SlideShare a Scribd company logo
Racial/Ethnic Differences in Report of Drug Testing
Practices at the Workplace Level in the U.S.
William C. Becker, MD,1,2 Salimah Meghani, PhD,3 Jeanette
M. Tetrault, MD,2
David A. Fiellin, MD2
1VA Connecticut Healthcare System, West Haven, Connecticut
2Yale University School of Medicine, New Haven, Connecticut
3University of Pennsylvania, Philadelphia, Pennsylvania
Background and Objectives: It is unknown whether racial/ethnic
differences in report of workplace drug testing persist when
analyzed
within and across various occupations. We sought to examine
the
association between worker demographics, workplace
characteristics,
and report of employment in a workplace that performs drug
testing.
Methods: We performed a cross‐sectional study of the 2008–
2010
National Survey on Drug Use and Health examining the
relationship
between race/ethnicity and report of workplace drug testing
among
employed, white, black, or Hispanic respondents �18 years old.
In
logistic regression analysis, we adjusted for demographic,
occupa-
tional, and other relevant variables and performed stratified
analyses
among three specific occupations.
Results: Among 69,163 respondents, 48.2% reported
employment in a
workplace that performs drug testing. On multivariable analysis,
younger age, male sex, black race, income greater than $20,000,
completion of high school and non‐urban residence were
associated with
report of drug testing at one’s workplace among the full sample
as were
non‐white collar occupation, work in medium or large
workplace, and
absence of other substance abuse/dependence. In stratified
analyses,
black race was associated with report of workplace level drug
testing
among executive/administrative/managerial/financial workers
and tech-
nicians/related support occupations; Hispanic ethnicity was
associated
with the outcome among technicians/related support
occupations.
Conclusions: Racial/ethnic differences in report of workplace
drug
testing exist within and across various occupations. These
differences
have important public health implications deserving further
study.
Scientific Significance: Increased report of drug testing where
racial/
ethnic minorities work highlights the potential bias that can be
introduced when drug testing policies are not implemented in a
universal fashion. (Am J Addict 2014;23:357–362)
INTRODUCTION
After and in spite of early controversy about the ethics of U.S.
workplace drug testing,1 its prevalence has been increasing
since
the 1980s and is now commonly conducted in both prospective
and current employees. A study from 2007 reported that 46% of
workers and 90% of Fortune 200 companies report some form of
drug testing.2 As employee drug use has been associated with
accidents at work and elsewhere, absenteeism, lower productiv-
ity, and decreased profits, many employers see drug testing as a
cost‐saving measure.3,4 Additionally, some data demonstrate a
deterrent effect of testing on worker drug use.5 Typical
workplace drug testing uses urine samples, but blood and hair
testing are also occasionally used. Urine tests usually include
the
so‐called “Federal 5” substances: marijuana, opiates, cocaine,
PCP, and amphetamines but may be expanded to include other
substances such as methadone, benzodiazepines, barbiturates,
and oxycodone.
In terms of potential benefits and risks, much is at stake for
prospective and current workers who undergo workplace drug
testing. On the benefit side, a positive drug test could lead to a
worker receiving treatment for a previously unrecognized
substance use disorder through enrollment in an employee
assistance or other available program. From a public health
standpoint, workplaces may be made safer for both employees
and the public if individuals with drug use are either not hired
in the first place or suspended for ongoing drug use. On the
other hand, employers may not hire applicants with positive
tests that may have resulted from sporadic, low‐level use.6
Furthermore, workers with evidence of substance use may lose
their jobs and health insurance for themselves and their
families, with or without an opportunity for treatment. As
employment and health insurance status are two of the most
significant social determinants of health,7,8 it follows that
workplace drug testing can have profound and long‐term
effects on individuals’ health.
Since the results obtained from workplace drug testing may
have major health‐related consequences for employees, an
Received December 11, 2012; revised June 4, 2013; accepted
August 10, 2013.
Presented as an oral presentation at the Society of General
Internal Medicine 33rd Annual Meeting, Minneapolis, MN,
April 2010.
Address correspondence to William C. Becker, MD, 950
Campbell Avenue, West Haven VAMC, Mail Stop 151B, West
Haven, CT 06516. E‐mail: [email protected]
The American Journal on Addictions, 23: 357–362, 2014
Copyright © American Academy of Addiction Psychiatry
ISSN: 1055-0496 print / 1521-0391 online
DOI: 10.1111/j.1521-0391.2014.12109.x
357
equitable system of implementation is critical to avoid
burdening vulnerable populations with a disproportionate
share of risk.9 Universal testing, exemplified by the U.S.’
Omnibus Transportation Employee Testing Act of 1991
requiring all transportation industry employees in “safety‐
sensitive” positions to have drug testing, is one strategy to
promote equity. However, beyond these laws pertaining to a
small subset of occupations, testing policies in the U.S. are
subject to wide variation in state laws/regulations concerning
when, where and how employers can implement workplace
drug testing programs. Generally, employers must have a
written policy requiring new hires to be drug‐free; written
notice must be given before the applicant may be tested. The
same testing program must be implemented for all applicants in
a particular category though a company may require testing for
pre‐specified positions only, provided this is stated and justified
in the written policy.10
Regarding healthcare settings (as opposed to workplaces),
studies have hypothesized that the absence of universal drug
testing policies across or within practices promotes differential
implementation by race, since, in the absence of protocols,
prejudice and bias may influence decision‐making.11,12 Indeed,
in clinical encounters, differential implementation in drug
testing has been reported: non‐white individuals have been
shown to be more likely to get tested.13 Similarly, the question
of equity or fairness within U.S. workplace drug testing
programs is of particular significance given the potential
health‐related consequences noted above. Previous research
using 2002–2004 data demonstrated increased reports of
workplace drug testing by black workers, by individuals
employed in certain occupations, such as transportation and
material moving workers, and by individuals working in larger
workplaces.14 However, the question of whether racial
differences in reports of workplace drug testing persist both
within and across occupations remains unanswered. As such,
the objectives of our study are to determine whether race/
ethnicity is associated with differential report of being
employed in a workplace that performs drug testing in an
updated data set, and to determine whether differences persist
within and across occupations.
METHODS
We performed a pooled cross‐sectional analysis of the U.S.
National Survey on Drug use and Health (NSDUH) years
2008 through 2010.15–17 The NSDUH is an annual, self‐report
survey of the civilian, non‐institutionalized U.S. population
that has undergone multiple validations over the past 30 years,
including a recent analysis of test‐retest reliability of key
measures.18 Potentially sensitive topics, which constitute a
large proportion of the survey, are queried using a computer‐
assisted, self‐administered platform that has also been
extensively validated for accuracy. Youths are over‐sampled
and larger states contribute more respondents.17 This study
was considered exempt from full review by the VA Connecticut
Healthcare and Yale University Human Investigations
Committees.
Analytic Sample
Our analytic sample included individuals who self‐reported
past‐year, part‐ or full‐time employment; age greater than or
equal to 18; white, black, or Hispanic race/ethnicity and an
answer to the question: “Does your workplace ever test its
employees for drug use?” Each survey year had approximately
3% missing data pertaining to this question. Response rate for
the overall survey averaged 76% per year.
Independent Variables
Our independent variable of interest was race/ethnicity, for
which we included self‐reported white, black and Hispanic
respondents. Covariates in our analyses fit in the following
three categories: (1) demographic, which included age, sex,
marital status, income, education, and population density of
residence; (2) occupational, which included occupation type,
for which respondents could choose among 15 options that we
classified dichotomously as white collar versus trade/craft/
labor based on the U.S. Office of Personnel Management’s
system19; and workplace size, categorized as small (less than
25 employees), medium (25–99 employees) or large (100 or
more employees); and (3) other potential confounders that
might influence the odds of reporting workplace testing which
included past‐year arrest, alcohol abuse/dependence and other
substance abuse/dependence.
