Alcohol Use Disorder Among Alabama Medicaid Recipients

Alcohol use disorder (AUD) is an increasing public health concern. Our study examined Alabama Medicaid claims from 2015 to 2020 to increase understanding of rural versus urban geographical differences in AUD rates in Alabama. Using Alabama Medicaid administrative claims data from January 1, 2015, to December 31, 2020, we identified Medicaid recipients with AUD. All data were managed within the ESRI ArcGIS software program. We added a rural-urban designation variable for each county using the rural-urban continuum codes from the United States Department of Agriculture. We examined 100% of Medicaid claims of AUD from 2015 to 2020 in Alabama. Within the state, there are 67 counties and 38 were counted as rural. Our findings show both urban and rural counties of Alabama experienced growth in AUD rates in the span of 5 years. However, rural counties experienced faster growth in AUD rates than their urban counterparts. Our study demonstrated the importance of geographical considerations in AUD rates and treatment in rural areas. Leveraging geographical information system technology and providing empirically valid treatment tailored specifically to geographic and cultural considerations experienced by rural populations, is a critical next step in ensuring optimally effective and culturally appropriate AUD treatment.