatment. Completion disparities for blacks and Hispanics were largely explained by differences in socioeconomic status and, in particular, greater unemployment and housing instability. However, the alcohol treatment disparity for Native Americans was not explained by socioeconomic or treatment variables, a finding that warrants further investigation. The Affordable Care Act could reduce financial barriers to treatment for minorities, but further steps, such as increased Medicaid funding for residential treatment and better cultural training for providers, would improve the likelihood of completing treatment and increase treatment providers' cultural competence.

译文

:在美国,约有200万人接受公共资助的药物滥用治疗,其中超过三分之一的人没有完成治疗。此外,患有成瘾性疾病的种族和少数民族大约占公共资助的药物滥用治疗计划中入院人数的40%,可能特别容易遭受不良后果的威胁。使用国家数据,我们发现黑人和西班牙裔美国人完成酒精和毒品治疗的可能性比白人低3.5-8.1个百分点,而美洲原住民完成酒精治疗的可能性降低了4.7个百分点。在这两种治疗方式中,只有亚裔美国人的表现要好于白人。黑人和西班牙裔人的完成差距主要是由于社会经济地位的差异,尤其是失业率上升和住房不稳定造成的。但是,没有通过社会经济或治疗变量来解释美国原住民在酒精治疗方面的差异,这一发现值得进一步研究。 《平价医疗法案》可以减少对少数群体进行治疗的经济障碍,但是进一步的措施,例如增加用于住院治疗的医疗补助资金以及对提供者的文化培训,将增加完成治疗的可能性,并提高治疗提供者的文化能力。

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