Income inequality, drug-related arrests, and the health of people who inject drugs: Reflections on seventeen years of research

• Published in: The International journal of drug policy Vol. 32; pp. 11 - 16
• Main Authors: Friedman, Samuel R, Barbara, Tempalski, Brady, Joanne E, West, Brooke S, Pouget, Enrique R, Williams, Leslie D, Jarlais, D.C Des, Cooper, Hannah L.F
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2016; Elsevier Science Ltd
• Subjects: Arrests; Cocaine; Cocaine-Related Disorders - epidemiology; Crime - economics; Crime - statistics & numerical data; Drug abuse; Drug law reform; Drug policy; Drug-related arrests; Drugs; Health; Health disparities; Health Status; Heroin; Heroin Dependence - epidemiology; HIV; HIV Infections - economics; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Income - statistics & numerical data; Income inequality; Internal Medicine; Intravenous drug addiction; Intravenous drug addicts; Intravenous drugs; Macro-social; Medical Education; Medical research; Metropolitan areas; Mortality; Oppression; People who inject drugs; Policing; Prevalence; Public health; Racism; Social issues; Social movements; Socioeconomic Factors; Substance Abuse, Intravenous - economics; Substance Abuse, Intravenous - epidemiology; Substance-Related Disorders - economics; Substance-Related Disorders - epidemiology; Urban Population; United States > US; racism; HIV; income inequality; Macro-social; people who inject drugs; health; drug law reform; drug-related arrests; Income inequality; Drug-related arrests; Health; Drug law reform; People who inject drugs; Racism
• ISSN: 0955-3959; 1873-4758
• DOI: 10.1016/j.drugpo.2016.03.003

Abstract This paper reviews and then discusses selected findings from a seventeen year study about the population prevalence of people who inject drugs (PWID) and of HIV prevalence and mortality among PWID in 96 large US metropolitan areas. Unlike most research, this study was conducted with the metropolitan area as the level of analysis. It found that metropolitan area measures of income inequality and of structural racism predicted all of these outcomes, and that rates of arrest for heroin and/or cocaine predicted HIV prevalence and mortality but did not predict changes in PWID population prevalence. Income inequality and measures of structural racism were associated with hard drug arrests or other properties of policing. These findings, whose limitations and implications for further research are discussed, suggest that efforts to respond to HIV and to drug injection should include supra -individual efforts to reduce both income inequality and racism. At a time when major social movements in many countries are trying to reduce inequality, racism and oppression (including reforming drug laws), these macro-social issues in public health should be both addressable and a priority in both research and action.