PREVALENCE AND SYSTEMS PLANNING

Race and Cultural Issues

This webpage identifies the major literature in the field of prevalence and systems planning: race and cultural issues. The time frame is from January 2000 through December 2014.

Bartholin, E. (2009). The racial disproportionality movement in child welfare: false facts and dangerous directions. Harvard Law School Faculty Scholarship Series. Paper 26.

This article analyzes the Racial Disproportionality Movement and related issues. The author argues that the racial equity for black children in the child welfare system should include the provision of protection against maltreatment equivalent to that of white children and that if black children are in fact more victimized by maltreatment, the movement’s proposed reforms would simply place black children at risk for future maltreatment and victimization.

Boyd, R. (2014). African American disproportionality and disparity in child welfare: Toward a comprehensive conceptual framework. Children and Youth Services Review, 37(1), pp. 15–27.

The disproportional representation and disparity experienced by African American children and families in the child welfare system have received increasing attention over the past three decades. A review of the literature for explanatory factors and conceptual frameworks reveals that, as with the general definitions of disproportionality and disparity, there is a need for increased precision and refinement of the current frameworks used to explain the occurrence of these phenomena in the child welfare system. In order to address these issues, an alternate conceptual framework is proposed, with explanatory factors organized into five major paths: 1) Disproportionate Need; 2) Human Decision-Making; 3) Agency-System Factors; 4) Placement Dynamics; and 5) Policy Impact. This comprehensive framework aims to enhance the theoretical basis relevant to future research, critical thinking, and analyzing responses to the issues of disproportionality and disparity in child welfare.

Cummings, J.R., Wen, H., Ko, M., & Dross, B.G. (2014). Race/Ethnicity and geographic access to medicaid substance use disorder treatment facilities in the United States. JAMA Psychiatry, 71(2), pp. 190-196. DOI: 10.1001/jamapsychiatry.2013.3575

This study looks at the availability of outpatient SUD treatment facilities that accept Medicaid across US counties and whether counties with a higher percentage of racial/ethnic minorities are more likely to have gaps in this infrastructure. Results show that counties with a higher percentage of black, rural, and/or uninsured residents are less likely to have one of these facilities. The potential for increasing access to SUD treatment via Medicaid expansion may be tempered by the local availability of facilities to provide care, particularly for counties with a high percentage of black and/or uninsured residents and for rural counties. Although states that opt in to the expansion will secure additional federal funds for the SUD treatment system, additional policies may need to be implemented to ensure that adequate geographic access exists across local communities to serve new enrollees.

De La Rosa, M., Dillon, F. R., Ganapati, N. E., Rojas, P., Pinto, E., & Prado, G. (2010). Mother-daughter attachment and drug abuse among Latinas in the United States. Journal of Drug Issues, 40(2), pp. 379-404.

This study examined associations between mother-daughter attachment and substance abuse among 158 Latina mothers and their adult daughters (N = 316). Dyads of mothers and daughters were categorized into four groups: (a) mother/daughter both drug or alcohol abusers (Dyad 1), (b) mother abuser and daughter non-abuser (Dyad 2), (c) mother non-abuser and daughter abuser (Dyad 3), and (d) mother/daughter both non-abusers (Dyad 4). Dyad 1 participants reported lower levels of attachment to each other than all other types of dyads. Participants born in the U.S. reported more substance abuse than their non-U.S. born counterparts. Future longitudinal research is recommended to determine the presence of a mother-daughter attachment threshold that, if established early and maintained, may act as a protective mechanism against the intergenerational co-occurrence of substance abuse among adult Latinas.

Marciano, M. O., Hook, J. L., Reich, J. L., & Lee, J. S. (2012). Multiple jeopardy: poor, economically, disconnected and child welfare involved. Child Maltreatment, 17(3), pp. 195-206. DOI: 10.1177/ 1077559512456737

This study took advantage of a statewide survey of child welfare–involved parents to examine economic disconnection in this population and to explore the relationship between disconnection and parent engagement in child welfare. Disconnected caregivers were younger and more frequently had children in out-of-home placements as opposed to receiving services in home than economically connected caregivers. They also reported higher unmet needs for basic services, such as housing and medical care, but were more likely to report financial help from their informal network. Finally, disconnected caregivers reported lower engagement in child welfare services even when controlling for demographic characteristics, chronic psychosocial risk factors, placement status, and maltreatment type. The findings document economic disconnection among child welfare–involved parents and raise important questions about the implications of disconnection for families and for child welfare outcomes.

Molina, M. K., Alegría, M. & Chen, C. (2012). Neighborhood context and substance use disorders: A comparative analysis of racial and ethnic groups in the United States. Drug and Alcohol Dependence, 125S, pp. S35– S43.

This study looks at nationally representative data (N = 13,837) to examine: (1) what neighborhood characteristics are associated with risk of substance use disorders?; (2) do the associations between neighborhood characteristics and substance use disorders remain after adjusting for individual-level factors?; and (3) do neighborhood characteristics associated with substance use disorders differ by race/ethnicity after adjusting for individual-level factors? According to the results, living in more affluent and residentially unstable census tracts was associated with decreased risk of past-year substance use disorder, even after adjusting for individual-level factors. However, when investigated, the interaction of race/ethnicity and census latent factors with past-year substance use disorders, we found different associations for the different racial/ethnic groups. The authors also found different associations between neighborhood affluence, residential instability and any past-year substance use and alcohol disorders by nativity. Characteristics of the environment might represent differential risk for substance disorders depending on a person’s ethnicity/race and nativity status.

Small, E., & Kohl, L. P. (2012). African American caregivers and substance abuse in child welfare: identification of multiple risk profiles. Journal of Family Violence, 27(5), pp. 415–426. DOI: 10.1007/s10896-012-9442-4

The authors analyze a subsample of National Survey of Child and Adolescent Well-being (NSCAW) to examine patterns and risks and identify classes of caregivers with similar risk profiles among African American caregivers with a substance abuse problem. Latent Class Analysis (LCA) was used to classify caregivers, and five classes were identified among this high risk sample—each with distinct risk profiles. Based on these findings, we discuss implications for tailored practices to enhance the safety and stability of children involved with child welfare.

Yu, J., Warner, L. A., Haverly, K., & Lambert-Wacey, D. (2014). Service utilization of Asians and other racial-ethnic groups: Comparisons in a state substance abuse treatment system. Substance Use & Misuse, 49(3), pp. 205-210. DOI: 10.3109/10826084.2013.840001

Based on an administrative data base of 410,000 substance abuse treatment clients in New York State, Asians are a small minority who differ significantly from other racial–ethnic groups on income, primary language, treatment setting, and substance of abuse, referral source, and discharge status. In particular, relative to other race-ethnicity groups such as whites, blacks, and Hispanics, significantly greater percentages of Asians are referred from drinking–driving programs and completed treatment. However, most of the significant differences between Asians and other groups are found among clients with a first admission, and tended to attenuate among clients with a second or third admission.

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