Examining the Association of police violence to syringe service program utilization in rural Appalachia Open Access

Greenwood, Harris (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/2v23vv678?locale=en


Background: Syringe service programs (SSPs) are a safe community-based prevention programs that provide a wide array of services to reduce harms people who use drugs face and are legally proliferating in rural Appalachia in tandem with the opioid epidemic. Police have interfered with SSP utilization in urban areas through crackdowns, arrests, harassment, and other forms of violence. This study examines the association of police violence to SSP utilization in 5 predominantly white, rural Kentucky counties heavily impacted by the opioid epidemic.



Methods: Cross-sectional surveys were conducted at baseline and at 6 months as part of the Rural Opioid Initiative. A logistic regression measured the association of police violence to the SSP utilization of 107 participants. Police violence was measured using 5 questions that assessed past-year frequencies of physical, psychological, neglectful, and sexual violence.



Results: 27% of the sample experienced some form of police violence. However, police violence was not statistically associated with SSP utilization among this rural sample after adjusting for sex/gender, age, homelessness in the past 6 months, HCV status at baseline, injection frequency in the past 30 days, destitution, and distance to the nearest SSP (aOR: 1.16, 95% CI=0.38, 3.51, p=.98). Those who could walk to the nearest SSP in 30 minutes or less had a 4.36 times higher odds visiting a SSP in the past 30 days compared to those who could not and this was statistically significant (aOR: 4.36, 95% CI= 1.18, 16.14 p=.02). Additionally, those experiencing destitution had a 0.20 times lower odds than those who do not (aOR: .20, 95%CI= 0.06, 0.60, p=.003).



Conclusions: This study is, as far as we know, the first to examine police violence and SSP use in a rural area. A lack of association among this rural and predominantly white sample may indicate that police violence functions differently in different geographies and that police violence among BIPOC populations in urban areas may be a form of anti-BIPOC structural racism that exacerbates the adverse effects of police violence.

Table of Contents

Chapter 1: Introduction

Problem Statement

Theoretical Framework

Purpose Statement

Research Question

Significance Statement

Chapter 2: Literature Review

Chapter 3: Student Contribution

Chapter 4: Manuscript





Chapter 5: Public Health Implications



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