RUNNING HEAD: POPULATIONS AT RISK

PopulationsatRisk
JeliannCarrillo
WayneStateUniversity
SW4997

RUNNING HEAD: POPULATIONS AT RISK

Abstract
ManyconsiderationsareeminentdeterminantsofAfricanAmericandruguse.
Factorssuchaslackofresources,poverty,andeducationcontinuetobeanissueamongst
thiscommunity.Alleviatingtheissuewilltaketimesincetherearemanydifferentroots

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contributingtotheproblem.Amendingpolicies,fundraisingandeducatingwouldbea
goodstartfortheseatriskpopulationstobegintorisefromthebottom.

Ms.JonesisasingleAfricanAmericanmiddleagedwoman.LastyearMs.Jones
wasfiredforbeatingoneofherstudentsafterbecomingirritated.Thisbehaviorwas
triggeredfromhernotbeingabletoconsumeherfavoritedrug,crack.Justreadingthis
caseMs.Jonesisalreadycategorizedinthreedifferentoppressedgroups,women,
AfricanAmerican,andadruguser.Nottomention,Ms.Jonesisnowunemployedwith
nochanceofgettinghercareerasaneducatorback.Despitetheodds,Ms.Jonesisa
voluntaryclientattheNationalCouncilonDrugandAlcoholismDependence(NCADD).
AfricanAmericansandDrugAbuse
Manybelievethatwearenowenteringthebirthofanewcivilrightsmovement.
Theracialissuesthathavebeenarisingcallforprofessionalstobeinformedand
knowledgeableespeciallyintheAfricanAmericanpopulation.Blackshavecomealong
waysincethecivilrightsmovement.However,alarmingstatisticsshowthatmultiple
factorsarecontributingtodrawbacksinprogress.Moreover,Iwillbefocusingonthe
AfricanAmericancommunityinrelationtodrugabuseandhowthesetwoatrisk
populationsjoinedareviewedasadarkwarpdifficulttoescapeandsetupforfailure.
ManyconsiderationsareeminentdeterminantsofAfricanAmericandruguse.
Accordingtothe2010U.S.Census,approximately36.3percentofthepopulation
currentlybelongstoaracialorethnicminoritygroup:AmericanIndianorAlaskaNative,
AsianAmerican,BlackorAfricanAmerican,HispanicorLatino,andNativeHawaiianor

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OtherPacificIslander.Duetothefactthatthesegroupsaretheminoritypopulation
interventionsandresourcesareverylimitedtosuittheirneeds.Accordingtothe
SubstanceAbuseandMentalHealthServicesAdministration,AfricanAmericans
compriseapproximately12%ofthepopulationintheUnitedStates,yetin1999they
accountedfor23%ofadmissionstopubliclyfundedsubstanceabusetreatmentfacilities
(1999).
Today,substanceabusecasescontinuetomultiplyinalarmingnumbers,
especiallyintheAfricanAmericancommunity.Untilrecently,whitemalepopulations
havedominatedstudiesofsubstanceabuse,withlittlefocusongender,ethnicityand
etiologicvariations(Cullen,2013).Theculturalbiasandemphasisonthemajoritywhite
Americanvaluesandlifestylesmaybeoneofthefactorscontributingtothesubstance
abusebehaviorsintheblackcommunity.Afterexaminingthestaggeringdatatheneed
foramoreculturallysensitivetreatmentplansarevitalforthisminoritypopulation.
IsThisPopulationConsideredatRisk?
Couldthispopulationbeconsideredatrisk?Withallofthedifferentdefinitions
foratriskpopulationsIdecidedtoconsiderthedefinitionthatisputforthbytheUS
DepartmentofHealthandHumanServices(AtRisk,BehavioralHealth,andHuman
ServicesCoordination,ABC),whichisusingthefollowingdefinition:
Before,during,andafteranincident,membersofatriskpopulationsmay
haveadditionalneedsinoneormoreareasInadditiontothose
individualsspecificallyrecognizedasatriskinthePandemicandAll

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HazardsPreparednessAct(i.e.havepharmacologicaldependency,
economicdisadvantageandalackofasupportsystem.
Ihavecondensedthedefinitiontohighlighttheareasinwhichidentifymytargeted
populationasatrisk.Ifweconsiderthisdefinitionaccurate,myclientMs.Jonesisa
clientpertainingtoapopulationatrisk.