Dependent Variable
The dependent variable in all analyses was the binary
response to the question “Does your workplace ever test its
employees for drug use?”
Data Analysis
Data analysis, using SAS 9.0 Cary, NC, proceeded in
several steps. First, we evaluated frequencies of the indepen-
dent and dependent variables described above. Next, we
assessed bivariate associations using chi‐square tests and
multivariable associations using logistic regression between
each independent variable listed above and report of workplace
drug testing. Since occupation type was associated with both
race/ethnicity and report of workplace drug testing, and thus
could confound the relationship between the two, we then
performed stratified multivariable models of drug testing using
logistic regression in three different occupations, namely (1)
executive/administrative/managerial/financial, which had the
lowest proportion of non‐white respondents; (2) technicians/
related support occupations, which had the highest proportion
of non‐white respondents, and (3) transportation & material
moving, an occupation wherein federal law requires drug
testing as noted above, using logistic regression. These models
did not contain the occupation classification variable as it
would have caused co‐linearity. We used sample weights to
adjust for the complex sampling design of the survey using
SAS‐callable SUDAAN.
358 Differences in U.S. Workplace Drug Testing July–August
2014
RESULTS
There were 69,163 respondents meeting our inclusion
criteria (Table 1). This sample of working individuals was
younger, had higher income and education attainment and
lower prevalence of substance use disorders compared to the
general U.S. population (data not shown).
In the full sample, 48.2% indicated that drug testing
occurred at their workplace. On bivariate analysis comparing
demographics and workplace drug testing (Table 1), respon-
dents ages 26–34 and 35–49, men, black respondents,
individuals with incomes $20,000 and above, respondents
who graduated high school and non‐urban respondents were
more likely to report workplace drug testing. With regard to
occupational variables, respondents in non‐white collar
occupations and individuals working in medium or large
workplaces were more likely to report workplace drug testing.
Bivariate analysis revealed an increased prevalence of
TABLE 1. Sample characteristics, proportion with report of
workplace drug testing (N ¼ 69,163)
Characteristic Overall n (%)
�
Report of workplace
drug testing
n ¼ 32,421 (48.2)
No report
n ¼ 36,742 (51.8)
Chi‐square
(p‐value)
Worker demographics
Age
18–25 33,377 (15.2) 14,684 (44.4) 18,693 (55.6) 93.2 (<.0001)
26–34 11,501 (19.0) 5,867 (51.9) 5,634 (48.1)
35–49 16,886 (34.6) 8,626 (51.9) 8,260 (48.1)
�50 7,399 (31.2) 3,244 (43.8) 4,155 (56.2)
Women 34,637 (46.6) 14,679 (43.0) 19,958 (57.0) 216.4
(<.0001)
Men 34,526 (53.4) 17,742 (52.8) 16,784 (47.2)
White 49,118 (72.9) 21,952 (45.9) 27,166 (54.1) 186.3 (<.0001)
Black 8,347 (12.0) 5,159 (63.6) 3,188 (36.4)
Hispanic 11,698 (15.2) 5,310 (47.2) 6,388 (52.8)
Household income, $
<20,000 12,802 (11.2) 4,954 (39.8) 7,848 (60.2) 44.6 (<.0001)
20,000–49,999 15,847 (19.8) 7,727 (48.9) 8,120 (51.1)
50,000–74,999 21,020 (31.0) 10,478 (50.9) 10,542 (49.1)
�75,000 19,484 (38.1) 9,262 (48.2) 10,232 (51.8)
Education
�11th grade 9,032 (11.2) 3,904 (45.8) 5,128 (54.2) 68.9
(<.0001)
Graduated high school 22,057 (29.8) 11,427 (54.2) 10,630
(45.8)
College 38,074 (59.1) 17,090 (45.7) 20,984 (54.3)
Married 26,099 (55.9) 12,961 (48.7) 13,138 (51.3) 2.9 (.09)
Not married 43,064 (44.1) 19,460 (47.6) 23,604 (52.4)
Urban 29,191 (51.9) 13,273 (46.2) 15,918 (53.8) 40.2 (<.0001)
Non‐urban 39,972 (48.1) 19,148 (50.5) 20,824 (49.6)
Occupational variables
White collar 35,680 (57.5) 15,735 (44.0) 19,945 (56.0) 206.1
(<.0001)
Non‐white collar 33,411 (42.5) 16,654 (54.0) 16,757 (46.0)
Workplace size
Small (<25) 33,962 (47.3) 10,344 (30.2) 23,618 (69.8) 914.8
(<.0001)
Medium (25–99) 16,141 (22.2) 8,304 (54.5) 7,837 (45.5)
Large (100 or more) 18,881 (30.5) 13,675 (71.7) 5,206 (28.3)
Other covariates
Alcohol abuse/dependence 8,635 (9.0) 3,705 (45.6) 4,930 (54.5)
6.9 (.01)
No alcohol abuse/dependence 60,528 (91.0) 28,716 (48.5)
31,812 (51.5)
Other substance 16,338 (16.0) 6,237 (40.5) 10,101 (59.6) 136.3
(<.0001)
No other substance 52,825 (84.1) 26,184 (49.7) 26,641 (50.3)
Arrested 2,871 (2.7) 1,252 (46.6) 1,619 (53.4) .66 (.42)
Not arrested 65,740 (97.3) 30,942 (48.3) 34,798 (51.7)
�Results are reported as unweighted n and weighted
percentages using SUDAAN.
Becker et al. July–August 2014 359
reporting workplace drug testing among respondents with no
alcohol abuse/dependence and no other substance abuse/
dependence.
On multivariable analysis (Table 2), we observed among the
full sample that younger age, male sex, black race, income
greater than $20,000, completion of high school and non‐urban
residence were each associated with report of workplace drug
testing. Additionally, non‐white collar occupation, work in
medium or large workplace, and absence of other substance
abuse/dependence were associated with report of workplace
drug testing.
