Report Summary:
This report presents an analysis of disparities in mental health status and substance abuse prevalence, as well as access to treatment services, in the 410-county Appalachian Region comprising all or parts of 13 states.
The aim of this research is to assist regional policy makers and public health practitioners in improving surveillance, research and health education, as well as to more effectively target investments designed to improve the delivery of substance abuse and mental health treatment and treatment outcomes. The specific objectives of this study are to:
- Identify whether there are specific disparities in mental health and substance abuse diagnoses within the region, and any apparent incidence clusters within the region;
- Identify and analyze available data to measure the accessibility of mental health services and substance abuse treatment services within the region and compare the region to other parts of the nation; and
- Develop a set of criteria and protocols to identify relevant case study communities within the Appalachian region and conduct case study analyses accordingly.
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Due to the length of this report, ARC is offering the full report, as well as each section, for download in PDF format. A report summary can be read by clicking on the link below.
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Executive Summary (HTML format)
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Full Report in PDF (4.4 MB)
Table of Contents and Executive Summary (53 KB)
CHAPTER 1: Introduction (131 KB)
1.1 Substance Abuse and Mental Health Disorders in Appalachia
1.2 Key Research Questions and Methodology
1.3 Importance of the Current Study
1.4 Structure of the Report
CHAPTER 2: Substance Use, Mental Disorders, and Access to Treatment Services in Household Surveys, 2002 -- 2005 (3.2 MB)
2.1 Introduction
2.2 Data
2.2.1 Overview
2.2.2 Limitations of the NSDUH
2.3 Methods
2.3.1 Analytic Sample
2.3.2 Measures
2.3.3 Statistical Methods
2.4 Results
2.4.1 Tables
2.4.2 Maps
2.5 Discussion
CHAPTER 3: Patient Admissions to Treatment for Abuse of Alcohol and Drugs in Appalachia, 2000 -- 2004 (468 KB)
3.1 Introduction
3.2 Data
3.2.1 Overview
3.2.2 Uses of TEDS
3.2.3 TEDS Measures Used in this Study
3.2.4 Limitations of the TEDS Series
3.3 Methods
3.3.1 Study Sample
3.3.2 Statistical Methods
3.4 Results
3.4.1 Tables
3.4.2. Figures
3.4.3. Maps
3.5 Discussion
CHAPTER 4: Substance Use and Mental Health Disorder Discharges from Appalachian and Other Community Hospitals in 2004 (194 KB)
4.1 Introduction
4.2 Data
4.2.1 Overview
4.2.2 Sample Design
4.2.3 Uses of the HCUP Nationwide Inpatient Sample
4.2.4 HCUP Measures Used in this Study
4.2.5 Limitations of HCUP NIS Data
4.3 Methods
4.3.1 Study Sample
4.3.2 Statistical Methods
4.4 Results
4.4.1 Tables
4.5 Discussion
CHAPTER 5: Substance Abuse Treatment Services in the Appalachian Region, 2005 (196 KB)
5.1 Introduction
5.2 Data
5.2.1 Overview
5.2.2 Sample Design
5.2.3 Uses of the N-SSATS
5.2.4 N-SSATS Measures Used in this Study
5.2.5 Limitations of the N-SSATS
5.3 Methods
5.3.1 Study Sample
5.3.2 Statistical Methods
5.4 Results
5.4.1 Tables
5.4.2 Figures
5.5 Discussion
CHAPTER 6: Substance Abuse and Mental Health – A Comparison of Appalachian Coal Mining Areas to Other Areas within the Appalachian Region (76 KB)
6.1 Introduction
6.2 Data and Analytic Samples
6.3 Results
6.4 Conclusion
CHAPTER 7: Case Study Analysis of Disparities in Mental Health Status and Substance Abuse Prevalence in the Appalachian Region and Access to Mental Health and Substance Abuse Treatment Services (158 KB)
7.1 Introduction
7.2 Case Study Process
7.3 Phase 1: Identification of Potential Data Sets/Sources
7.4 Phase 2: Selection of Pairs of Counties for Case Study
7.5 Phase 3: Onsite Focus Group and Key Informant Interviews
7.6 Phase 4: Development of Community Resource Inventory
7.7 Phase 5: Key Findings
7.8 Discussion and Conclusions
Case Study Appendix of Model Programs
County Profiles
CHAPTER 8: Conclusions (80 KB)
APPENDIX
APPENDIX A: Data Sources
APPENDIX B: Literature Review of the Prevalence of Substance Abuse and Mental Health Disorders, Access to Treatment Services, and Disparities in Appalachia
APPENDIX C: Results from the 2005 National Survey on Drug Use and Health: National Findings
APPENDIX D: County-Level Data Profiles for Appalachian Case Studies
References
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