StatisticalDataofatRiskPopulation
Povertyremainsasignificantriskfactorforsubstanceabuse.Alarmingstatistics
showthatthemedianincomefornonHispanicWhitehouseholdswas$58,270,andit
was$34,598forBlackhouseholds(DeNavasWalt,2013).Thatisahugegapandmany
factorscancontributetoaffectthosenumbers.Anoverwhelming254,062African
AmericansinDetroitlivebelowthepovertylevelbasedon20002011data.(CityData,
2011).ThisisdirectevidencethatAfricanAmericansareanatriskpopulation.
Additionally,statisticsshowthat66%percentofwomenlivinginDetroitwithno
husbandpresentlivesinpoverty(CityData,2011).
Further,feminizedpovertyisparticularlyapparentinAfricanAmericanfamilies
whereover57%ofchildrenexperiencedpovertyinfamiliesheadedbyawoman(U.S.
BureauoftheCensus,1993).TheoverrepresentationofAfricanAmericanwomenin
povertyplacesthemathigherriskforaddictionandfurtherrestrictsaccesstotreatment
(Rhodes,1993).Today,
Socioeconomicstatusisadirectresultoftheamountofeducationreceived.
AccordingtotheU.S.DepartmentofEducation,amongU.S.residentsin200910,Black

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studentsearned12percentofallmaster'sdegreesconferred.Thatisonly12%ofthe
wholeblackpopulation.AccordingtotheWashingtonPost,Detroithasoneofthelargest
schoolsystemswiththelowesthighschoolgraduationrateat46%(2013).Itissafeto
saythateducationisamajorfactorintheeconomicdisparitiesamongstblacks.
Expertsonsubstanceabusedisordersagreethatpovertyandothersocioeconomic
factorshaveagreatimpactonthepopularityofsubstanceabuseintheAfricanAmerican
community(Cullen2013).A1992studyidentifiedpoverty,illiteracy,limitedjob
opportunities,pooreducation,highavailabilityofdrugs,andstressesoftheurban
lifestyleasunderpinningsofsubstanceabuseintheblackcommunity(Clucas,1992).
TheseareallfactorsthathavebeendiscussedatgroupmeetingwithMs.Jonesandother
membersofNCADDclientele.
Accordingtothe2009NationalSurveyonDrugUseandHealth(NSDUH),illicit
druguseintheUnitedStateshasrisentoitshighestlevelineightyears.Notonlyisdrug
andalcoholabuseintheUnitedStatesbecomingmoreofanissueastimegoesonebut
alsoitisalsoextremelycostly.AccordingtotheNationalInstituteonDrugAbuse,the
costofsubstanceabusetoAmericansocietywasanestimated$181billion.Ofthis,an
overwhelming$107billionwasassociatedwithdrugrelatedcrime(2009).Duetothe
statisticaldataandtheevidenceoflikelinesstorelapse,financialsupportforatrisk
populationsisanotherfactorwemustconsider.Peopletendtohavelessempathy
especially,fordrugaddicts.Somepeoplemightevenconsiderfundinganorganization
likeNCADDawaste.Manydonorsareallocatingtheirmoneytoresearchingaddict
behaviorsandmotives.Therearecountlessarticleswithendlessdataondrugaddicts.

