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Is Childcare Availability in Addiction Treatment Associated with County-Level Childcare Prices and Median Income in
Orrin D Ware1, G Rose Geiger1, Malina A Howard2
1School of Social Work, University of North Carolina at Chapel Hill, NC, USA.
Insights
Childcare costs, not income, are linked to childcare availability in US addiction treatment centers. Investing in family services can improve access for parents needing substance use disorder treatment.
Area of Science:
- Public Health
- Health Services Research
- Addiction Medicine
Background:
- Substance use disorder treatment access is challenging for parents due to childcare needs.
- Childcare services at treatment facilities can mitigate these barriers.
- The association between local economic factors and childcare availability in these facilities is understudied.
Purpose of the Study:
- To determine if county-level childcare prices correlate with childcare service availability in US substance use disorder treatment facilities.
- To assess if county-level median household income correlates with childcare service availability in US substance use disorder treatment facilities.
Main Methods:
- Cross-sectional study of 9,003 US substance use disorder treatment facilities.
- Linked county-level childcare costs and median income data to facility locations.
- Used logistic regression to analyze associations between childcare availability and economic indicators, controlling for facility characteristics.
Main Results:
- Only 5.7% of facilities offered childcare services.
- Higher county childcare costs (toddler and preschool centers) showed a slight association with childcare availability.
- Median household income was not significantly associated with childcare availability.
Conclusions:
- Local childcare costs, not median income, are marginally associated with childcare availability in addiction treatment settings.
- Investing in family-friendly services at treatment facilities may reduce access barriers for parents with substance use disorders.
Background:
When parents or other guardians of children need treatment for a substance use disorder, it presents challenges impacting both them and their children, as a lack of childcare can be a barrier to treatment access. However, some treatment facilities provide childcare services to increase access. Little is known about how local economic factors like childcare costs and income levels are associated with the availability of childcare services in addiction treatment programs in the United States.
Objectives:
This study's objectives were twofold: (1) assess whether county-level childcare prices are associated with the availability of childcare services in substance use disorder treatment facilities, and (2) assess whether county-level median household income is associated with the availability of childcare services in substance use disorder treatment facilities.
Design:
This is a cross-sectional study.
Methods:
This study examined n = 9003 substance use disorder treatment facilities in the United States. Childcare costs and median income estimates were linked with facilities based on the county in which they were located. Univariable and bivariable statistics were used to examine the facilities. An adjusted logistic regression model was used to evaluate associations between childcare availability and county-level economic indicators, while controlling for facility-level characteristics.
Results:
Approximately 5.7% (n = 514) of the facilities in the sample had childcare services. The multivariable logistic regression model identified factors associated with facilities having childcare including having outpatient and residential treatment (compared to having only outpatient only), accepting females only (compared to accepting males only), having a pregnant or postpartum program/group, accepting Medicaid, slightly higher county-level toddler center prices, and slightly higher county-level preschool center prices.
Conclusion:
Local childcare costs, but not median income appears to be slightly associated with the availability of childcare services in substance use disorder treatment settings. Economic investment in family-friendly services may help reduce access barriers for parents seeking treatment.
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