Understanding the preference for receiving mental health and substance use support in African Americans 50 and older

Abstract

Objective

This study aims to determine whether current tobacco and/or alcohol use is associated with setting preferences for seeking support for substance use (SU) and mental health (MH) services to African Americans ages 50 and older.

Methods

Data from 368 African American individuals (aged 50+) who participated in a community-based needs assessment survey were used. Preferences included community-based (e.g., health centers) and traditional settings (e.g., doctor’s office). SU was measured as a categorical variable detailing past-month use of conventional cigarettes and alcohol graded by risk levels. Logistic regression models tested the associations between SU and setting preference before and after adjusting for the influence of self-reported MH diagnoses.

Results

Prior to adjustment for the influence of MH outcomes, high-risk use of tobacco and alcohol in the past month was associated with a lower odds of preferring MH/SU support in traditional settings (OR = 0.23, 95% CI = 0.06–0.85) compared to participants engaged in no-/low- risk substance use. This association was no longer significant after accounting for the influence of mental health symptoms and covariates.

Discussion

These results provide preliminary evidence that mental health outcomes mediate the association between substance use and setting preference for seeking MH/SU support in traditional settings.

Translational Significance

This exploratory study encourages additional investigation of the association between substance use, setting preferences, and the likelihood of seeking treatment in community health centers using larger sample sizes. Additional opportunities to offer mental health/substance use support to African American older adults within clinical settings should be explored.

Keywords:

• African Americans
• alcohol
• health services
• mental health
• smoking

Acknowledgements

The authors gratefully acknowledge and thank the inisightful feedback and support of members of the Richmond Health and Wellness Project Community Advisory Council — Caroline Austin, Annette Braxton, Ida Bynum, Roosevelt Byrd, John Campbell, Sharon Christian, Joyce Cosby, Cynthia Dixon, Henrietta Fischer, Randy Gill, Christopher Green, Ernestine Green, Cliff Massenburg, Jessie Roots, and Gwen Watts; and the iCubedHealth and Wellness in Aging Transdisciplinary Core — during the preparation of this manuscript; the East End community residents who participated in the survey; the Richmond Memorial Health Foundation for funding to support the resident research team members for data collection; the tenant councils, churches, and civic associations for their support of this project in the Creighton, Fairfield, Mosby, Whitcomb, and Fulton neighborhoods; and the members and organizations of Seventh District Health and Wellness Initiative/Peter Paul Community Action Network who donated their time, resources and energy to developing the data collection effort.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the author, [E.P], upon reasonable request.

Additional information

Funding

Data collection was supported by funding from CTSA award No. UL1TR000058 from the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent official views of the National Center for Advancing Translational Sciences or the National Institutes of Health.