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- Title
The War on Drugs, Racialized Capitalism, and Health Care Utilization Among White People Who Use Drugs in 22 Rural Appalachian Counties.
- Authors
Cooper, Hannah L. F.; Livingston, Melvin "Douglas"; Crawford, Natalie D.; Feinberg, Judith; Ford, Chandra L.; Go, Vivian; Ibragimov, Umed; Jahangir, Tasfia; Mullany, Anna; Miller, William C.; Peddireddy, Snigdha; Salas-Hernandez, Leslie; Smith, Gordon; Young, April M.; Zule, William; Sewell, Ali
- Abstract
Objectives. To analyze War on Drugs encounters and their relationships to health care utilization among White people who use drugs (PWUD) in 22 Appalachian rural counties in Kentucky, West Virginia, Ohio, and North Carolina. Methods. We recruited White PWUD using chain referral sampling in 2018 to 2020. Surveys asked about criminal–legal encounters, unmet health care needs, and other covariates. We used generalized estimating equations to regress unmet need on criminal–legal encounters in multivariable models. Results. In this sample (n = 957), rates of stop and search, arrest, incarceration, and community supervision were high (44.0%, 26.8%, 36.3%, and 31.1%, respectively), as was unmet need (68.5%). Criminal–legal encounters were unrelated to unmet need (stops: adjusted prevalence ratio [APR] = 1.13; 95% confidence interval [CI] = 0.97, 1.32; arrest: APR = 0.95; 95% CI = 0.78, 1.15; incarceration: APR = 1.01; 95% CI = 0.89, 1.14; community supervision: APR = 0.99; 95% CI = 0.90, 1.09). Conclusions. Contrasting with findings from predominantly Black urban areas, criminal–legal encounters and unmet need were unrelated among White Appalachian PWUD. Research should explore whether and under what conditions White supremacy's benefits might buffer adverse impacts of the War on Drugs in Appalachia. (Am J Public Health. 2024;114(10):1086–1096. https://doi.org/10.2105/AJPH.2024.307744)
- Subjects
NORTH Carolina; OHIO; KENTUCKY; WEST Virginia; APPALACHIAN Region; MEDICAL care use; SUPERVISION of employees; IMPRISONMENT; AFRICAN Americans; RESEARCH funding; WHITE people; RACISM; PSYCHOLOGY of drug abusers; RURAL conditions; METROPOLITAN areas; MEDICAL needs assessment; CONFIDENCE intervals; COMMUNITY-based social services
- Publication
American Journal of Public Health, 2024, Vol 114, Issue 10, p1086
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2024.307744