Racial disparity in risk factors for substantiation of child maltreatment

This study examined racial disparity in impacts that welfare use, substance abuse, depression, and intimate partner violence (IPV) make on substantiation of reported child maltreatment. A sample of 1493 African Americans, 848 Hispanics, and 2144 Whites was employed, extracted from the National Survey of Child and Adolescent Well-Being. Logistic regression results indicated that each ethnic subsample had a distinct set of significant risk factors for substantiation. For the African American subsample, relatively long periods spent receiving Temporary Assistance for Needy Families (TANF) reduced likelihood of substantiation, as did caregivers' alcohol dependence. For the Hispanic subsample, TANF receipt lowered substantiation's likelihood, while caregivers' drug use raised its likelihood. For the White subsample, caregivers' TANF receipt and substance abuse showed no significant impact. No subsample's substantiation likelihood appeared significantly affected by depression or IPV. Implications for services are suggested.     

Gender differences in client–provider relationship as active ingredient in substance abuse treatment

The client–provider relationship is increasingly evaluated as an active ingredient in the delivery of substance abuse treatment services. This study examines gender differences in client–provider relationship as an important treatment ingredient affecting retention in treatment and reduced post-treatment substance use. The study uses data collected for the National Treatment Improvement Evaluation Study (NTIES), a prospective, cohort study of U.S. substance abuse treatment programs and their clients. Data on individual characteristics were collected at the pre-treatment interview; on client–provider relationship and services received at treatment exit; and on post-treatment drug use at 12 months post-treatment. The analytic sample consists of 3027 clients from 59 service delivery units (1922 men and 1105 women). Structural equation modeling (SEM) was used to assess the structural relations and causal connections between relationship and service variables and treatment outcome variables. Results indicate that a positive client–provider relationship is related directly to longer duration and reduced post-treatment drug use for the total sample and for men analyzed separately. For women, a positive client–provider relationship was related directly to treatment duration and only indirectly to reduced post-treatment drug use. The findings point to the significance of including client–provider relationship in service delivery models – both as a therapeutic element as well as an element facilitative of matching services to specific client needs.     

Longitudinal trends in substance use and mental health service needs in child welfare

Caregiver substance use and mental health problems have long been discussed as concerns in promoting positive child welfare outcomes. Yet the absence of longitudinal data focused on racial/ethnic differences in service needs and substance use has limited child welfare systems in their ability to address potential disparities. This study examines racial/ethnic trends in service needs and patterns of substances used among child welfare-involved caregivers over a 15-year period (2000–2015) from a large, urban county located in the Midwestern United States. Substance use service needs showed an increase over time among White non-Hispanic individuals, and declined over time for all racial/ethnic minority groups. Mental health service needs increased over time, with White non-Hispanic individuals experiencing the largest increase. Co-occurring service needs showed a moderate increase for all groups. Trends associated with service needs across the lifespan were relatively similar across racial and ethnic groups, with needs peaking between ages 30 and 35. When examining specific substances used, cocaine use decreased over time for all individuals. However, marijuana use increased substantially for Black/African American individuals, while opioid use increased substantially for White non-Hispanic individuals. These results highlight key areas where trends among child welfare-involved caregivers differ from population-based trends and suggest that improved coordination between child welfare agencies, mental health and substance use treatment providers may be a key step in reducing the disparities observed.     

Closing the Need-Service Gap: Gender Differences in Matching Services to Client Needs in Comprehensive Substance Abuse Treatment

Despite the broad recognition in social work that services are more effective when they are tailored to individual client needs, we have only limited evidence of the impact that services matched to client needs have on treatment outcomes. This study examines gender differences in the impact of matched services, access services, and outcome-targeted services on substance abuse treatment outcomes by using data collected from 1992 through 1997 for the National Treatment Improvement Evaluation Study, a prospective, cohort study of substance abuse treatment programs and clients. The analytic sample consists of 3,027 clients (1,105 women and 1,922 men) who reported needed services from 59 treatment facilities. Findings from the study indicate that overall programs have only limited success in targeting services to client needs, but when they do, receipt of substance abuse counseling and matched services predicts both remaining in treatment and reduced posttreatment substance use for both women and men, but especially for women.     