In our stratified models (Table 2), we observed an
independent association between black race and report of
workplace drug testing among respondents in both executive/
administrative/managerial/financial and technicians/related
support occupations; however, there was no association
TABLE 2. Adjusted odds of report of workplace drug testing,
multivariable models (N ¼ 69,163)
Characteristic
Full sample
OR (95% CI)
Stratified sub‐samples
Executive,
administrative,
managerial, financial
(n ¼ 7,043)
OR (95% CI)
Technicians and
related support
occupations
(n ¼ 4,047)
OR (95% CI)
Transportation and
material moving
workers (n ¼ 4,041)
OR (95% CI)
Worker demographics
Age
18–25 1.2 (1.1–1.3) 1.1 (.9–1.5) 1.8 (1.2–2.6) .9 (.6–1.3)
26–34 1.4 (1.3–1.5) 1.3 (1.1–1.6) 1.5 (1.00–2.1) 1.5 (.9–2.3)
35–49 1.3 (1.2–1.4) 1.2 (1.03–1.5) 1.2 (.9–1.7) 1.7 (1.1–2.5)
�50 ref ref ref ref
Women, n (%) ref ref ref ref
Men 1.5 (1.4–1.6) 1.2 (1.01–1.4) 1.7 (1.2–2.2) 1.7 (1.1–2.5)
White ref ref ref ref
Black 2.1 (1.9–2.2) 1.8 (1.2–2.6) 2.4 (1.7–3.4) 1.4 (.9–2.1)
Hispanic 1.0 (.9–1.2) .9 (.6–1.2) 1.4 (1.01–2.0) .8 (.5–1.2)
Household income, $
<20,000 ref ref ref ref
20,000–49,999 1.3 (1.2–1.5) 1.7 (1.1–2.5) .9 (.6–1.2) 1.4 (.9–
2.0)
50,000–74,999 1.5 (1.3–1.6) 1.7 (1.1–2.6) .9 (.7–1.3) 2.0 (1.4–
2.8)
�75,000 1.4 (1.2–1.5) 1.8 (1.1–2.7) .7 (.5–1.1) 1.9 (1.3–2.8)
Education
�11th grade 1.1 (.98–1.2) .9 (.7–1.3) 1.1 (.6–2.0) .9 (.6–1.5)
Graduated high school 1.5 (1.4–1.6) 1.3 (1.1–1.6) .9 (.7–1.1)
1.4 (.9–2.0)
College ref ref ref ref
Married 1.0 (.9–1.1) 1.1 (.9–1.3) 1.2 (.9–1.5) 1.2 (.9–1.7)
Not married 1.0 1.0 1.0 1.0
Urban .8 (.7–.8) .8 (.7–1.00) .8 (.6–.97) .7 (.6–.99)
Non‐urban 1.0 1.0 1.0 1.0
Occupational variables
White collar ref n/a n/a n/a
Non‐white collar 1.6 (1.5–1.7)
Workplace size
Small (<25) ref ref ref ref
Medium (25–99) 2.9 (2.8–3.1) 3.0 (2.4–3.7) 3.5 (2.7–4.7) 3.5
(2.6–4.7)
Large (100 or more) 6.5 (5.9–7.1) 5.5 (4.4–6.9) 6.5 (5.2–8.2)
7.3 (5.0–10.6)
Other covariates
Alcohol .9 (.8–1.02) .8 (.7–1.1) 1.0 (.6–1.7) .6 (.4–.8)
No alcohol 1.0 1.0 1.0 1.0
Other substance .7 (.7–.8) .8 (.7–1.1) .7 (.5–.96) .6 (.4–.8)
No other substance 1.0 1.0 1.0 1.0
Arrested 1.0 (.8–1.1) 1.8 (.9–3.7) .6 (.2–1.5) .8 (.5–1.1)
Not arrested 1.0 1.0 1.0 1.0
360 Differences in U.S. Workplace Drug Testing July–August
2014
between black race and report of workplace drug testing among
transportation and material moving workers. Additionally,
among respondents in executive/administration/managerial/
financial occupations, we found increased odds of reporting
workplace drug testing among respondents ages 26–34 and
35–49, men, individuals with incomes $20,000 and above,
respondents who graduated high school and individuals
working in medium or large workplaces. Among respondents
in technicians/related support occupations, we observed
increased odds of reporting workplace drug testing among
respondents ages 18–25, men, Hispanic respondents, non‐
urban respondents, individuals working in medium or large
workplaces and respondents with no other substance abuse/
dependence. Among respondents in transportation and
material moving occupations, we found increased odds of
reporting workplace drug testing among respondents ages 35–
49, men, individuals with incomes $50,000 and above, non‐
urban respondents, individuals working in medium or large
workplaces, respondents with no alcohol abuse/dependence
and respondents with no other substance abuse/dependence.
DISCUSSION
In this large U.S. community‐based sample of workers
representing a wide spectrum of demographics and occupa-
tions, we found that black race was associated with report of
being employed in a workplace that performs drug testing. This
association persisted after adjustment for relevant demograph-
ic, occupational, and other covariates and among stratified
analyses in occupations with the lowest and highest
proportions of black workers. Interestingly, among transporta-
tion and material moving workers, where workplace drug
testing is U.S. government‐mandated and therefore may occur
in a more uniform manner, we found no association between
black race and report of employment in a workplace that
performs drug testing. Additionally, we found an association
between Hispanic ethnicity and being employed in a workplace
that performs drug testing among technicians/related support
occupations. Consistent with a study of another large
community sample,14 workers in larger workplaces had higher
odds of being employed in a workplace that performs drug
testing, possibly due to larger workplaces’ increased adminis-
trative capacity to implement programs and larger budgets to
pay for them. An unexpected finding was the association
between the absence of alcohol and substance use disorders
and report of employment in a workplace that performs drug
testing. This may relate to one of the limitations of the study,
discussed below.
Our discussion will focus on potential explanations for these
findings, their implications and areas for future study and
potential policy interventions. Key to this discussion is an
acknowledgement of one of the limitations of the study: the
lack of specificity of the outcome variable: “Does your
workplace ever test its employees for drug use?” Some
respondents may have answered “yes,” referring to their
knowledge or perception that that drug testing took place in
their workplace, when they themselves had not undergone
testing. In light of this, we hypothesize two explanations for
racial differences in report of being employed in a workplace
that performs drug testing that are not mutually exclusive and
may interrelate. First is the structural hypothesis: blacks (and
Hispanic technicians and other support workers) dispropor-
tionately held jobs where workplace drug testing occurred.
Second is the discrimination hypothesis: employers may have
consciously or unconsciously discriminated against blacks at
the individual or group level by differentially requiring
workplace drug testing even within the same job. Interrelation
of these two hypotheses could have occurred; for example, an
employer could have enforced mandatory workplace drug
testing in an entire division of its workforce in part because of
the racial composition of that division. Empirical data on
workplace testing among communication workers unions
supports this hypothesis.20
Due to the lack of specificity of the dependent variable, we
were unable to fully test these hypotheses. However, through
the use of detailed analyses—logistic regression and stratifica-
tion among certain occupations—we observed a persistence of
the association between black race and report of being
employed in a workplace that performs drug testing,
suggesting that the structural hypothesis cannot entirely
explain these differences. Further study is needed at the
individual workplace level to understand the potential
mechanisms of structural versus discriminatory workplace
drug testing especially given the potential for significant
health‐related consequences of workplace drug testing,
including the inability to obtain employment or the loss of
employment and health insurance.
Our study has other limitations. First, data were obtained via
self‐report, which has an inherent degree of recall bias,
possibly leading to inaccuracy and misclassification of
information.21 It is possible that recall bias operated differently
for different racial/ethnic groups; for example, blacks may
have disproportionately been more likely to recall (and thus
report) workplace drug testing due to heightened awareness of
perceived or actual racial profiling and stigma. Additionally,
individuals without alcohol and substance use disorders may
have disproportionately answered that they were employed in a
workplace that performs drug testing, assuming that it was
occurring in others with alcohol and substance use disorders.
Also, individuals with alcohol or substance use disorders may
have been underrepresented in the study since they may have
been more likely to be unemployed because of results of prior
workplace drug testing. Second, as the data are cross‐sectional,
we could not infer causal relationships between variables and
thus avoided doing so. Though we adjusted for several
potential confounds of the relationship between race/ethnicity
and report of being employed in a workplace that performs
drug testing, the cross‐sectional nature of the analysis allows
for the possibility of unmeasured confounders.
Our study, the first to investigate the association between
race and report of being employed in a workplace that performs
Becker et al. July–August 2014 361
drug testing within and across occupations, revealed significant
differences in report of a practice that can have far‐reaching
implications for workers, their livelihoods and their health. The
hypotheses that we have presented on the precipitants of this
disparity deserve further study at a more detailed level in order
to guide policy‐level interventions.
Dr. Becker was supported by a Veterans Health Adminis-
tration Health Services Research & Development Career
Development Award (08‐276); Dr. Fiellin was supported by
NIDA R01‐DA020576‐01A1 and NIAAA U01‐AA020795‐01.
Disclaimer: The views expressed in this article are those of
the authors and do not necessarily reflect the position or policy
of the Department of Veterans Affairs or the United States
government.
Declaration of Interest
The authors report no conflicts of interest. The authors alone
are responsible for the content and writing of this article.
REFERENCES
1. Holden C. Doctors square off on employee drug testing.
Science.
1987;238:744–745.
