Socially vulnerable communities in the U.S. show higher rates of schizophrenia and substance use disorders but receive significantly less treatment for these conditions, according to a recent study published in JAMA Psychiatry.

The study examined the association between social vulnerability and the prevalence and treatment of mental health and substance use disorders among U.S. adults. Researchers analyzed data from 4,674 participants (2,904 females [62.13%] and 1,770 males [37.87%]) aged 18 and older, collected from October 2020 to October 2022. The mean age was 41.51 years (SD = 13.41 years).

Key findings indicated that higher social vulnerability is associated with an increased prevalence of specific mental health and substance use disorders, including schizophrenia spectrum disorder, opioid use disorder, and stimulant use disorder. Treatment rates for these disorders were lower in socially vulnerable communities despite the increased prevalence. The study found no association between social vulnerability and the prevalence of major depressive disorder or generalized anxiety disorder.

Researchers utilized the Social Vulnerability Metric (SVM) and the Area Deprivation Index (ADI) to assess social vulnerability at the zip code level. The SVM demonstrated stronger associations with disorder prevalence compared to the ADI. For schizophrenia spectrum disorder, the adjusted odds ratio (aOR) was 17.22 with the SVM, compared to 11.38 with the ADI. For opioid use disorder, the SVM's aOR was 9.47, significantly higher than the ADI's 2.05.

The study revealed a significant reduction in mental health treatment for individuals with schizophrenia spectrum disorder in socially vulnerable areas (aOR = 0.001; 95% CI, 0.00-0.18). Additionally, there was a reduction in substance use disorder treatment for individuals with opioid use disorder or stimulant use disorder in these areas (aOR = 0.24; 95% CI, 0.02-2.80).

For full disclosures, please refer to the original study.