Source: NORTH CAROLINA STATE UNIV submitted to
RURAL/URBAN COMMUNITY CHARACTERISTICS RELATED TO EFFORTS TO DEAL WITH SUBSTANCE ABUSE
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
TERMINATED
Funding Source
Reporting Frequency
Annual
Accession No.
0162824
Grant No.
(N/A)
Project No.
NC06353
Proposal No.
(N/A)
Multistate No.
(N/A)
Program Code
(N/A)
Project Start Date
Oct 1, 1999
Project End Date
Sep 30, 2004
Grant Year
(N/A)
Project Director
Moxley, R. L.
Recipient Organization
NORTH CAROLINA STATE UNIV
(N/A)
RALEIGH,NC 27695
Performing Department
SOCIOLOGY, ANTHROP & SOC WORK
Non Technical Summary
(N/A)
Animal Health Component
70%
Research Effort Categories
Basic
30%
Applied
70%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
6086099308050%
7236199117050%
Goals / Objectives
To assess substance abuse problems in rural compared to urban communities and study community characteristics and conditions to analyze their degree of influence on levels of substance abuse problems and efforts to deal with them (especially prevention programs). Community characteristics include socioeconomic and standard demographic data and measures of social capital. This will provide knowledge to guide policies and action plans for interventions to reduce substance abuse problems.
Project Methods
Data on community county seat characteristics will be acquired partly from precollected data obtained from the US Census and state government agencies, some data (especially on prevention efforts) will be acquired by mail and phone surveys. Measures of socioeconomic demographic and social capital will be constructed using factor analytic and multidimensional scaling techniques. Multivariate regression models will be the primary mode of analysis of the relationships between measures.

Progress 10/01/99 to 09/30/04

Outputs
This project began with a thorough review of the literature on treatment facilities in rural areas. Very little literature was found on this topic. This was followed by a phone survey of substance abuse treatment centers in the most eastern 56 counties of North Carolina. The survey provided data on 47 privately run substance abuse treatment centers. The analysis of these data was reported in a paper by Moxley and Rice (2001) at the Southern Sociological Society meetings and an abstract of this work was published in Sociological Abstracts. Some of the main findings involved the discovery that large percentages of the private treatment centers did not show up in the list of licensed North Carolina facilities. Also, in over 60% of the first phone calls it was not possible to talk to a counselor. This would be very important in the case of acute needs or emergency substance abuse situations. On average 23 per cent of clients in each facility commute from another county for treatment. The average commute is 42 miles. During the past year a mail survey was carried out to contact key informants in all 100 county seat communities. Information was collected on substance abuse prevention efforts (outlined in Objective B) as the main dependent variable. In addition data was collected on measures of social capital and a number of community services and demographic variables. The survey measured reflections of the concept of social capital in terms of available civic participation activities such as the number of voluntary associations, presence or absence of town hall meetings, and a variety of types of political participation by community members. The survey was sent to the type of key informants who are most likely to have community legitimacy (identified in publicly available information sources such as the Directory of Municipal Officials and Buyers Guide). Specifically the survey was sent to mayors, town clerks, directors of chambers of commerce, and superintendents of instruction in each county seat. The survey was recently completed and the data coded into an electronic data base. The returns follow for each category of respondent after all follow-up efforts (post cards, new surveys, etc.) commonly known as the Dillman Method. The return rates are 64.5 percent for chamber of commerce directors, 70 percent for twon clerks, 64 percent for mayors, and 82 percent for school superintendents. The analysis of these data is currently underway.

Impacts
Research in the last ten years, has convencingly demonstrated that many rural areas have substance abuse problems. A basic understanding of the optimal conditions leading to substance abuse prevention programs,especially community wide efforts(which have proven to be the most successful)will aid policy makers and practicioners in planning future substance abuse prevention. Many of the concepts being studied, have been shown to affect other aspects of community quality of life. It is very important for social science to discover whether a number of the phenomina being studied(e.g. social capital)positively predict stronger efforts of substance abuse prevention at the local level.