2. Carpenter CS. Workplace drug testing and worker drug use.
Health Serv
Res. 2007;42:795–810.
3. Cashman CM, Ruotsalainen JH, Greiner BA, et al. Alcohol
and drug
screening of occupational drivers for preventing injury.
Cochrane
Database Syst Rev. 2009; 1–21.
4. Kraus JF. The effects of certain drug‐testing programs on
injury reduction
in the workplace: An evidence‐based review. Int J Occup
Environ Health.
2001;7:103–108.
5. Committee on Drug Use in the Workplace, National Research
Council/
Institute of Medicine. Under the Influence?: Drugs and the
American Work
Force. Washington, DC: The National Academies Press; 1994.
6. Macdonald S, Hall W, Roman P, et al. Testing for cannabis in
the work‐
place: A review of the evidence. Addiction. 2010;105:408–416.
7. Marmot M. Social determinants of health inequalities.
Lancet.
2005;365:1099–1104.
8. Puig‐Barrachina V, Malmusi D, Martenez JM, et al.
Monitoring social
determinants of health inequalities: The impact of
unemployment among
vulnerable groups. Int J Health Serv. 2011;41:459–482.
9. Braveman PA, Kumanyika S, Fielding J, et al. Health
disparities and health
equity: The issue is justice. Am J Public Health.
2011;101(Suppl 1):S149–
S155.
10. Bush DM. The U.S. Mandatory Guidelines for Federal
Workplace Drug
Testing Programs: Current status and future considerations.
Forensic Sci
Int. 2008;174:111–119.
11. Burgess DJ, van Ryn M, Crowley‐Matoka M, et al.
Understanding the
provider contribution to race/ethnicity disparities in pain
treatment:
Insights from dual process models of stereotyping. Pain Med.
2006;7:119–
134.
12. Crowley‐Matoka M, Saha S, Dobscha SK, et al. Problems of
quality and
equity in pain management: Exploring the role of biomedical
culture. Pain
Med. 2009;10:1312–1324.
13. Becker WC, Starrels JL, Heo M, et al. Racial differences in
primary care
opioid risk reduction strategies. Ann Fam Med. 2011;9:219–
225.
14. Larson SL, Eyerman J, Foster MS, et al. Worker Substance
Use and
Workplace Policies and Programs. Rockville, MD: Substance
Abuse and
Mental Health Services Administration, Office of Applied
Studies; 2007.
15. United States Department of Health and Human Services.
National survey
on drug use and health, 2009 [Computer file]. In: Substance
Abuse and
Mental Health Services Administration, ed. Ann Arbor, MI:
Inter‐
University Consortium for Political and Social Research.
16. United States Department of Health and Human Services,
Substance
Abuse and Mental Health Services Administration. National
Survey on
Drug Use and Health, 2010 [computer file]. Ann Arbor, MI:
Inter‐
University Consortium for Political and Social Research; 2010.
17. United States Department of Health and Human Services,
Substance
Abuse and Mental Health Services Administration. National
Survey on
Drug Use and Health, 2008. Ann Arbor, MI: Inter‐University
Consortium
for Political and Social Research; 2008.
18. Kennet J, Gfroerer J. Introduction. In: Kennet J, Gfroerer J,
eds. Evaluating
and Improving Methods Used in the National Survey on Drug
Use and
Health. Rockville, MD: Substance Abuse and Mental Health
Services
Administration, Office of Applied Studies; 2005.
19. U.S. Office of Personnel Management. Federal Civilian
Workforce
Statistics: Occupations of Federal White‐Collar and Blue‐Collar
Workers.
Washington, DC: U.S. Office of Personnel Management; 2000.
20. Gee GC, Curbow B, Ensminger ME, et al. Are you positive?
The
relationship of minority composition to workplace drug and
alcohol
testing. J Drug Issues. 2005;35:755–778.
21. Raphael K. Recall bias: A proposal for assessment and
control. Int J
Epidemiol. 1987;16:167–170.
362 Differences in U.S. Workplace Drug Testing July–August
2014
Copyright of American Journal on Addictions is the property of
Wiley-Blackwell and its
content may not be copied or emailed to multiple sites or posted
to a listserv without the
copyright holder's express written permission. However, users
may print, download, or email
articles for individual use.
[1]
PS 1010 – American Government
Fall 2016
Essay #2
Topic: Unlike other advanced presidential democracies, the
United States does not directly elect its chief executive. The
election of the president is a seminal debate in American
politics; in modern times, the Electoral College has come under
increased scrutiny following the 2000 election which saw
Democratic nominee Al Gore win the popular vote yet lose to
Republican nominee George W. Bush. More recently, the
Electoral College has been challenged by the emergence of the
National Popular Vote (NPV) compact, which would require
signatory states to award their electoral votes to the winner
of the national popular vote regardless if that candidate won the
popular vote within the state. (For example: Texas would
have awarded its electoral votes in 2012 to Obama under NPV
despite Obama losing the popular vote in Texas.) While
critics argue the Electoral College is inherently anti-democratic,
supporters are much more likely to argue that the
Electoral College provides a necessary check on the masses
(e.g. preventing a demagogue from being elected), while also
challenging the notion that the presidential election is meant to
be popular (i.e. directly elected by voters).
Directions: For this essay, you will compose a “position paper”
on ONE (1) of the following topics:
1. Defend the Electoral College; provide an argument justifying
why the Electoral College is a necessary inclusion
in the U.S. political system.
2. Revise the Electoral College; identify how you would
“improve” the Electoral College to make it more
democratic, etc.
3. Abolish/Replace the Electoral College; explain why and how
you would replace the Electoral College with a
“better” method.
Format: Your essay should take the form of a one-page (single-
spaced) position paper. You will need to start with an
introduction which includes your thesis statement. Good thesis
statements clearly state to your reader the purpose of your
essay. For example: if you believe the Electoral College is
inherently anti-democratic, your thesis may be: “The Electoral
College denies the people their basic, democratic right to
choose who governs them; therefore, it should be abolished.”
Generally, your thesis statement will be the final sentence in
your introduction.
Next, you will offer your rationale/proposal. It is expected that
this section will be several paragraphs, where you rely
extensively on outside sources and course concepts in justifying
your position. This is the body of your position paper.
While there is no definitive way to craft this section, you should
make sure that your argument proceeds in a logical
fashion. For instance: if you wish to keep the Electoral College,
you may elect to arrange your body section as three
paragraphs, each with a “reason” for keeping it.
Finally, you should include a conclusion which provides a
summation of your position. This may, unlike a formal essay,
be relatively brief (3-4 sentences) rather than a substantive
restitution.
Your position paper should be:
1. Single-spaced;
2. 1-page MAXIMUM;
3. Time News Roman, 11-point or 12-point font;
4. Normal, 1-inch margins;
5. Cited correctly; and
6. Name placed at the beginning of the paper (preferably in the
header).
Citations: Throughout your essay, it is expected that you will
refer extensively to outside sources and/or course concepts
discussed in lectures and readings. Given the space constraints,
moreover, you should NOT rely on direct quotes;
rather, you should paraphrase and synthesize information from
your sources. Remember: citation is an important
formatting technique which allows you to correctly attribute
information/ideas/concepts which are not your own without
plagiarizing. Whenever you use an idea which is not yours, you
should cite where that idea came from.
While there are several ways to cite an author, for this
assignment you can use either APA or APSA citation styles.
Besides in-text citation, you should also include a list of
references of every source you use in your essay at the end (this
[2]
page does NOT count against your page limit). Again, each
style can provide guidance as to how you construct a works
cited/references page. If you are unfamiliar with any of these
styles, you can consult the following sources:
**Purdue Online Writing Lab (OWL): The Purdue Online
Writing Lab (OWL for short) is a fantastic resource for
paper writing. It contains graphical links and explanations for
APA, Chicago, and MLA citation styles, while also
including general guidance on how to write good papers
(including grammar help). (Links are also posted on Blackboard
under “Essays.”)
