{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T07:59:37Z","timestamp":1780646377740,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015283","name":"Bloomberg Philanthropies","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015283","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Quantify racial and ethnic disparities in harm reduction and substance use disorder (SUD) treatment use among people who use drugs and compare estimates using a healthcare disparities measurement method aligned with the Institute of Medicine (IOM) definition of healthcare disparities against other regression approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Setting and Design<\/jats:title>\n                    <jats:p>45\u2010minute telephone survey of people who use drugs administered from January 2023 to August 2024 across four US locations (i.e., Milwaukee County, Wisconsin; Flint\/Detroit, Michigan; statewide in New Jersey; and Bernalillo County, New Mexico). Service use disparities were estimated using propensity score models with rank\u2010replace methods and compared against standard covariate\u2010adjusted logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Analytic Sample<\/jats:title>\n                    <jats:p>\n                      Survey response data from 1651 respondents who identified as White non\u2010Hispanic (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009572), Black non\u2010Hispanic (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009479), Hispanic (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009453), or American Indian\/Alaska Native (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009147) and had used drugs in the past 30\u2009days. Exposures included respondent demographics, health status, social determinants of health (SDOH), and race\/ethnicity. Outcomes included use of any harm reduction services, fentanyl test strip use, naloxone possession, any SUD treatment use, and receipt of buprenorphine, methadone, or naloxone in the past 30\u2009days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>Compared to White non\u2010Hispanic (NH) respondents, Black NH respondents were 17.8 (95% CI: \u22120.24, \u22120.12) percentage points less likely to use harm reduction services and 8.8 (95% CI: \u22120.15, \u22120.03) points less likely to use SUD treatment. Hispanic respondents were 12.8 percentage points less likely to use any SUD treatment (95% CI: \u22120.20, \u22120.06), while American Indian\/Alaska Native respondents were 11 percentage points less likely (95% CI: 0.20, \u22120.02). Standard adjustment models tended to mask or overestimate healthcare disparities relative to rank and replace with propensity scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Racial and ethnic disparities in harm reduction and treatment necessitate policy reform. Social determinants adjustment should be performed carefully to prevent inaccurately estimating health disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.70081","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:49:52Z","timestamp":1767167392000},"page":"1-12","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Estimating Racial and Ethnic Disparities in Substance Use Disorder Treatment and Harm Reduction Services: Findings From a Survey of People Who Use Drugs"],"prefix":"10.1111","volume":"61","author":[{"given":"Jason B.","family":"Gibbons","sequence":"first","affiliation":[{"name":"Program on Regulation, Therapeutics and Law, Division of Pharmacoepidemiology &amp; Pharmacoeconomics Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachini","family":"Bandara","sequence":"additional","affiliation":[{"name":"Department of Health Policy &amp; Management Johns Hopkins University Bloomberg School of Public Health Baltimore Maryland USA"},{"name":"Department of Mental Health Johns Hopkins University Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin Le","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Cambridge Health Alliance, Harvard Medical School Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Byrne","sequence":"additional","affiliation":[{"name":"Department of Health Policy &amp; Management Johns Hopkins University Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia K.","family":"Sugarman","sequence":"additional","affiliation":[{"name":"Department of Health Policy &amp; Management Johns Hopkins University Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Kerins","sequence":"additional","affiliation":[{"name":"Vital Strategies New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Pugh","sequence":"additional","affiliation":[{"name":"Vital Strategies New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric G.","family":"Hulsey","sequence":"additional","affiliation":[{"name":"Institute for Research, Education, and Training on Addictions Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daliah","family":"Heller","sequence":"additional","affiliation":[{"name":"Vital Strategies New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minna","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice Brown University Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Saloner","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy, and Practice Brown University Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Drug Overdose Deaths in the United States, 2002\u20132022","author":"Spencer M. 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