Treatment Facility Neighborhood Environment and Outpatient Treatment Completion

• Author: Timothy P. Johnson,Michael Fendrich,Lillian Pickup,Young Ik Cho
• Published date: 01 July 2013
• DOI: 10.1177/0022042612472332
• Date: 01 July 2013
• Subject Matter: Articles

Journal of Drug Issues

43(3) 374 –385

© The Author(s) 2013

Reprints and permissions:

sagepub.com/journalsPermissions.nav

DOI: 10.1177/0022042612472332

jod.sagepub.com

Article

472332JODXXX10.1177/0022042612472332Journal of Drug IssuesCho et al.

1University of Wisconsin–Milwaukee , USA

2University of Illinois at Chicago, USA

3Illinois Division of Alcoholism & Substance Abuse, Chicago, USA

Corresponding Author:

Young Ik Cho, University of Wisconsin–Milwaukee, 1240 N 10th Street, Milwaukee, WI 53205, USA.

Email: cho3@uwm.edu

Treatment Facility

Neighborhood Environment

and Outpatient Treatment

Completion

Young Ik Cho1, Timothy P. Johnson2, Michael Fendrich1, and

Lillian Pickup3

Abstract

The current study focuses on three dimensions of treatment neighborhood environments

that may influence treatment retention: neighborhood disadvantage, stability, and concentrated

immigration. We examined treatment outcomes for a total of 9,319 individuals who were ad-

mitted for initial treatment in 56 outpatient clinics in Cook County, Illinois. Census-tract-level

data were used to measure facility neighborhood environment. We found that neighborhood

disadvantage was unrelated to individual treatment completion. Immigrant concentration was

found to increase the likelihood of substance abuse treatment completion, although it was

attenuated after controlling for patient problem severity and referral sources. Neighborhood

stability was found to be positively related to treatment completion. These results suggest

that knowledge of neighborhood context should be an important consideration when making

placement decisions of new treatment facilities. Knowledge of neighborhood impact on treat-

ment attrition should also be considered essential information to be used for client placement,

treatment program design, and discharge protocols.

Keywords

treatment outcomes, treatment completion, neighborhood effects

Introduction

There is a growing body of research that explores neighborhood effects on various social, behav-

ioral, and health outcomes (for a review, see Diez-Roux, 2001; Ellen, Mijanovich, & Dillman,

2001; Gephart, 1997; Leventhal & Brooks-Gunn, 2000; Pickett & Pearl, 2001; Robert, 1999;

Sampson, Morenoff, & Gannon-Rowley, 2002), including potential associations between neigh-

borhood contextual effects and substance abuse behaviors (cf. Fendrich, Lippert, Johnson, &

Brondino, 2010). Only a few investigations, however, have considered the effects of neighbor-

hood context on treatment outcomes (Jacobson, 2004, 2006). Understanding whether and how