Following its Public Health Council meeting, the Massachusetts Department of Public Health (MDPH) released a data brief summarizing results of a study conducted by the Boston Public Health Commission (BPHC) addressing health equity issues in the current opioid epidemic. Specifically, the research team found that Black residents who were treated at local hospitals for opioid overdose were significantly less likely to have accessed state-funded substance use disorder treatment services than their White counterparts following discharge.
“While we have seen differences in opioid overdose rates and opioid treatment rates before, to our knowledge this study for the first time quantifies those differences by the race of the patient. In order to address these lower rates of accessing treatment for Black residents, we need to better understand the many factors influencing the different pathways to treatment,” said Dan Dooley, Director of the Research and Evaluation Office at BPHC and lead author of the data brief.
According to the brief, the odds of receiving subsequent substance use disorder treatment within 30 days following a hospital patient encounter for opioid overdose were 29% lower for Black residents throughout Massachusetts than for their White counterparts; this difference was statistically significant (p<0.05). Among Boston residents, the odds were 58% lower for Black residents in comparison with White residents adjusting for other important risk factors (e.g. age, sex and insurance coverage), and this difference was statistically significant.
The study was a collaboration between MDPH and BPHC researchers, who analyzed 2011-2015 hospital and substance use treatment data, as well as other data sources originally linked as part of the Chapter 55 opioid analytical dataset now identified as The Massachusetts Public Health Data (PHD) Warehouse. Managed by MPDH, the PHD partner program supports a unique collaboration between public, private, and non-profit organizations to analyze population health trends with a focus on fatal and non-fatal opioid overdoses, and other public health priorities.
“The public health data warehouse that DPH established initially under the law known as Chapter 55 has been instrumental in allowing us to examine patterns of substance use treatment and outcomes. This collaboration between DPH and BPHC underscores the benefits of working with a large data system to shed light on disparities in access to care across different demographic groups within Boston and to inform intervention strategies to ensure access for all,” said Monica Bharel, MD, MPH, Commissioner of the Massachusetts Department of Public Health.
Understanding differences in access to care involves studying many factors that influence the pathway to treatment including whether referrals are made, whether attempts to access services are made, and whether appropriate services are available and affordable. This data brief highlights the need to explore these pathways using a health equity lens. BPHC works with other city and state agencies as well as Boston’s local hospitals to develop strategies to address the opioid epidemic.
“Advancing health equity is at the core of the work we do at BPHC. This latest brief highlights the capabilities of our team to analyze data in important ways in order to understand current and emerging health inequities among Boston residents. This type of analysis is important as we face the opioid epidemic,” said Monica Valdes Lupi, JD, MPH, Executive Director of BPHC.
The Research and Evaluation Office at BPHC is staying in close communication with colleagues at MDPH regarding the potential for continuing this important study as well as looking at other avenues, including collaborating directly with local hospitals in Boston, to assess potential for enhancing existing treatment referring capacity. MDPH anticipates extending an opportunity in the fall of 2019 to run additional analyses using more recent data (through 2017) via the PHD partner program.