Among the project objectives is the construction of a county level data base for North Carolina counties from available national data sets that have information on health and disease problems arising from drug and alcohol abuse with data relevant to the county level. From the variables in this data base a county index of substance abuse severity (CISAS) will be constructed for rank ordering all 100 North Carolina counties. It is anticipated that a drug and an alcohol dimension will emerge from the analysis of these variables. Using this index, rural and urban counties will be compared in order to gain a better perspective on the relative severity of substance abuse in rural counties. As an additional measure of county substance abuse problems, a survey of all private licensed treatment centers will be carried out to supplement treatment data already available from state centers. The private data will be combined with the available data on state centers to provide a complete composite of the total amount and types of treatment extant in all counties of North Carolina. Treatment rates will be used in a factor analysis along with the pre-collected data variables to determine which variables, if any, are reflecting an underlying factor. If the county treatment rate variable does not fit with any underlying factor it will be used alone as a measure of substance abuse severity due to its face validity. This will be a significant addition to the array of indirect measures of county substance abuse. Once the measure(s) of substance abuse severity is constructed it will be used to compare rural and urban counties based on several alterative definitions of rural and urban. The most general definition is the census designation of metropolitan and nonmetropolitan counties as proxy categories for rural and urban, but other more sophisticated rural-urban dimensions have been constructed and will be utilized. More detailed analysis will use the CISAS measure(s) as the dependent variable to examine potential county conditions affecting county drug and alcohol problem rates. Community interaction theory and structural theory suggest that emergent properties reflecting activeness and competitiveness of the community are related to a range of community improvement efforts, level of services, and general social well being. Alteratively ecological theory suggests a number of variables that affect the basic adaptation of a population to its environment. Variables derived from these two theoretical perspectives will be used as sets of independent variables to test relationships to the CISAS measurement. Principal components factor analysis will be used in constructing CISAS measures. Regression analysis will be the basic statistical analysis model employed.
