The major goals of this project are detecting, understanding, and reducing Latino health care disparities in the context of the Affordable Care Act.
The Institute of Medicine has called for the examination of Latino subgroups to better understand the causes of important disparities in health care and inform interventions to reduce such disparities. This study's analysis of existing data represents a timely and cost-efficient opportunity to have a large overall impact on Latino health care disparities research and policy. The innovative aspect of the proposed research is to detect, understand, and reduce client- and program-level disparities in addiction treatment outcomes for Mexican Americans. Aim 1 will focus on detection of treatment disparities between Mexican Americans and non-Latino Whites and Aim 2 will focus on understanding the extent to which key organizational factors (e.g., acceptance of public insurance, delivery of evidence-based treatment [EBT], and delivery of culturally and linguistically appropriate services [CLAS]) may help in the reduction of these treatment disparities. Aim 3 seeks to expand on the study's disparities conceptual framework by testing the extent to which increases in program acceptance of public insurance (i.e., Medicaid), which will expand as part of the Affordable Care Act and mostly affect Latinos in Los Angeles County, may lead to improvements in quality of care (i.e., delivery of EBT and CLAS). This study is of high public health relevance given it will provide federal and state insurance administrators, policy makers, and community-based substance abuse treatment providers with new and critical information to help promote health equities for the most uninsured and critically underserved ethnic minority subpopulation in the United States (i.e., Mexican Americans). Note: The total award amount stated above is an estimate and is subject to annual renewal.
National Institute on Drug Abuse
Multi-PI: Brian Garner, RTI International
Benjamin Cook, Harvard Medical School