**American Political Science Association (APSA) Manual of
Style: If you wish to use the standard style used by
political scientists, you can find an electronic copy of APSA’s
citation guide here. (A link is also posted on Blackboard.)
**WSU Writing Center: The Writing Center also offers
assistance in composing and formatting essays, much like OWL
above but with the added benefit of having a “live” person
assisting you. The Writing Center is located in the
Undergraduate Library, Room 2310. Visit their website to
schedule an appointment, or call 313-577-2544 (a link is also
posted on Blackboard). Regardless of your writing proficiency,
the Writing Center is an invaluable resource which can
take your writing to the next level!
**See Me: I am available to help with any component of this
essay, especially proper citation style. Either visit during my
office hours, email me, or otherwise schedule an appointment.
Note: I cannot help with questions or drafts submitted
within twenty-four hours of the deadline.
Grading: Your essay will be submitted on Blackboard via the
SafeAssign feature, which will check against plagiarism.
As I know that learning to cite requires practice, I will construe
failure to cite liberally and use it as a learning opportunity.
However, this does not mean I will overlook clear instances of
cheating (e.g. copying another’s work or “forgetting” to
include an outside source in your works cited page). In grading
your essay, I will use the following guidelines (50 points
possible):
A: Provides a clear thesis statement, identifying the author’s
position regarding the Electoral College. Body
section is detailed, logical, and creative. Evidence marshalled is
cited correctly and used appropriately; the author
does not use direct quotes but instead relies on synthesis and
paraphrasing. Finally, the paper itself is written as
grammatically pleasing, and in clear, concise language.
B: Has similar features as an “A” paper above, but may be
somewhat less clear, substantively, in spots. Rationale
is logical, but there may be areas that further evidence is
needed. Author may fail to adequately synthesize
materials and relies on one or two direct quotes. Grammatically,
there may be some errors present, but they are
minor, while the paper itself is written clearly.
C: Compared to “A” and “B” papers, “C” papers contain
numerous substantive errors; do not have a clear thesis;
nor provide sufficient, factual evidence. The writing may be
unclear and contain errors which detract from the
narrative, making the paper difficult to read.
D: In addition to some of the weaknesses of a “C” paper, the
essay is marred by significant inaccuracies and/or is
missing required elements.
F: Plagiarized in part or whole. Too short. Off-topic.
Unreadable. Not turned in.
SafeAssign: Submit your completed essay on Blackboard.
Navigate to the “Essays” tab, click on “Essay #2,” and then
click on the SafeAssign link within the folder (i.e. the link
which has the directions attached). You can upload your
document thereafter. NOTE: Make sure your document is saved
as a Word Document (.doc or .docx); failure to upload a
Word document will result in delayed grading. If you encounter
difficulties with uploading your file, please email me as
soon as possible so that I can rectify the situation.
***THIS ESSAY IS DUE AT 12:50 P.M. ON OCTOBER 19,
2016 ON BLACKBOARD***
https://owl.english.purdue.edu/owl/resource/560/01/
https://owl.english.purdue.edu/owl/resource/717/01/
https://owl.english.purdue.edu/owl/resource/747/01/
http://www.apsanet.org/Portals/54/APSA%20Files/publications/
APSAStyleManual2006.pdf
clas.wayne.edu/WRITING/

More Related Content

DOCX
DEBRA R. COMER CrossroadsA Case Against Workplace Drug Tes
PPT
Patient Recruitment in Clinical Trials
PDF
A Model For Pharmacological Research Treatment Of Cocaine Dependence
PDF
Racism as Experienced by Physicians of Color in the Health Care Setting
PDF
American Journal of Emergency & Critical Care Medicine
DOCX
BioMed CentralPage 1 of 9(page number not for citation p
PDF
PCOMS: A Viable Quality Improvement Strategy for Public Behavioral Health
PDF
Stratification of clinical survey data
DEBRA R. COMER CrossroadsA Case Against Workplace Drug Tes
Patient Recruitment in Clinical Trials
A Model For Pharmacological Research Treatment Of Cocaine Dependence
Racism as Experienced by Physicians of Color in the Health Care Setting
American Journal of Emergency & Critical Care Medicine
BioMed CentralPage 1 of 9(page number not for citation p
PCOMS: A Viable Quality Improvement Strategy for Public Behavioral Health
Stratification of clinical survey data

Similar to RacialEthnic Differences in Report of Drug TestingPractices.docx (20)

PPT
Gender Difference in Response to Preventative Health Care
PDF
6e683e2f35c71f7f897b420db582aaf9a866.pdf
PDF
Influence of medicare formulary restrictions on evidence based prescribing pr...
PDF
Physician Dispensing - BRP Pharmaceuticals
PDF
Nicotine Tob Res-2016-Chidiac-ntr_ntw250
DOCX
FitnessSubstance AbuseDo Alcohol Consumers Exercise More.docx
PDF
The economic burden of prescription opioid overdose... 2013.
PDF
High Dose Initiation
DOCX
Measuring Drug and Alcohol Use AmongCollege Student-Athletes
PPTX
Week 3 educational product puckett
PDF
Sept2016-TRI-Current Employment and SUD
PDF
An Internet questionnaire to identify Drug seeking behavior in a patient in t...
PDF
Pain Validity Test identifies drug seeking behavior. Stop opioid abuse. Prote...
PDF
Pain Validity Test to detect drug seeking behavior
PDF
COT and Adverse Risk Selection
PDF
scopus database journal
PDF
journal research paper
PDF
ugc carelist journals
PDF
journals to publish paper
PDF
published research
Gender Difference in Response to Preventative Health Care
6e683e2f35c71f7f897b420db582aaf9a866.pdf
Influence of medicare formulary restrictions on evidence based prescribing pr...
Physician Dispensing - BRP Pharmaceuticals
Nicotine Tob Res-2016-Chidiac-ntr_ntw250
FitnessSubstance AbuseDo Alcohol Consumers Exercise More.docx
The economic burden of prescription opioid overdose... 2013.
High Dose Initiation
Measuring Drug and Alcohol Use AmongCollege Student-Athletes
Week 3 educational product puckett
Sept2016-TRI-Current Employment and SUD
An Internet questionnaire to identify Drug seeking behavior in a patient in t...
Pain Validity Test identifies drug seeking behavior. Stop opioid abuse. Prote...
