Do neighborhood characteristics of sober living houses impact recovery outcomes? A multilevel analysis of observational data from Los Angeles County.

Abstract

To identify neighborhood factors associated with recovery outcomes for sober living house (SLH) residents. Six-month longitudinal data for new SLH residents (n=557) was linked with census tract data, services available, alcohol outlets, and Walk Scores® (0-100 score indicating access to neighborhood resources) for 48 SLHs in 44 neighborhoods in Los Angeles County. Non-significant neighborhood characteristics in separate regressions for all outcomes were residents' ratings of perceived risk, percentage of residences with access to a car, percentage of homes over $500,000, percentage of renter-occupied units, percentage with income less than $25,000, percentage that were non-white, the density of substance inpatient within 10 miles, and transit scores from Walk Score®. Multilevel regressions found outpatient substance abuse treatment and density of AA groups were positively associated with more abstinent days. No neighborhood variables were associated with psychiatric symptoms. Higher perceived neighborhood cohesion, lower crime ratings, and better transportation ratings were associated with higher recovery capital. Greater neighborhood densities of substance abuse services and AA groups may help residents achieve more days abstinent. While residents may achieve better substance use outcomes even with negative perceptions of the neighborhood, positive perceptions of the neighborhoods may help them acquire more recovery capital.