Socioeconomic and racial/ethnic spatial polarization and incarceration among people who inject drugs in 19 US metropolitan areas, 2015

• Type of Material: Article
• Authors: Akilah Wise, Emory University; Behzad Kianian, Emory University; Howard Chang, Emory University; Sabriya Linton, Johns Hopkins University; Mary E. Wolfe, Emory University; Justin Smith, Emory University; Barbara Tempalski, National Development and Research Institutes, Inc.; Don Des Jarlais, New York University; Zev Ross, ZevRoss Spatial Analysis; Salaam Semaan, Centers for Disease Control and Prevention; Cyprian Wejnert, Centers for Disease Control and Prevention; Catlainn Sionean, Centers for Disease Control and Prevention; Hannah Cooper, Emory University
• Language: English
• Date: 2023-09
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Authors. Published by Elsevier Ltd.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016%2Fj.ssmph.2023.101486
• Title of Journal or Parent Work: SSM - Population Health
• Volume: 23
• Start Page: 101486
• Grant/Funding Information: This research was supported by two NIH grants: ‘‘Place Characteristics & Disparities in HIV in IDUS: A Multilevel Analysis of NHBS’’ (DA035101; Cooper, PI) and the Emory Center for AIDS Research (P30 AI050409; Curran, PI). It was also supported by the Centers for Disease Control and Prevention, and the National HIV Behavioral Surveillance Study Group.
• Keywords: drug injection; Spatial social polarization; racial/economic polarization; incarceration; Index of Concentration at the Extremes (ICE)
• Research Categories: Sociology, Public and Social Welfare; Sociology, Ethnic and Racial Studies

Abstract

The purpose of this study is to test, for the first time, the association between spatial social polarization and incarceration among people who inject drugs (PWID) in 19 large U.S. metropolitan statistical areas (MSAs) in 2015. PWID were recruited from MSAs for the Centers for Disease Control and Prevention's 2015 National HIV Behavioral Surveillance. Administrative data were used to describe the ZIP-code areas, counties, and MSAs where PWID lived. We operationalized spatial polarization using the Index of Concentration at the Extremes (ICE), a measure that reflects polarization in race and household income at the ZIP-code level. We tested the association between spatial polarization and odds of past-year arrest and detainment using multilevel multivariable models. We found 37% of the sample reported being incarcerated in the past year. Report of past-year incarceration varied by race/ethnicity: 45% of non-Hispanic white PWID reported past-year incarceration, as did 25% of non-Hispanic Black PWID, and 43% of Hispanic/Latino PWID (N = 9047). Adjusted odds ratios suggest that Black PWID living in ZIP-code areas with a higher ICE score, meaning more white and affluent, had higher odds of past-year incarceration, compared to white PWID. In previous research, incarceration has been found to be associated with HIV acquisition and can deter PWID from engaging in harm reduction activities.