A collaboration between NORC’s Walsh Center for Rural Health Analysis and its Substance Abuse, Mental Health, and Criminal Justice Studies departments this study was conducted for the Appalachian Regional Commission (ARC) to assess substance abuse and mental health disparities, and access to treatment services, within the Appalachian region. The study included:
- A comprehensive literature review and annotated bibliography to identify important themes and gaps in substance abuse, mental health, and disparities research, targeting the Appalachian region;
- Identification of relevant data sources to assess regional mental health and substance abuse disparities;
- Application of appropriate statistical procedures to describe trends, patterns and associations among data elements; and
- Case studies to highlight county level experiences in addressing these challenges as a complement to quantitative analyses.
- For this last component, the Walsh Center partnered with two regional entities, East Tennessee State University (ETSU) and the Coalition on Appalachian Substance Abuse Policy (CASAP).
For the quantitative analysis, primary data sources included the National Survey on Drug Use and Health (NSDUH), the Treatment Episode Data Set (TEDS), the Healthcare Cost and Utilization Project (HCUP), and the National Survey of Substance Abuse Treatment Services (N-SSATS). All data are reported to the lowest possible geographic level. To the extent feasible, analyses made the following comparisons: Appalachia versus non-Appalachia; Appalachian sub-regions (northern vs. central vs. southern); and economic development status of Appalachian Counties as defined by ARC (distressed vs. at risk vs. transitional vs. competitive vs. attainment). Results were displayed in tables and graphically using GIS mapping.
Quantitative data compiled and analyzed by NORC and qualitative data gathered by ETSU were presented in a draft project report during a meeting hosted within the Appalachian region by CASAP in October 2007. Revisions were made based on attendee recommendations. The report was presented to ARC for additional revisions prior to final publication.