SPH Researchers Win Award, Discover Racial Disparities in Access to Health Care for Drug and Alcohol Abusers Seeking Treatment

UNT Health Science Center researchers from the School of Public Health were awarded the top prize for Best Paper in Health Promotion and Prevention at the Business and Health Administration Association’s 2006 conference.

The paper, “Disparities in Access to Health Care: The Case of a Drug and Alcohol Abuse Detoxification Treatment Program among Minority Groups in a Texas Hospital,” was written by Alberto Coustasse, MD, MBA, DrPH, research assistant professor in health management and policy; Heidi Venegas, a doctoral student in the School of Public Health; Karan Singh, PhD, professor and chair of biostatistics; and Fernando Treviño, PhD, MPH, dean of the School of Public Health and professor of health management and policy.

The study analyzed racial disparities in health care insurance access, length of stay, drug and alcohol abuse, and relapse, at a community hospital in Texas where people were seeking medical detoxification services. The researchers found that non-Hispanic blacks were more likely to be insured compared to non-Hispanic whites, mostly through public insurance, such as Medicaid and Medicare.

However, Hispanics were three times more likely to be uninsured compared to non-Hispanic blacks and were more likely to have a shorter length of stay than non-Hispanic whites. The researchers concluded that the differences in care were a result of aggressive case management, barriers to healthcare based on socio-cultural issues and possibly discriminatory practices. The researchers could not conclude whether the differences in care based on these factors were intentional or unintentional.

“These findings are not news,” Dr. Coustasse said. “But the main thing is that Hispanic Medicaid patients were being discharged earlier than other patients. That is news and a reality of discriminatory and/or stereotyping practices.”

The researchers also discovered that Hispanics were more likely to relapse. The researchers believe that the relapses occurred because Hispanics were discharged earlier, interrupting the normal course of care. This interruption of care hindered access to treatment such as rehab. At the time of the study, the waiting period for the only public rehabilitation facility in the county was 21 days.

The researchers conclude that this 21-day wait increased the instance of relapse among Hispanics, creating a vicious circle.

“If you have to wait 21 days, forget it,” Dr. Coustasse said.

The researchers received the award in March at the annual Midwest Business Administration Association Conference, which took place in Chicago.

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Contact: Kay Colley 817-735-2553, cell 817-980-5090, e-mail kacolley@hsc.unt.edu.

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