Availability of substance abuse treatment services in Spanish: A GIS analysis of Latino communities in Los Angeles County, California

Abstract

BackgroundThe percentage of Latino clients entering outpatient substance abuse treatment (OSAT) in the United States has increased significantly in the past 10 years. Evidence suggests that a lack of services in Spanish is a significant barrier to treatment access among Latinos.MethodsUsing a geographic information system (GIS) approach, data from the U.S. Census Bureau and the National Survey of Substance Abuse Treatment Services (N-SSATS) were analyzed to determine the geographic distance between OSAT facilities with services in Spanish and Latino communities throughout Los Angeles County, CA. Data from N-SSATS were also analyzed using logistic regression models to examine organizational characteristics and their association with offering services in Spanish. Our GIS methods are tested in their ability to provide baseline measures to inform future analysis comparing changes in demography and service infrastructure.ResultsGIS analysis revealed cold spots representing high-density Latino communities with extensive travel distance to facilities offering services in Spanish. The average linear distance between Latino communities and facilities offering Spanish-language services ranged from 2 to 6 miles, while the location of the cold spots pointed to a need for services in Spanish in a particular subregion of the county. Further, secondary data analysis revealed that, on average, being privately owned (OR = .23, 95% CI = 0.06-0.90) was associated with a lower likelihood of providing services in Spanish compared to public facilities. Additionally, a facility with a state license (OR = 2.08, 95% CI = 1.12-3.88) or a higher number of Medicaid recipients (OR = 2.98, 95% CI = 1.76-5.05) was twice as likely to offer services in Spanish.ConclusionDespite the significant presence of Latinos in L.A. County in 2000, low capacity was found in discrete Latino communities in terms of offering OSAT services in Spanish. Funding and regulation play a significant role in facilities' capacity to offer these services. Future studies should build from our multi-method approach to compare changes in population demography and system infrastructure and inform health care policy that seeks to improve providers' capacity to provide linguistically competent care.

Travel distance to outpatient substance use disorder treatment facilities for Spanish-speaking clients

“…A secondary aim was to demonstrate the utility of geographic information systems (GIS) with respect to measuring and describing travel distance as a measure of service accessibility. Although the analysis of travel distance is exploratory, this study expands on our preliminary work on the straight or linear geographic distance between two defined points, namely Latino communities in L.A. County and SUD treatment services in Spanish (Guerrero, Pan, Curtis, & Lizano, 2011). …”

Spatial accessibility of drug treatment facilities and the effects on locus of control, drug use, and service use among heroin-injecting Mexican American men

“…More recently used geographies include census tracts, which are U.S. Census Bureau-designated geographies that average around 4,000 persons and provide greater geographic specificity (e.g. Guerrero, et al, 2013; Guerrero, et al, 2011). Drug abuse research has certainly benefitted from the use of administrative geographic measures to identify hotspots and inform health care policy interventions and significant insights have been gathered using the use of these geographic units.…”

“…Recent studies (Guerrero, et al, 2013; Guerrero, et al, 2011) have explored the use of GIS as a tool to identify specific Hispanic communities with less access to Spanish-serving treatment facilities in Los Angeles County, California, United States. For example, Guerrero and colleagues (Guerrero, et al, 2013) used spatial autocorrelation analysis to identify five “hot spots” or communities, which had high concentrations of Hispanics (74% to 86%) and were significantly farther from Spanish-serving facilities than the rest of the county.…”

“…Compared to non-Hispanic Whites, Hispanics tend to utilize fewer services, be less satisfied with the treatment they do receive, be more likely to prematurely terminate treatment, and exhibit poorer treatment outcomes (Alegria et al, 2006; Alvarez, Jason, Olson, Ferrari, & Davis, 2007; Hser, Huang, Teruya, & Anglin, 2004; Substance Abuse and Mental Health Services Administration, 2009a). While access to care has been generally studied based on wait time to enter treatment or as a service barrier to care, limited research has explored the geographic accessibility of treatment for Hispanic communities with great need for services (Guerrero, Kao, & Perron, 2013; Guerrero, Pan, Curtis, & Lizano, 2011). …”

A review on the potential role and application of GIS in the management of substance abuse

“…There are certain researches which applied GIS to analyse the distance of the treatment centre. In a study by Guerrero et al (2011), the GIS approach was used to map the distribution of Latino residents and calculate the distance between census block and facility offering services. In a study by Guerrero et al (2013), they used GIS to determine the travel distance from the outpatients of substance abuse and treatment facilities with services.…”