Barriers to Healthcare and Social Service Utilization Among Rural Older Adults Who Use Drugs

Author:

Prusaczyk Beth12ORCID,Tilmon Sandra3,Landman Joshua4,Seibert Drake5ORCID,Colston David C.67,Westergaard Ryan8,Cooper Hannah9,Feinberg Judith10,Friedmann Peter D.11,Go Vivian F.6,Khoury Dalia12,Korthius Todd13,Mixson Sarah14,Moellner Alexandria15,Nolte Kerry16,Smith Gordon17,Young April18,Pho Mai T.19,Jenkins Wiley20

Affiliation:

1. Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA

2. Institute for Informatics, Data Science, and Biostatistics, Center for Population Health Informatics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA

3. Biological Sciences Division, University of Chicago, Chicago, IL, USA

4. Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA

5. Medical School, Medical College of Wisconsin, Milwaukee, WI, USA

6. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

7. Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA

8. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

9. Rollins School of Public Health, Emory University, Atlanta, GA, USA

10. Department of Medicine, School of Medicine, West Virginia University, Morgantown, WV, USA

11. Department of Medicine, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, USA

12. RTI International, Research Triangle Park, NC, USA

13. Department of Medicine, Oregon Health and Sciences University, Portland, OR, USA

14. Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA

15. Division of Infectious Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

16. College of Health and Human Services, University of New Hampshire, Durham, NH, USA

17. School of Public Health, West Virginia University, Morgantown, WV, USA

18. College of Public Health, University of Kentucky, Lexington, KY, USA

19. Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago Medical Center, Chicago, IL, USA

20. Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA

Abstract

The objective of this study was to understand barriers to healthcare and social service utilization among older adults residing in rural areas who use drugs. A cross-sectional survey of persons who use opioids or inject drugs in rural counties with high overdose rates across ten states was conducted. For this analysis, participants were restricted to only the 375 individuals aged 50 and older. They were asked about barriers to utilizing healthcare and social services. Multivariate analyses were conducted. The most common barriers were a lack of transportation and a fear of stigma. The average number of barriers was 2.53. Those who were either uninsured or homeless endorsed 37% more barriers. For every five-year increase in age, the number of barriers reduced by 15%. Efforts to reduce these barriers may include expanding eligibility for transportation and housing services and leveraging trusted community members to broker linkages to providers to overcome stigma.

Funder

National Institute on Aging

National Institute on Drug Abuse

Publisher

SAGE Publications

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