Publications

  • No publications reported this period


Progress 10/01/02 to 09/30/03

Outputs
NORTH CAROLINA AGRICULTURAL RESEARCH SERVICE PROJECT PROGRESS REPORT Project Number: NCARS AD421 Project Title: Rural/Urban Community Characteristics Related to Efforts to Deal With Substance Abuse This project is currently pursuing the primary goals of Objective C. These goals are to analyze the relationships between community social capital and rural/urban characteristics and their influence on substance abuse prevention efforts (Outlined in objective B). A literature search and review was conducted in preparation for research to provide evidence for these ideas during the past year. Also, a survey is underway to collect data. We hypothesize that levels of communal social capital will positively influence substance abuse prevention efforts. The research also specifies the broad general hypothesis that rural/urban measures influence the amount of substance abuse prevention efforts and services present in a community. Socioeconomic and demographic variables will be obtained from pre-collected data sources as control variables that may influence the interaction between social capital and rural/urban measures and the presence of substance abuse prevention efforts. The survey is currently underway to collect primary data on community indicators of "social capital". This survey focuses on measuring community levels of social capital and operationalizes the concept of social capital in terms of available civic participation activities such as: organizational memberships, voluntary associations, town hall meetings, newspaper readership, political participation, etc. The questionnaire will be administered to key informants, community leaders and officials who have sufficient community legitimacy and representativeness to be identified by communities in publicly available data sources. Compendiums are available, which list such positions, such as the North Carolina League of Municipalities, Directory of Municipal Officials and Buyers Guide (2003), lists of Chambers of Commerce, and lists of education officials (i.e. heads of Parent Teacher Associations). The survey methodology will follow the Dillman method for mail and telephone surveys (1978) using the total design method of advance letters and multiple follow up efforts. In conjunction to the survey efforts, a database is being compiled that includes general demographic and socioeconomic data from the 1980, 1990, and 2000 US Census on counties in North Carolina. This data will be used to measure control variables that may intervene in the hypothesized relationships between social capital and rural/urban measures and their influence on substance abuse prevention efforts.

Impacts
Research in the last ten years, has convencingly demonstrated that many rural areas have substance abuse problems. A basic understanding of the optimal conditions leading to substance abuse prevention programs,especially community wide efforts(which have proven to be the most successful)will aid policy makers and practicioners in planning future substance abuse prevention. Many of the concepts being studied, have been shown to affect other aspects of community quality of life. It is very important for social science to discover whether a number of the phenomina being studied(e.g. social capital)positively predict stronger efforts of substance abuse prevention at the local level.

Publications

  • No publications reported this period


Progress 10/01/01 to 09/30/02

Outputs
A dispositon study of the phone calls made during the previously reported substance abuse treatment survey was carried out. Contacts (592)were attempted with 96 centers in central and eastern North Carolina counties.The most frequent response was a recording (196 times or 33%). Interviewers were asked to call back 128 times (21% of calls). On 73 occasions (12% of calls) there was no answer. This constitutes 75% of calls. The other 25% were scattered over 13 other types of responses some of which constitute other categories of "unreachability". In additon to the phone response patterns, a study of the number and types of these treatment agencies that are unlicensed is underway.

Impacts
This study raises a number of disturbing issues that the treatment community and policy planners need to address, especially in the state of North Carolina. For example, in over 60% of the calls a potential client could not talk to anyone on the first call, which would be very important with acute or emergency substance abuse situations.

Publications

  • No publications reported this period


Progress 10/01/00 to 09/30/01

Outputs
The survey done in Yr. 99-00 yielded data on 47 privately run substance abuse treatment centers concerning characteristics of their clients and especially their commuting for treatment. The survey covered approximately one-half the state of NC from the central piedmont area contiguous to the coast containing 56 (56%) of NC counties. An analysis was carried out first (by the PI and his RA's efforts) on the non-reporting facilities identified by the paid data collection agency. (A methodological paper was prepared including this data and presented at a professonal meeting). A second analysis was done on the data from the reporting facilities Many of the 'non-reporting facilities' turned out to be out of business, or ineligible (e.g. state or federal or non-substance-abuse-treatment businesses.)or 'unrecheachable'(infinite rings or recorder reached, but no calls returned If all these are dropped from the eligible facility list the response rate is 68%. A sample of the findings include: 46% of these counties have no private treatment facilities, 75% of facilities draw clients from other counties (the median is 6). Twenty-three% of clients in each facility on average commute from . The average commute is 42 miles.

Impacts
Copmmuting for treatment is so widespread that the previous studies which use treatment levels of local private clinics in their calculations for estimates of local substance abuse levels in the population are likely significantly off the mark. Also, studies which use the same data to help in estimating needs for service or crime control are likely errneous. In addition commuting-for-treatment is not mostly a rural phenomenon. Indeed clients from the three most urbanized counties were from 17, 14, and 13 facilities in other counties. The knowledge presented in the three papers out of this study are helping social scientists and substance abuse treatment planners to understand better the problems and treatment interrelationships. The third paper presented was: 'Obtaining Data from Records in Private Treatment Facilities: Failures, Successes, and Findings' by Moxley, RL and Kennon Rice. Presented at the Southern sociological Society Meetings, April 4-7, 2001, Atlanta,Ga.