Racial/ethnic disparities in prior mental health service use among incarcerated adolescents

Research on racial and ethnic disparities in mental health and substance abuse service use among incarcerated youth in the U.S. is inconclusive. This cross-sectional study adds to our understanding of racial and ethnic disparities by examining the prior use of mental health and substance abuse services among incarcerated juveniles. Guided by Andersen's behavioral model of health service utilization, a series of logistic regression analyses were conducted on a non-probability sample of 13–19 year-old youth in two residential facilities for juvenile offenders in Western Pennsylvania (N = 181). Black and Hispanic youth were less likely than White youth to have used mental health and substance abuse services, even when controlling for predisposing, enabling, and need factors. Additional analyses revealed that these differences did not hold across all service types, specifically with regards to outpatient service use. Significant differences did exist, however, in the prior use of inpatient mental health and substance abuse services. This suggests that White youth are often funneled into the mental health system, while youth of color enter the justice system. Implications for racial/ethnic disproportionality in service use and justice system involvement are discussed.     

Neighborhoods, Family, and Substance Use: Comparisons of the Relations across Racial and Ethnic Groups

This study examines how substance use among adolescents is related to several risk and protective factors derived from two ecological contexts: the neighborhood and the family. It explicitly investigates how the relationships between substance use and the factors vary across different racial and ethnic groups. Findings suggest many common correlates and processes of substance use for adolescents, regardless of race or ethnicity, including that neighborhood safety is associated with substance use. There are also some racial and ethnic group differences in relationships, including that low attachment to and lack of social opportunities in neighborhoods more strongly predict substance use among whites than among other racial and ethnic groups and that family management decreases the relationship between neighborhood safety and substance use among African Americans. A better understanding of the associations among factors that influence substance use across racial and ethnic subgroups can help effectively target preventive interventions for different groups.     

Racial and Ethnic Determinants of Interracial and Ethnic Trust

The purpose of this cross-sectional study was to discern which individual factors are associated with interracial/ethnic trust among a national probability sample of African Americans, Latinos, and non-Hispanic whites. Using national data from the 2000 Community Benchmark Survey, the multiple regression results indicate that, even after controlling for education and income, African Americans and Latinos reported significantly lower levels of interracial/ethnic trust than did non-Hispanic whites. Additionally, separate regression equations indicate that predictors associated with interracial/ethnic trust varied by racial and ethnic group. Implications and future research are discussed.     

Social and Health Service Use and Treatment Outcomes for Sexual Minorities in a National Sample of Substance Abuse Treatment Programs

This study examines substance use severity, levels of social and health service utilization, and the impact of service utilization on treatment outcomes for sexual minorities versus non-minorities. The sample included 3,094 clients from the National Treatment Improvement Evaluation Study (NTIES). Substance use severity among sexual minorities and non-sexual minorities was similar at treatment entry and at 12 months post-discharge. Differences in social and health service utilization were significant for substance abuse counseling and health services. Significant interactions between sexuality and access services and sexuality and mental health services were also found. Practice and research implications are discussed.     

Asian American Identification with African Americans,Latinos, and Whites: The Roles of Discrimination and Self-Identified Skin Tone

ABSTRACT

Using a sample of up to 1,208 Asian Americans, we examine the effects of skin tone on perceived commonality with African Americans, Latinos, and whites. Overall, we find that Asian Americans are more likely to identify with whites than with African Americans or Latinos. When we account for skin tone, we find that Asian Americans with a medium skin tone experience increased odds of perceiving a commonality with African Americans and Latinos. While we expected the relationship between skin tone and perceived commonality to be mediated by experiences of discrimination, this was not the case. We conclude that Asian Americans occupy a position toward the top of the black-white binary and the oppressive racial hierarchy that exists within the United States. Like previous scholars, we suggest that Asian Americans can use their relative standing to disrupt the oppressive racial hierarchy. However, we recognize that whites, holding a position at the top of the racial hierarchy, must also be responsible for dismantling it.     

