Journal of Drug Issues 43(3) 374–385 © The Author(s) 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0022042612472332 jod.sagepub.com Article 2332JOD XX X 10.1177/0022042612472332Journal of Drug IssuesCho et al. 1 University of Wisconsin–Milwaukee, USA 2 University of Illinois at Chicago, USA 3 Illinois Division of Alcoholism & Substance Abuse, Chicago, USA Corresponding Author: Young Ik Cho, University of Wisconsin–Milwaukee, 1240 N 10th Street, Milwaukee, WI 53205, USA. Email: cho3@uwm.edu Treatment Facility Neighborhood Environment and Outpatient Treatment Completion Young Ik Cho 1 ,Timothy P. Johnson 2 , Michael Fendrich 1 , and Lillian Pickup 3 Abstract The current study focuses on three dimensions of treatment neighborhood environments that may influence treatment retention: neighborhood disadvantage, stability, and concentrated immigration. We examined treatment outcomes for a total of 9,319 individuals who were ad- mitted for initial treatment in 56 outpatient clinics in Cook County, Illinois. Census-tract-level data were used to measure facility neighborhood environment. We found that neighborhood disadvantage was unrelated to individual treatment completion. Immigrant concentration was found to increase the likelihood of substance abuse treatment completion, although it was attenuated after controlling for patient problem severity and referral sources. Neighborhood stability was found to be positively related to treatment completion. These results suggest that knowledge of neighborhood context should be an important consideration when making placement decisions of new treatment facilities. Knowledge of neighborhood impact on treat- ment attrition should also be considered essential information to be used for client placement, treatment program design, and discharge protocols. Keywords treatment outcomes, treatment completion, neighborhood effects Introduction There is a growing body of research that explores neighborhood effects on various social, behav- ioral, and health outcomes (for a review, see Diez-Roux, 2001; Ellen, Mijanovich, & Dillman, 2001; Gephart, 1997; Leventhal & Brooks-Gunn, 2000; Pickett & Pearl, 2001; Robert, 1999; Sampson, Morenoff, & Gannon-Rowley, 2002), including potential associations between neigh- borhood contextual effects and substance abuse behaviors (cf. Fendrich, Lippert, Johnson, & Brondino, 2010). Only a few investigations, however, have considered the effects of neighbor- hood context on treatment outcomes (Jacobson, 2004, 2006). Understanding whether and how