Publications

  • Moxley,R.L. & Kennon Rice, 'Cient Characteristics and Commuting for TRreatment: Private substance Abuse Facilities in Eastern North Carolina Counties' Sociological Abstracts, April, 2000, P.41.


Progress 10/01/99 to 09/30/00

Outputs
A statewide mailed survey of private treatment facilities using our questionnaire was completed and the data entered into a computer data base by a subcontractor. Preliminary analysis of the data and especially the disposition report on the follow-up phone calls to non-respondents revealed multiple errors and discrepancies. The work was sent back to the subcontractor for corrections and clarifications. When the data was again received, a study of all the non-respondents from the telephone follow-up survey was under taken and is in progress. During the next year a methodological research paper will be produced based on this experience. Also, a re-analysis of the mail survey data will be done on the corrected files.

Impacts
The major immediate impact is that the research efforts, especially the discovery of major gaps in certain areas of research and the discovery of precollected data sets on North Carolina counties on substance abuse (rural areas and adult populations), laid the ground work for a substantially larger two-year NIDA/NIH grant. The knowledge presented in two papers is helping social scientists and planners to understand more problems and treatment interrelationships.

Publications

  • No publications reported this period


Progress 10/01/98 to 09/30/99

Outputs
The state-wide survey of private treatment facilities was nearly completed. The task of gaining the cooperation of facility directors was too difficult to complete in the proposed time frame. An analysis of time and types of contacts and paper on the survey methodology explaining the difficulties and solutions is planned. In the meantime, analysis was carried out on the data for 17 counties of eastern North Carolina which contains unique types of data, such as "county of residence" of clients. A paper based on this concerning commuter patterns will be presented at the Southern Sociological Society annual meeting in April 2000. These findings will help social scientists and planners understand more about where the greatest needs are versus facilities and willingness of clients to commute. Some of the general findings coming out of the various analyses follow. There were 56 eastern counties in the target sample, but we found that 39 counties had no private facilities. The analysis of the data for these 44 eastern facilities indicated that the average commute for those commuting from outside the county is 27.2 miles. The average commute (including those inside the county as zero) is 11 miles. On the average, facilities have 23.7% of their clients commuting from outside the county. The client populations of these facilities have the following characteristics : Out of an average client population of 148, an average of 44.13 are drug treatment clients and 79 are being treated for alcohol related problems. The rest are being treated for combined problems with drugs and alcohol. These facilities reported the following specialties in offering inpatient treatment: (11%), nonhospital medical detox (3%), outpatient detox (8.3%), residential treatment/rehab (22%), outpatient facilities (61%) and day treatment (17%). (These figures need not add to 100% since a facility may offer more than one.) Further analyses of this data and the combined eastern and western North Carolina data will be analyzed during the coming year.

Impacts
The major immediate impact is that the research efforts, especially the discovery of major gaps in certain areas of research and the discovery of precollected data sets on North Carolina counties on substance abuse (rural areas and adult populations), laid the ground work for a substantially larger two-year NIDA/NIH grant. The knowledge presented in two papers is helping social scientists and planners to understand more problems and treatment interrelationships.

Publications

  • No publications reported this period


Progress 01/01/98 to 12/31/98

Outputs
Based on the 1997 project data base and some new data added this year, a new analysis of North Carolina substance abuse treatment facility locations by county was undertaken. A paper was written and presented at the Southern Sociological Society meetings. The analysis deals with predictors of the number of 1996 county per capita substance abuse treatment facilities of all types except individual counselors or therapists. Variables from the 1990 US Census (population size, % in poverty, ratio of young to old (% 25 and younger/% 65 and older), % nonwhite, % college grads age 25 and older, population change 1980 to 1990, and median family income), a State Bureau of Investigation variable (drug possession arrests), a USDA rural-urban continuum variable (the metro, adjacent and nonmetro Beal codes), and a county centrality variable based on road distance from an interstate, are included as independent variables. Median family income (Beta.76), percent nonwhite (Beta .35), county centrality (Beta .29), and per capita drug possession arrests are all positively related to county treatment facilities and significant at the .01 level. Therefore, it is concluded that substance abuse facilities in North Carolina tend to become located in counties with: high mean family incomes, high % black population, high drug possession arrests, and county centrality(close to interstates). In addition, a mail-survey of a sample of private drug treatment agencies in the central and eastern counties of North Carolina was completed this year. Data are currently being coded, checked and stored in the North Carolina Drug and Alcohol Study Data base. The analysis of these data next year will be important because the state of North Carolina does not keep records on private treatment agencies and little is known about them. In addition the data obtained emphasize many detailed characteristics of the clients of these facilities, including their county of origin, age, sex, education, drug(s) of addiction, and employment, most of which represent new focuses and new data in the large sample survey approach to treatment facilities research.