Race and Inclusion in Volunteerism: Using Communication Theory to Improve Volunteer Retention

Maintaining relationships with racially diverse audiences can challenge nonprofit organizations. Through a survey of 634 volunteers, this study examined the role of inclusion in predicting relationship quality and future volunteerism for participants of diverse racial and ethnic backgrounds, including African Americans, Asians, Caucasians, and Hispanic/Latinos. Results suggest a positive relationship between level of inclusion, relationship quality, and future volunteer intention. However, inclusion was varied among groups indicating that communication and inclusive behaviors are experienced differently for diverse audiences.     

Racial/Ethnic Differences in Court Referred Pathways to Mental Health Services for Children in Foster Care

Racial/Ethnic disparity in placement patterns and service utilization among children in foster care has been documented in a variety of studies. This study examined the role of the court process in referring children in foster care to mental health services and tested for racial/ethnic differences in the patterns of referral and service use. Court records for 142 children ages 2–16, representing Caucasian, African American, and Hispanic racial/ethnic groups were reviewed. Results indicate that the court process does play a significant role in referring children to services. Significant differences by race and ethnicity in mental health service utilization prior to the child's protective placement, as well as service orders, and post-placement service use were identified. Caucasian youth were more likely to receive orders for psychotherapy and to have documented use of psychotherapy than were African American and Hispanic youth, even when the possible confounding effects of age and type of maltreatment were controlled. Implications for the effective delivery of supportive services to those children most in need are discussed.     

Healthcare Experiences of Latinos in a Nontraditional Destination Area

The purpose of this study was to describe the health and healthcare experiences of immigrant Latinos compared to USA-born Latinos, Whites, and African Americans in Greater Cincinnati, Ohio, a nontraditional immigrant destination area. Immigrant Latinos had significantly worse physical and mental health than other groups and significantly more barriers to healthcare. Latinos rated the degree to which their town is socially accepting of Latinos. Lower social acceptance was correlated with worse mental health and more barriers to healthcare. Geographic information system (GIS) mapping techniques revealed geographic patterns in the association between social acceptance of Latinos and health outcomes.     

Second-generation Central Americans and the formation of an ethnoracial identity in Los Angeles

ABSTRACT

Whether Latinos in the United States are an ethnic or racial group is extensively debated. Some propose Latinos are an ethnic group on their way to becoming white, others contend Latinos are a racialised group, and an alternate perspective posits Latinos are an ethnoracial group. This study intervenes in this debate by examining the identities of second- and 1.5-generation Central Americans in Los Angeles, California. Drawing on 27 in-depth interviews, I show Central Americans have an identity repertoire, which includes national origin, panethnic, racial, and minority identities. I also capture the situations and reference groups that influence the deployment of ethnic and racial identities. These results suggest Central Americans develop an ethnoracial identity. I argue Central Americans’ ethnoracial identity emerges from agency – subjective understandings of themselves and resisting invisibility in Mexican Los Angeles – and from structure – a racialised society, institutionally-created panethnic categories, and racially-based experiences.     

Latinos/as and White Racial Frame: The Procrustean Bed of Assimilation

When North American slavery was established in the 1600s, an interpretive perspective was developed that sought to justify the institution of African American slavery. This composite perspective, a "white racial frame," was later extended by whites to other racial groups such as Latinos/as. This racial frame, which has become white "common sense," includes important racial stereotypes, understandings, images, and inclinations to act. Various forms of this racial framing exist among different U.S. racial groups, but a strong white racial frame has prevailed because whites have long had the power and the resources to impose this reality. A hegemonic situation occurs when people of color consent in various ways to this white racial framing and common sense. This acceptance varies. We discuss four forms of consent to white racial framing that appear in our in-depth interviews in a national sample of Latinos/as. Three forms reference Latinos: acceptance of elements of the racial frame, active enactment of the racial frame, and internalized violence. The fourth use of racial framing is directed by Latinos at African Americans.     

Racial and Ethnic Differences in Family Caregiving in California

Abstract

Family caregivers are the main source of long-term care for older persons in the United States. At the same time, cultural values and beliefs shape decisions surrounding who provides care and whether families use formal support interventions to assist the caregiver. The current article examines how the family caregiving experience differs among racial and ethnic groups in terms of caregiver characteristics, service utilization, caregiver strain, and coping mechanisms. Telephone interviews were conducted in English and Spanish with a random sample of 1,643 respondents in California who provide care to someone age 50 or over. Bivariate analyses showed evidence of ethnic differences in the demographic characteristics of caregivers, intensity of care provided, caregiver health, level of financial strain, religious service attendance, formal service utilization and barriers to formal services. Odds ratios showed that White and African American caregivers were about two times as likely to use formal caregiver services as were Asian/Native Hawaiian/Pacific Islander and Latina American caregivers. Implied by these findings is the need for further understanding of caregiver service needs among diverse racial and ethnic groups.     

