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Using a structural vulnerability framework to understand the impact of COVID- 19 on the lives of Medicaid beneficiaries receiving substance use treatment in New York City
dc.contributor.authorZhen-Duan, Jenny
dc.contributor.authorGade, Neerav
dc.contributor.authorFalgas-Bagué, Irene
dc.contributor.authorSue, Kimberly L.
dc.contributor.authorDeJonckheere, Melissa
dc.contributor.authorAlegría, Margarita
dc.date.accessioned2022-09-26T16:04:08Z
dc.date.available2023-11-26 12:04:06en
dc.date.available2022-09-26T16:04:08Z
dc.date.issued2022-10
dc.identifier.citationZhen-Duan, Jenny ; Gade, Neerav; Falgas-Bagué, Irene ; Sue, Kimberly L.; DeJonckheere, Melissa; Alegría, Margarita (2022). "Using a structural vulnerability framework to understand the impact of COVID- 19 on the lives of Medicaid beneficiaries receiving substance use treatment in New York City." Health Services Research 57(5): 1104-1111.
dc.identifier.issn0017-9124
dc.identifier.issn1475-6773
dc.identifier.urihttps://hdl.handle.net/2027.42/174820
dc.description.abstractObjectiveTo investigate how the COVID- 19 pandemic impacted low- income individuals with substance use disorder (SUD) in New York City (NYC) during the beginning of the pandemic, using a structural competency and structural vulnerability theoretical framework and a qualitative research approach.Data SourcesPrimary qualitative data were collected from racial/ethnic minority adults enrolled in Medicaid receiving outpatient substance use treatment (e.g., medication, counseling) in NYC.Study DesignSemi- structured in- depth qualitative interviews (N = 20) were conducted during - stay- at- home- orders in NYC, the first epicenter of the COVID- 19 pandemic in the United States. Interviews were conducted over the phone during the earlier stages of the pandemic, between April 2020 and June 2020.Data Collection/Extraction MethodsSemi- structured in- depth interviews were conducted and audio recorded, transcribed, and analyzed using a thematic analysis approach.Principal FindingsThree themes were yielded from our thematic analysis: (1) COVID- 19 heightened food insecurity and housing conditions increased risks of infection; (2) stay- at- home orders limited access to resources but had positive impacts in strengthening social relationships and reducing substance use triggers; and (3) although COVID- 19 created challenges for treatment, most described that SUD care improved during the pandemic.ConclusionsWhile COVID- 19 exacerbated numerous structural vulnerabilities among low- income individuals with SUD, programmatic adaptations to COVID- 19 SUD care, including telehealth and loosening restrictions around medications for opioid use disorders mitigated past difficulties that patients had faced. Reducing structural vulnerabilities for Medicaid patients will require continuation of telehealth treatment delivery, retaining flexible medication regulations, and mobilizing community resources to mitigate economic disparities.
dc.publisherBlackwell Publishing Ltd
dc.publisherWiley Periodicals, Inc.
dc.subject.otherstructural vulnerability
dc.subject.othersubstance use disorders
dc.subject.otherMedicaid
dc.subject.otherdisparities
dc.subject.otherCOVID- 19
dc.titleUsing a structural vulnerability framework to understand the impact of COVID- 19 on the lives of Medicaid beneficiaries receiving substance use treatment in New York City
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelPublic Health
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/174820/1/hesr13975_am.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/174820/2/hesr13975.pdf
dc.identifier.doi10.1111/1475-6773.13975
dc.identifier.sourceHealth Services Research
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dc.working.doiNOen
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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