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AfricanAmericanwomenremainapopulationthatisbothunlikelytoreceive
adequatetreatmentandmorelikelytobepunishedforbehaviorassociatedwithalcohol
anddruguse(Rhodes,1997).Thiswasagreatarticlebecauseittoucheduponallofthe
areasofinjusticemyclient,Ms.Jonesiscurrentlyfacing.AccordingtoRhodes,the
unequalallocationofresourcesforAfricanAmericanwomenoriginates,inpart,inthe
failureoftraditionaladdictionmodelstoacknowledgetheenvironmentalfactorsthat
shapetheexperienceofminorityandfemaleaddicts(1997).Althoughisarticleisolder,it
goestoshowthatevenafter18yearswearestillbattlingthesameissueswiththesame
oppressedgroups.
SocioculturalAspectsofSubstanceAbuse
AfterspeakingtoMs.Jones,andothermembersofthiscommunityinrehabas
well,theyallexpressedacommonpressuretofulfillsocietalexpectations.Culturaland
socialnormsarerulesorexpectationsofbehaviorwithinaspecificculturalorsocial
group(WorldHealthOrganization,n.d.).TimeandtimeagainNCADDclientsexpress
theconvenienceandavailabilityofdrugsintheircommunityaswellasitbeingasocial
norm.Avarietyofexternalandinternalpressuresarethoughttomaintainculturaland
socialnorms(WorldHealthOrganization,n.d.).Individualsfeelthethreatofsocial
disapprovalorpunishmentandfeelingsofguiltandshameifthosenormsarenot
fulfilled.
Manyofthesedrugtransactionsaretakingplaceinvacant/abandonedbuildings.
Inaddition,manyAfricanAmericanshavebeensubjectedtoviolenceasa
primaryoppressor,whichrobsthecommunityoftheresourcesneededtosolvedrug

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problems(Cullen,2013).Whenwediscussviolencewearenotonlyreferringtocrime
butalsotakeintoconsiderationinthecontextofracialdiscrimination.In2015,theracial
injusticeawarenessspikedwithmanycasesbeingbroughttocourt.Peoplearestartingto
realizethattheminoritypopulationsarenotgiventhejusticeorresourcesneededto
progress.Theminoritynursearticleaddressedthatminoritygroupslackaccesstofood
andclothing,aremorepronetohomelessness,overcrowdedlivingconditions,lackof
healthinsurance,andrestrictedsocialwelfarepolicy.AccordingtoMs.Jones,Theseare
allstressorsthatusedrugstonumbreality(personalcommunication,2015).
SolutionstotheDilemmas
PovertyisprobablythebiggestissuetotacklenotonlyinDetroitbutacrossthe
Nation.Sobigthatpolicymakersandourgovernmenthaveavoidedtackingonthetask
forchange.Povertyisasocialissuethatwilltaketimetoalleviate.Duetothecountless
contributingfactorstopovertyitisahardtopictotackle.Thebestoptionwouldbeto
offeralternativetrainingandeducation.Makeeducationaffordableforallpeople.Thisis
somethingthatisbeingproposedbypresidentObama.Hehopestooffercommunity
collegeeducationfornocost.Theeffectsofthispolicywillbelongtermbutnonetheless
takeusastepcloserinlesseningthepovertyissue.
Whilehelpingatriskpopulationsmayseemasanoverwhelmingtaskto
undertake,itcanbemanageablewithpolicychangesandprogramimplementation.
Programsthatunderstandandarecommittedtothecommunitiestheywillbeserving.
Preplanningisthekey.Understandingourcommunities,understandingwholivesinthe
communities,andwhatorganizationsandpoliciesarealreadyinplacemakesitpossible

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toprepare.Mostcommunitieshavecommunitybasedorganizationsalreadyinplace.
Manyoftheseoldorganizationsdorequiresomeassistanceinrevampingand
reorganizingtokeepupwiththedemandinsocialchanges.Thatiswherepoliciescome
intohelpkeeporganizationsupdatedandreadilyavailabletohelp.
Anotherentitythatprovidesservices/programsisthelocalDHSoffice.They
oftenareawareofprogramsthatservemanyoftheatriskpopulationsintheareaand
couldbegoodsourcesofnotonlyinformationbutalsogovernmentassistanceforthose
whoqualify.DHSofficestendtohaveabadreputationwiththecommunitybecauseof
theirlackofempathyforclients.Again,toalleviatethisissueemployeesshouldundergo
specialsensitivitytrainingstoeducateonthepopulationandtheneedsofthatpopulation.
Toplaythedevilsadvocate,thepublicshouldalsobeeducatedonwhatresources
andaidedifferentagenciescanprovideaswellaslearningwhotheleadersarewithinthe
communitythathaslocalconnections.Notonlymustweeducatethecommunityof
resourcesandprogramsthatmaybeavailablebutwemustalsoofferspecialeducational
trainingstohelpthemgetjobs.Lifeskillstraining,resumeworkshops,alternative
educationoptions,theseareallexamplesofprogramsthatarealreadyinplaceinmost
communitiesjustnotadvertisedenougharoundthecommunity.Manyagenciesofferhelp
infindingjobsortrainingopportunitiesfortheirclients.
Fortunately,thereareorganizationscommittedtothosesufferingfromsubstance
abuseandaddictionproblems.Therearecountlessdrugtreatmentprogramsandselfhelp
groupsavailabletosupport.Withtherighttreatmentplanandsupport,recoveryis
challengingbutnotimpossible.However,asstatedearlier,thebiggestissueisfunding