Pain Validity Test to detect drug seeking behavior
COT and Adverse Risk Selection
scopus database journal
journal research paper
ugc carelist journals
journals to publish paper
published research

More from makdul (20)

DOCX
According to Davenport (2014) social media and health care are c.docx
DOCX
According to (Fatehi, Gordon & Florida, N.D.) theoretical orient.docx
DOCX
According to Libertarianism, there is no right to any social service.docx
DOCX
According to Kirk (2016), most of your time will be spent working wi.docx
DOCX
According to cultural deviance theorists like Cohen, deviant sub.docx
DOCX
According to Gray et al, (2017) critical appraisal is the proce.docx
DOCX
According to article Insecure Policing Under Racial Capitalism by.docx
DOCX
Abstract In this experiment, examining the equivalence poi.docx
DOCX
ACC 403- ASSIGNMENT 2 RUBRIC!!!Points 280Assignment 2 Audi.docx
DOCX
ACC 601 Managerial Accounting Group Case 3 (160 points) .docx
DOCX
Academic Integrity A Letter to My Students[1] Bill T.docx
DOCX
Access the Center for Disease Control and Prevention’s (CDC’s) Nu.docx
DOCX
According to DSM 5 This patient had very many symptoms that sugg.docx
DOCX
Acceptable concerts include professional orchestras, soloists, jazz,.docx
DOCX
ACA was passed in 2010, under the presidency of Barack Obama. Pr.docx
DOCX
Access the FASB website. Once you login, click the FASB Accounting S.docx
DOCX
Academic Paper  Overview  This performance task was intended to asse.docx
DOCX
Academic Research Team Project PaperCOVID-19 Open Research Datas.docx
DOCX
AbstractVoice over Internet Protocol (VoIP) is an advanced t.docx
DOCX
Abstract                                 Structure of Abstra.docx
According to Davenport (2014) social media and health care are c.docx
According to (Fatehi, Gordon & Florida, N.D.) theoretical orient.docx
According to Libertarianism, there is no right to any social service.docx
According to Kirk (2016), most of your time will be spent working wi.docx
According to cultural deviance theorists like Cohen, deviant sub.docx
According to Gray et al, (2017) critical appraisal is the proce.docx
According to article Insecure Policing Under Racial Capitalism by.docx
Abstract In this experiment, examining the equivalence poi.docx
ACC 403- ASSIGNMENT 2 RUBRIC!!!Points 280Assignment 2 Audi.docx
ACC 601 Managerial Accounting Group Case 3 (160 points) .docx
Academic Integrity A Letter to My Students[1] Bill T.docx
Access the Center for Disease Control and Prevention’s (CDC’s) Nu.docx
According to DSM 5 This patient had very many symptoms that sugg.docx
Acceptable concerts include professional orchestras, soloists, jazz,.docx
ACA was passed in 2010, under the presidency of Barack Obama. Pr.docx
Access the FASB website. Once you login, click the FASB Accounting S.docx
Academic Paper  Overview  This performance task was intended to asse.docx
Academic Research Team Project PaperCOVID-19 Open Research Datas.docx
AbstractVoice over Internet Protocol (VoIP) is an advanced t.docx
Abstract                                 Structure of Abstra.docx

Recently uploaded (20)

PPTX
Renaissance Architecture: A Journey from Faith to Humanism
PPTX
Introduction_to_Human_Anatomy_and_Physiology_for_B.Pharm.pptx
PDF
Pre independence Education in Inndia.pdf
PDF
01-Introduction-to-Information-Management.pdf
PPTX
1st Inaugural Professorial Lecture held on 19th February 2020 (Governance and...
PDF
2.FourierTransform-ShortQuestionswithAnswers.pdf
PPTX
Pharma ospi slides which help in ospi learning
PPTX
PPT- ENG7_QUARTER1_LESSON1_WEEK1. IMAGERY -DESCRIPTIONS pptx.pptx
PDF
TR - Agricultural Crops Production NC III.pdf
PDF
Supply Chain Operations Speaking Notes -ICLT Program
PPTX
Institutional Correction lecture only . . .
PDF
Sports Quiz easy sports quiz sports quiz
PDF
Anesthesia in Laparoscopic Surgery in India
PPTX
Microbial diseases, their pathogenesis and prophylaxis
PPTX
master seminar digital applications in india
PDF
Abdominal Access Techniques with Prof. Dr. R K Mishra
PPTX
Final Presentation General Medicine 03-08-2024.pptx
PPTX
human mycosis Human fungal infections are called human mycosis..pptx
PDF
O7-L3 Supply Chain Operations - ICLT Program
PPTX
GDM (1) (1).pptx small presentation for students
Renaissance Architecture: A Journey from Faith to Humanism
Introduction_to_Human_Anatomy_and_Physiology_for_B.Pharm.pptx
Pre independence Education in Inndia.pdf
01-Introduction-to-Information-Management.pdf
1st Inaugural Professorial Lecture held on 19th February 2020 (Governance and...
2.FourierTransform-ShortQuestionswithAnswers.pdf
Pharma ospi slides which help in ospi learning
PPT- ENG7_QUARTER1_LESSON1_WEEK1. IMAGERY -DESCRIPTIONS pptx.pptx
TR - Agricultural Crops Production NC III.pdf
Supply Chain Operations Speaking Notes -ICLT Program
Institutional Correction lecture only . . .
Sports Quiz easy sports quiz sports quiz
Anesthesia in Laparoscopic Surgery in India
Microbial diseases, their pathogenesis and prophylaxis
master seminar digital applications in india
Abdominal Access Techniques with Prof. Dr. R K Mishra
Final Presentation General Medicine 03-08-2024.pptx
human mycosis Human fungal infections are called human mycosis..pptx
O7-L3 Supply Chain Operations - ICLT Program
GDM (1) (1).pptx small presentation for students

RacialEthnic Differences in Report of Drug TestingPractices.docx

  • 1. Racial/Ethnic Differences in Report of Drug Testing Practices at the Workplace Level in the U.S. William C. Becker, MD,1,2 Salimah Meghani, PhD,3 Jeanette M. Tetrault, MD,2 David A. Fiellin, MD2 1VA Connecticut Healthcare System, West Haven, Connecticut 2Yale University School of Medicine, New Haven, Connecticut 3University of Pennsylvania, Philadelphia, Pennsylvania Background and Objectives: It is unknown whether racial/ethnic differences in report of workplace drug testing persist when analyzed within and across various occupations. We sought to examine the association between worker demographics, workplace characteristics, and report of employment in a workplace that performs drug testing. Methods: We performed a cross‐sectional study of the 2008– 2010 National Survey on Drug Use and Health examining the relationship between race/ethnicity and report of workplace drug testing among employed, white, black, or Hispanic respondents �18 years old. In logistic regression analysis, we adjusted for demographic, occupa- tional, and other relevant variables and performed stratified analyses
  • 2. among three specific occupations. Results: Among 69,163 respondents, 48.2% reported employment in a workplace that performs drug testing. On multivariable analysis, younger age, male sex, black race, income greater than $20,000, completion of high school and non‐urban residence were associated with report of drug testing at one’s workplace among the full sample as were non‐white collar occupation, work in medium or large workplace, and absence of other substance abuse/dependence. In stratified analyses, black race was associated with report of workplace level drug testing among executive/administrative/managerial/financial workers and tech- nicians/related support occupations; Hispanic ethnicity was associated with the outcome among technicians/related support occupations. Conclusions: Racial/ethnic differences in report of workplace drug testing exist within and across various occupations. These differences have important public health implications deserving further study. Scientific Significance: Increased report of drug testing where racial/ ethnic minorities work highlights the potential bias that can be introduced when drug testing policies are not implemented in a universal fashion. (Am J Addict 2014;23:357–362) INTRODUCTION After and in spite of early controversy about the ethics of U.S.
