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Substance Abuse and Mental Health Services Administration
Socioeconomic Marginality and Health Services Utilization Among Central Harlem Substance Users
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The article examines whether decrements in socioeconomic measures in a poor, substance using population predict changes in health services utilization. The authors analyzed a sample, consisted of 658 "hard drug" (crack, powder cocaine, and heroin) users drawn from Central Harlem in New York City during 1998 and 1999, and was stratified according to operational measures indicating socioeconomic marginality. The authors assert that in this sample socioeconomic marginality reflected by low levels of income, education, and employment sometimes predicts greater rates of health services utilization and, in other cases, it predicts lower rates. The authors also state that when the sample is stratified according to an operational measure of homelessness, the gradient of greater utilization and self-reported morbidity for the homeless is more marked and consistent. The article concludes that results are supportive of a public health model of drug user treatment that recommends that it occur as part of an integrated strategy addressing poverty, homelessness, violence, and related social problems. (Authors)
Substance Use & Misuse