Impact of Medicaid, Race/Ethnicity, and Criminal Justice Referral on Opioid Use Disorder Treatment.

We examined the impact of Medicaid expansion and of race/ethnicity on medication-assisted treatment (MAT) for opioid use disorder among those referred for treatment through the criminal justice system. Using a cross-sectional design, we combined data from the Substance Use and Mental Health Services Administration's Treatment Episode Data Set with data on Medicaid expansion and age-adjusted mortality for drug poisoning deaths. Logistic regression was performed within state panels from 2012 to 2016, with 2014 excluded due to this being the transitional Medicaid expansion year. We found that Medicaid expansion led to an increase in the use of MAT to treat those referred to substance treatment facilities through the criminal justice system. We also identified key racial disparities in the use of MAT for those referred from the criminal justice system, with Blacks and Hispanics less likely to receive MAT than non-Hispanic Whites.

Public perceptions of the role of government and nonstate actors in responding to COVID-19.

In this article, we examine public perceptions of the importance of different levels of government and of nongovernmental entities in responding to the COVID-19 pandemic. By analyzing the case of COVID-19, we illuminate patterns that may be helpful for understanding public perceptions of the response to a broader range of crises, including the impacts of hurricanes, tornadoes, earthquakes, wildfires, and other hazards. We contribute to the public policy literature on public perceptions of government response to crises and expand it to include consideration of the role of nonstate actors. Drawing on a representative survey of 1200 registered voters in Texas, we find that individuals are more likely to view government as extremely important to respond to the pandemic than nonstate actors. We find that perceptions of the role of state and nonstate actors are shaped by risk perception, political ideology and religion, gender, and race/ethnicity. We do not find evidence that direct impacts from the COVID-19 pandemic consistently shape perceptions of the role of state and nonstate actors.

En este artículo, examinamos la percepción pública sobre la importancia de los diferentes niveles de gobierno y de las entidades no gubernamentales en la respuesta a la pandemia de COVID­19. Al analizar el caso de COVID­19, esperamos resaltar patrones que podrían ser útiles para comprender las percepciones públicas de la respuesta a una gama más amplia de crisis, incluidos los impactos de huracanes, tornados, terremotos, incendios forestales y otros peligros. Contribuimos a la literatura de políticas públicas sobre las percepciones públicas de la respuesta del gobierno a las crisis y la ampliamos para incluir la consideración del papel de los actores no estatales. Basándonos en una encuesta representativa de 1,200 votantes registrados en Texas, encontramos que es más probable que las personas vean al gobierno como algo extremadamente importante para responder a la pandemia que los actores no estatales. Encontramos que las percepciones del papel de los actores estatales y no estatales están determinadas por la percepción del riesgo, la ideología política y la religión, el género y la raza / etnia. No encontramos evidencia de que los impactos directos de la pandemia de COVID­19 moldeen consistentemente las percepciones del rol de los actores estatales y no estatales.

From Disaster Response to Community Recovery: Nongovernmental Entities, Government, and Public Health.

In this article, we examine the role of nongovernmental entities (NGEs; nonprofits, religious groups, and businesses) in disaster response and recovery. Although media reports and the existing scholarly literature focus heavily on the role of governments, NGEs provide critical services related to public safety and public health after disasters. NGEs are crucial because of their ability to quickly provide services, their flexibility, and their unique capacity to reach marginalized populations. To examine the role of NGEs, we surveyed 115 NGEs engaged in disaster response. We also conducted extensive field work, completing 44 hours of semistructured interviews with staff from NGEs and government agencies in postdisaster areas in Texas, Florida, Puerto Rico, Northern California, and Southern California. Finally, we compiled quantitative data on the distribution of nonprofit organizations. We found that, in addition to high levels of variation in NGE resources across counties, NGEs face serious coordination and service delivery problems. Federal funding for expanding the capacity of local Voluntary Organizations Active in Disaster groups, we suggest, would help NGEs and government to coordinate response efforts and ensure that recoveries better address underlying social and economic vulnerabilities.