Predictors of substance abuse treatment outcomes in Tennessee

In planning and implementing programs to treat substance abuse, it is important to understand which factors influence post-treatment abstinence.This article identifies and analyzes several variables important in predicting the likelihood of abstinence among substance abuse clients. The data used in this study was collected from 1,350 clients treated for alcohol or drug abuse in residential, halfway house, or outpatient facilities in Tennessee. We analyzed 22 variables as possible treatment outcome predictors by using two statistical procedures: stepwise logistic regression analysis and Quick, Unbiased, Efficient, Statistical Tree (QUEST) analysis, a tree-structured classification algorithm analysis. We found one pretreatment, five in-treatment, and three post-treatment variables to be significant predictors of treatment outcome: previous treatment history, perceived helpfulness of the treatment, simultaneous treatment for mental health, number of days in treatment,completion of treatment, special skills training during treatment, obtaining healthcare services for major physical health problem after treatment, living with someone using alcohol or drugs post treatment, and arrest record since treatment.     

A Comparison of Sanctions in African American and White TANF Leavers

In this study the authors explore racial disparities in the uses of sanctions and the different impact of sanctions on the economic well-being of African American and White TANF leavers. The study analyzed 907 African American and 1,336 White welfare leavers from the 1999 and 2002 data of the NSAF. Chi-square results show that sanctions are more significantly imposed to African Americans than Whites. On the other hand, regression results show that the impact of sanctions on the employment and family income of African Americans and Whites are comparable. Implications suggest that states need to have an appropriate sanction process, training programs for caseworkers, or other policy changes to reduce the racial disparities.     

Experience of Racism as a Correlate of Developmental and Health Outcomes Among Urban Adolescent Mental Health Clients

Summary

Correlates of race/ethnicity and perceived racism among 760 urban, predominantly Hispanic/Latino and African-American, adolescent mental health clients were investigated using an exploratory, clinical data-mining approach. All racial/ethnic groups reported substantial rates of racism, ranging from 80.0% for Asian/Pacific Islanders to 32.4% for Hispanic/Latinos. Racism was associated with significantly elevated environmental risk (e.g., violence, sexual abuse or assault, exposure to drug use), behavioral risk (e.g., drug use) and worry (e.g., worry about hurting self or others, worry about doing dangerous things). Overall, racism was significantly associated with more negative health and well-being outcomes than ability to get a gun, sexual orientation, and being enrolled in school. The authors conclude that experience of racism should be routinely assessed at intake to mental health services along with traumatic experiences such as physical or sexual abuse.     

Race and Loss of Privilege: African American/White Differences in the Determinants of Job Layoffs From Upper-Tier Occupations

Data from the Panel Study of Income Dynamics supports predictions from the minority vulnerability thesis concerning the determinants of job layoffs among African Americans and Whites who work in upper-middle-class occupations. Specifically, after controlling for seniority, layoffs for African Americans are relatively unstructured by traditional stratification-based causal factors, namely, background socioeconomic status, human-capital credentials, and job/labor market characteristics. Analyses also indicate that racial differences in the determinants of layoffs are more pronounced in nonservice-based than service-based firms in the private sector and in the private sector relative to the public sector.     

Abstinence-Only: Are You Not Working the Program or Is the Program Not Working for You?

Low retention rates are common in substance use treatment programs. The dominant model of service delivery in the United States is abstinence-only, a high-threshold service delivery model requiring abstinence. What “doesn’t work” for the client—from the client point of view—is an overlooked source of insight about client engagement and disengagement. We report client counter-narratives about the choice to disengage from abstinence-based services, shifting from a story of “dropouts” to one of self-respect. Understanding why clients choose to disengage from treatment can help us as practitioners to “meet clients where they are” and enhance engagement in substance abuse treatment.