Impacts
(N/A)

Publications

  • No publications reported this period


Progress 01/01/97 to 12/31/97

Outputs
Analysis was begun on a database constructed and discussed over the past year. The most advanced analysis at this stage deals with sociological predictors of drug and alcohol abuse related problems in the 100 counties of North Carolina. Data on alcohol related mortality, drug possession arrests, and DWI convictions are the measures of county drug problems. Independent variables hypothesized to affect these are county population size, population density, income, race, gender, education, population change, interstate highway proximity, and rural/urban county distinctions. The percentage non-white and the number of college graduates are both positive significant predictors of increasing alcohol related mortality. The two strongest positive predictors of DWI convictions per county are population size and county proximity to an interstate. Also, the Beal rural/urban county measure indicates a significant positive relationship of urbaneness with DWI convictions. The analytical set of variables explaining the greatest amount of variance (R squared=.85) is for predictors of drug possession. Population size and urbaneness are also strong significant positive predictors of drug possession arrests. These results are important since little comparative research on substance abuse has been done on localities.

Impacts
(N/A)

Publications

  • MOXLEY, R.L. and THOMSON, R.J. 1997. Peanut CRSP human resource development. In: Impacts and scientific advances through collaborative research on peanuts, edited by J.H. Williams, et al. Griffin, Ga.: CRSP Management Office. pp 155-170.


Progress 01/01/95 to 12/30/95

Outputs
An extensive search and study was carried out on secondary data sources for dataon county level North Carolina drug and alcohol, health, mental health, and crime problems. Twenty-three data bases were identified and studied. One excellent data base at the North Carolina Medical Data Base Commission was discovered on all North Carolina hospital health files. It contains a large number of variables on diagnoses related to drug and alcohol abuse. Ninety-eight variables from several sources were purchased and coded or electronically downloaded. These will be combined with the previous forty variables. This will create the most comprehensive data bank on North Carolina drug and alcohol problem indicators (138 variables) available. After some intensive data checking procedures, this data base will be ready for the analysis phase in the coming year. Other research findings indicate that communities with high solidarity and legitimate normative internal political competitiveness are significantly more likely to be higher on the social/health services index. These findings are based on a study of 58 North Carolina county seats with the employment of 6 demographic and economic control variables. These results are contrary to the mass society thesis, national social system theories and political economy theories which suggest the unimportance of local community initiatives compared to external forces.

Impacts
(N/A)

Publications

  • MOXLEY, R.L. and PROCTOR, C.P. 1995. Community solidarity, political competitiveness and social rigidity: Relationships with social and health services. Rural Sociology 60(2):310-322.
  • WIMBERLEY, R.C. and MOXLEY, R.L. 1995. Dimensions of farm commodity production: Horses, strawberries, and why. Southern Rural Sociology 11:43-59.


Progress 01/01/94 to 12/30/94

Outputs
Efforts focused on assessing the current knowledge base on North Carolina (NC) county drug and alcohol problems, writing grant proposals to obtain additional funds to support more intensive research on parts of the project, and searching for secondary data at the county level on North Carolina drug and alcohol problems. Proposals have been written to the USDA National Research Initiative Competitive Grants Program, National Institute on Drug Abuse, and North Carolina Division Of Substance Abuse Services. A few appropriate sources of data have been discovered and are being coded to begin the construction of a data base on North Carolina counties. These data and their sources include (1) licensed private drug and alcohol residential and out-patient treatment units (source: NC Division of Facilities Services (DFS)); (2) licensed private hospitals with drug and alcohol inpatient treatment (source: NC DFS); (3) beds available for either alcohol treatment programs or drug treatment programs (source: NC Medical Facilities Planning Section, DFS); (4) discharge data on patients treated in private facilities for drugs and alcohol by county of residence in 1993 (source: 1993-94 N.C. DFS Survey); (5) comparable data on state services and patients treated (source: NC Division of Mental Health, Disability, and Substance Abuse Services).

Impacts
(N/A)

Publications

  • THOMSON, R., MOXLEY, R.L. and PETERS, D. 1994. Socioeconomic impacts of peanut CRSP graduate training efforts. Research Report 94-10. Griffin, GA: US AID Peanut CRSP. 28p.