  • 3. workplace drug testing,1 its prevalence has been increasing since the 1980s and is now commonly conducted in both prospective and current employees. A study from 2007 reported that 46% of workers and 90% of Fortune 200 companies report some form of drug testing.2 As employee drug use has been associated with accidents at work and elsewhere, absenteeism, lower productiv- ity, and decreased profits, many employers see drug testing as a cost‐saving measure.3,4 Additionally, some data demonstrate a deterrent effect of testing on worker drug use.5 Typical workplace drug testing uses urine samples, but blood and hair testing are also occasionally used. Urine tests usually include the so‐called “Federal 5” substances: marijuana, opiates, cocaine, PCP, and amphetamines but may be expanded to include other substances such as methadone, benzodiazepines, barbiturates, and oxycodone. In terms of potential benefits and risks, much is at stake for prospective and current workers who undergo workplace drug testing. On the benefit side, a positive drug test could lead to a worker receiving treatment for a previously unrecognized substance use disorder through enrollment in an employee assistance or other available program. From a public health standpoint, workplaces may be made safer for both employees and the public if individuals with drug use are either not hired in the first place or suspended for ongoing drug use. On the other hand, employers may not hire applicants with positive tests that may have resulted from sporadic, low‐level use.6 Furthermore, workers with evidence of substance use may lose their jobs and health insurance for themselves and their families, with or without an opportunity for treatment. As employment and health insurance status are two of the most significant social determinants of health,7,8 it follows that workplace drug testing can have profound and long‐term
  • 4. effects on individuals’ health. Since the results obtained from workplace drug testing may have major health‐related consequences for employees, an Received December 11, 2012; revised June 4, 2013; accepted August 10, 2013. Presented as an oral presentation at the Society of General Internal Medicine 33rd Annual Meeting, Minneapolis, MN, April 2010. Address correspondence to William C. Becker, MD, 950 Campbell Avenue, West Haven VAMC, Mail Stop 151B, West Haven, CT 06516. E‐mail: [email protected] The American Journal on Addictions, 23: 357–362, 2014 Copyright © American Academy of Addiction Psychiatry ISSN: 1055-0496 print / 1521-0391 online DOI: 10.1111/j.1521-0391.2014.12109.x 357 equitable system of implementation is critical to avoid burdening vulnerable populations with a disproportionate share of risk.9 Universal testing, exemplified by the U.S.’ Omnibus Transportation Employee Testing Act of 1991 requiring all transportation industry employees in “safety‐ sensitive” positions to have drug testing, is one strategy to promote equity. However, beyond these laws pertaining to a small subset of occupations, testing policies in the U.S. are subject to wide variation in state laws/regulations concerning when, where and how employers can implement workplace drug testing programs. Generally, employers must have a written policy requiring new hires to be drug‐free; written
  • 5. notice must be given before the applicant may be tested. The same testing program must be implemented for all applicants in a particular category though a company may require testing for pre‐specified positions only, provided this is stated and justified in the written policy.10 Regarding healthcare settings (as opposed to workplaces), studies have hypothesized that the absence of universal drug testing policies across or within practices promotes differential implementation by race, since, in the absence of protocols, prejudice and bias may influence decision‐making.11,12 Indeed, in clinical encounters, differential implementation in drug testing has been reported: non‐white individuals have been shown to be more likely to get tested.13 Similarly, the question of equity or fairness within U.S. workplace drug testing programs is of particular significance given the potential health‐related consequences noted above. Previous research using 2002–2004 data demonstrated increased reports of workplace drug testing by black workers, by individuals employed in certain occupations, such as transportation and material moving workers, and by individuals working in larger workplaces.14 However, the question of whether racial differences in reports of workplace drug testing persist both within and across occupations remains unanswered. As such, the objectives of our study are to determine whether race/ ethnicity is associated with differential report of being employed in a workplace that performs drug testing in an updated data set, and to determine whether differences persist within and across occupations. METHODS We performed a pooled cross‐sectional analysis of the U.S. National Survey on Drug use and Health (NSDUH) years 2008 through 2010.15–17 The NSDUH is an annual, self‐report survey of the civilian, non‐institutionalized U.S. population
  • 6. that has undergone multiple validations over the past 30 years, including a recent analysis of test‐retest reliability of key measures.18 Potentially sensitive topics, which constitute a large proportion of the survey, are queried using a computer‐ assisted, self‐administered platform that has also been extensively validated for accuracy. Youths are over‐sampled and larger states contribute more respondents.17 This study was considered exempt from full review by the VA Connecticut Healthcare and Yale University Human Investigations Committees. Analytic Sample Our analytic sample included individuals who self‐reported past‐year, part‐ or full‐time employment; age greater than or equal to 18; white, black, or Hispanic race/ethnicity and an answer to the question: “Does your workplace ever test its employees for drug use?” Each survey year had approximately 3% missing data pertaining to this question. Response rate for the overall survey averaged 76% per year. Independent Variables Our independent variable of interest was race/ethnicity, for which we included self‐reported white, black and Hispanic respondents. Covariates in our analyses fit in the following three categories: (1) demographic, which included age, sex, marital status, income, education, and population density of residence; (2) occupational, which included occupation type, for which respondents could choose among 15 options that we classified dichotomously as white collar versus trade/craft/ labor based on the U.S. Office of Personnel Management’s system19; and workplace size, categorized as small (less than 25 employees), medium (25–99 employees) or large (100 or more employees); and (3) other potential confounders that
  • 7. might influence the odds of reporting workplace testing which included past‐year arrest, alcohol abuse/dependence and other substance abuse/dependence. Dependent Variable The dependent variable in all analyses was the binary response to the question “Does your workplace ever test its employees for drug use?” Data Analysis Data analysis, using SAS 9.0 Cary, NC, proceeded in several steps. First, we evaluated frequencies of the indepen- dent and dependent variables described above. Next, we assessed bivariate associations using chi‐square tests and multivariable associations using logistic regression between each independent variable listed above and report of workplace drug testing. Since occupation type was associated with both race/ethnicity and report of workplace drug testing, and thus could confound the relationship between the two, we then performed stratified multivariable models of drug testing using logistic regression in three different occupations, namely (1) executive/administrative/managerial/financial, which had the lowest proportion of non‐white respondents; (2) technicians/ related support occupations, which had the highest proportion of non‐white respondents, and (3) transportation & material moving, an occupation wherein federal law requires drug testing as noted above, using logistic regression. These models did not contain the occupation classification variable as it would have caused co‐linearity. We used sample weights to adjust for the complex sampling design of the survey using SAS‐callable SUDAAN. 358 Differences in U.S. Workplace Drug Testing July–August 2014