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andconvincingthepublicanddonorsthatthispopulationisworthinvestingin.Ibelieve
recordingmoredataandshowingtheratesatwhichpeoplearegraduatingfromprograms
andmaintainingtheirbehaviorwillhelpconvincedonorsthatnewerintervention
methodsareworking.Showingtheimportanceofgettingpeoplecleanisworththeir
money.
Manyorganizationshavearisentohelpalleviatethisissue.Organizationslikethe
onementionedthroughoutthisanalysis,theNationalCouncilonAlcoholismandDrug
Dependence(alsoknownasVantagePoint)isavoluntary,nonprofitagencycommitted
toimprovingcommunityhealththroughprovidingsubstanceabuseprevention,
education,training,treatmentandadvocacyforthemetropolitanDetroitArea.Vantage
PointClinicsservestheSoutheastMichigancommunitythroughtwolocations.Thisis
justoneofthemanyorganizationstohelptreatsubstanceabuse.
Associalworkerswehaveanethicalresponsibilitytoourclients.Wemustserve
ourclientwiththebestinterestinmind.Whenethicaldilemmasarisesuchas
discriminationwehavetostandupforwhatisethical.Weabidebysixethicalprinciples
setforthbytheNASW:service,socialjustice,dignityandworthoftheperson,
importanceofhumanrelationships,integrity,andcompetence.Theseprinciplessetforth
idealstowhichallsocialworkersshouldaspire.
Themosteffectiveandimportantsolutionforthisdilemmaisculturalcompetent
practice.ThisissomethingthathasbeenbroughttotheattentiontotheNational
AssociationofSocialWorkers.The2008NASWDelegateAssemblyapprovedthe
followingrevisionstotheNASWCodeofEthics:

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1.05CulturalCompetenceandSocialDiversity
(c)Socialworkersshouldobtaineducationaboutandseektounderstandthe
natureofsocialdiversityandoppressionwithrespecttorace,ethnicity,national
origin,color,sex,sexualorientation,genderidentityorexpression,age,marital
status,politicalbelief,religion,immigrationstatus,andmentalorphysical
disability.
Addingthisrevisiontothecodeofethicswasapositivesteptowardschange.Today,
culturalcompetenceanddiversityclassesarebeingimplementedinthesocialwork
schoolscurriculum.Thismeansthatmoreandmoresocialworkersarebeingequipped
forculturallycompetentcare.

Conclusion
Organizationsingeneralstrivetomaketheirservicesconvenientfortargeted
populations.Thisparticularorganizationisstrategicallyplacedinanareawherethe
servicesareneeded.ThepopulationdemographicsinthisareaofDetroitisprimarily
AfricanAmerican.98%ofNCADDclientsareAfricanAmericanandapproximately
78%arecourtorderedand22%arevoluntaryclients(NCADD).
Factorssuchaslackofresources,poverty,andeducationcontinuetobeanissue
amongstthiscommunity.Alleviatingtheissuewilltaketimesincetherearemany
differentrootscontributingtotheproblem.Amendingpolicies,fundraisingandeducating
wouldbeagoodstartfortheseatriskpopulationstobegintorisefromthebottom.The

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keycomponentinhelpingthisoppressedpopulationisculturalcompetentpracticeand
educatingtoempower.

AsforMs.Jones,shecontinuestomakepositivestridesinrecoveryyetisjustanother
statistic.
References
CodeofEthics.(2008,January1).RetrievedFebruary12,2015,from
http://www.socialworkers.org/pubs/code/code.asp
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SubstanceAbuseandMentalHealthServicesAdministration(2002).TheDasisReport:

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BlackAdmissionstoSubstanceAbuseTreatment:1999.Rockville,Md.:Office
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