  • 8. RESULTS There were 69,163 respondents meeting our inclusion criteria (Table 1). This sample of working individuals was younger, had higher income and education attainment and lower prevalence of substance use disorders compared to the general U.S. population (data not shown). In the full sample, 48.2% indicated that drug testing occurred at their workplace. On bivariate analysis comparing demographics and workplace drug testing (Table 1), respon- dents ages 26–34 and 35–49, men, black respondents, individuals with incomes $20,000 and above, respondents who graduated high school and non‐urban respondents were more likely to report workplace drug testing. With regard to occupational variables, respondents in non‐white collar occupations and individuals working in medium or large workplaces were more likely to report workplace drug testing. Bivariate analysis revealed an increased prevalence of TABLE 1. Sample characteristics, proportion with report of workplace drug testing (N ¼ 69,163) Characteristic Overall n (%) � Report of workplace drug testing n ¼ 32,421 (48.2) No report
  • 9. n ¼ 36,742 (51.8) Chi‐square (p‐value) Worker demographics Age 18–25 33,377 (15.2) 14,684 (44.4) 18,693 (55.6) 93.2 (<.0001) 26–34 11,501 (19.0) 5,867 (51.9) 5,634 (48.1) 35–49 16,886 (34.6) 8,626 (51.9) 8,260 (48.1) �50 7,399 (31.2) 3,244 (43.8) 4,155 (56.2) Women 34,637 (46.6) 14,679 (43.0) 19,958 (57.0) 216.4 (<.0001) Men 34,526 (53.4) 17,742 (52.8) 16,784 (47.2) White 49,118 (72.9) 21,952 (45.9) 27,166 (54.1) 186.3 (<.0001) Black 8,347 (12.0) 5,159 (63.6) 3,188 (36.4) Hispanic 11,698 (15.2) 5,310 (47.2) 6,388 (52.8) Household income, $ <20,000 12,802 (11.2) 4,954 (39.8) 7,848 (60.2) 44.6 (<.0001) 20,000–49,999 15,847 (19.8) 7,727 (48.9) 8,120 (51.1) 50,000–74,999 21,020 (31.0) 10,478 (50.9) 10,542 (49.1) �75,000 19,484 (38.1) 9,262 (48.2) 10,232 (51.8) Education �11th grade 9,032 (11.2) 3,904 (45.8) 5,128 (54.2) 68.9 (<.0001) Graduated high school 22,057 (29.8) 11,427 (54.2) 10,630 (45.8) College 38,074 (59.1) 17,090 (45.7) 20,984 (54.3) Married 26,099 (55.9) 12,961 (48.7) 13,138 (51.3) 2.9 (.09) Not married 43,064 (44.1) 19,460 (47.6) 23,604 (52.4) Urban 29,191 (51.9) 13,273 (46.2) 15,918 (53.8) 40.2 (<.0001) Non‐urban 39,972 (48.1) 19,148 (50.5) 20,824 (49.6)
  • 10. Occupational variables White collar 35,680 (57.5) 15,735 (44.0) 19,945 (56.0) 206.1 (<.0001) Non‐white collar 33,411 (42.5) 16,654 (54.0) 16,757 (46.0) Workplace size Small (<25) 33,962 (47.3) 10,344 (30.2) 23,618 (69.8) 914.8 (<.0001) Medium (25–99) 16,141 (22.2) 8,304 (54.5) 7,837 (45.5) Large (100 or more) 18,881 (30.5) 13,675 (71.7) 5,206 (28.3) Other covariates Alcohol abuse/dependence 8,635 (9.0) 3,705 (45.6) 4,930 (54.5) 6.9 (.01) No alcohol abuse/dependence 60,528 (91.0) 28,716 (48.5) 31,812 (51.5) Other substance 16,338 (16.0) 6,237 (40.5) 10,101 (59.6) 136.3 (<.0001) No other substance 52,825 (84.1) 26,184 (49.7) 26,641 (50.3) Arrested 2,871 (2.7) 1,252 (46.6) 1,619 (53.4) .66 (.42) Not arrested 65,740 (97.3) 30,942 (48.3) 34,798 (51.7) �Results are reported as unweighted n and weighted percentages using SUDAAN. Becker et al. July–August 2014 359 reporting workplace drug testing among respondents with no alcohol abuse/dependence and no other substance abuse/ dependence. On multivariable analysis (Table 2), we observed among the full sample that younger age, male sex, black race, income
  • 11. greater than $20,000, completion of high school and non‐urban residence were each associated with report of workplace drug testing. Additionally, non‐white collar occupation, work in medium or large workplace, and absence of other substance abuse/dependence were associated with report of workplace drug testing. In our stratified models (Table 2), we observed an independent association between black race and report of workplace drug testing among respondents in both executive/ administrative/managerial/financial and technicians/related support occupations; however, there was no association TABLE 2. Adjusted odds of report of workplace drug testing, multivariable models (N ¼ 69,163) Characteristic Full sample OR (95% CI) Stratified sub‐samples Executive, administrative, managerial, financial (n ¼ 7,043) OR (95% CI) Technicians and related support occupations (n ¼ 4,047)
  • 12. OR (95% CI) Transportation and material moving workers (n ¼ 4,041) OR (95% CI) Worker demographics Age 18–25 1.2 (1.1–1.3) 1.1 (.9–1.5) 1.8 (1.2–2.6) .9 (.6–1.3) 26–34 1.4 (1.3–1.5) 1.3 (1.1–1.6) 1.5 (1.00–2.1) 1.5 (.9–2.3) 35–49 1.3 (1.2–1.4) 1.2 (1.03–1.5) 1.2 (.9–1.7) 1.7 (1.1–2.5) �50 ref ref ref ref Women, n (%) ref ref ref ref Men 1.5 (1.4–1.6) 1.2 (1.01–1.4) 1.7 (1.2–2.2) 1.7 (1.1–2.5) White ref ref ref ref Black 2.1 (1.9–2.2) 1.8 (1.2–2.6) 2.4 (1.7–3.4) 1.4 (.9–2.1) Hispanic 1.0 (.9–1.2) .9 (.6–1.2) 1.4 (1.01–2.0) .8 (.5–1.2) Household income, $ <20,000 ref ref ref ref 20,000–49,999 1.3 (1.2–1.5) 1.7 (1.1–2.5) .9 (.6–1.2) 1.4 (.9– 2.0) 50,000–74,999 1.5 (1.3–1.6) 1.7 (1.1–2.6) .9 (.7–1.3) 2.0 (1.4– 2.8) �75,000 1.4 (1.2–1.5) 1.8 (1.1–2.7) .7 (.5–1.1) 1.9 (1.3–2.8) Education �11th grade 1.1 (.98–1.2) .9 (.7–1.3) 1.1 (.6–2.0) .9 (.6–1.5) Graduated high school 1.5 (1.4–1.6) 1.3 (1.1–1.6) .9 (.7–1.1) 1.4 (.9–2.0) College ref ref ref ref
  • 13. Married 1.0 (.9–1.1) 1.1 (.9–1.3) 1.2 (.9–1.5) 1.2 (.9–1.7) Not married 1.0 1.0 1.0 1.0 Urban .8 (.7–.8) .8 (.7–1.00) .8 (.6–.97) .7 (.6–.99) Non‐urban 1.0 1.0 1.0 1.0 Occupational variables White collar ref n/a n/a n/a Non‐white collar 1.6 (1.5–1.7) Workplace size Small (<25) ref ref ref ref Medium (25–99) 2.9 (2.8–3.1) 3.0 (2.4–3.7) 3.5 (2.7–4.7) 3.5 (2.6–4.7) Large (100 or more) 6.5 (5.9–7.1) 5.5 (4.4–6.9) 6.5 (5.2–8.2) 7.3 (5.0–10.6) Other covariates Alcohol .9 (.8–1.02) .8 (.7–1.1) 1.0 (.6–1.7) .6 (.4–.8) No alcohol 1.0 1.0 1.0 1.0 Other substance .7 (.7–.8) .8 (.7–1.1) .7 (.5–.96) .6 (.4–.8) No other substance 1.0 1.0 1.0 1.0 Arrested 1.0 (.8–1.1) 1.8 (.9–3.7) .6 (.2–1.5) .8 (.5–1.1) Not arrested 1.0 1.0 1.0 1.0 360 Differences in U.S. Workplace Drug Testing July–August 2014 between black race and report of workplace drug testing among transportation and material moving workers. Additionally, among respondents in executive/administration/managerial/ financial occupations, we found increased odds of reporting workplace drug testing among respondents ages 26–34 and 35–49, men, individuals with incomes $20,000 and above, respondents who graduated high school and individuals
  • 14. working in medium or large workplaces. Among respondents in technicians/related support occupations, we observed increased odds of reporting workplace drug testing among respondents ages 18–25, men, Hispanic respondents, non‐ urban respondents, individuals working in medium or large workplaces and respondents with no other substance abuse/ dependence. Among respondents in transportation and material moving occupations, we found increased odds of reporting workplace drug testing among respondents ages 35– 49, men, individuals with incomes $50,000 and above, non‐ urban respondents, individuals working in medium or large workplaces, respondents with no alcohol abuse/dependence and respondents with no other substance abuse/dependence. DISCUSSION In this large U.S. community‐based sample of workers representing a wide spectrum of demographics and occupa- tions, we found that black race was associated with report of being employed in a workplace that performs drug testing. This association persisted after adjustment for relevant demograph- ic, occupational, and other covariates and among stratified analyses in occupations with the lowest and highest proportions of black workers. Interestingly, among transporta- tion and material moving workers, where workplace drug testing is U.S. government‐mandated and therefore may occur in a more uniform manner, we found no association between black race and report of employment in a workplace that performs drug testing. Additionally, we found an association between Hispanic ethnicity and being employed in a workplace that performs drug testing among technicians/related support occupations. Consistent with a study of another large community sample,14 workers in larger workplaces had higher odds of being employed in a workplace that performs drug testing, possibly due to larger workplaces’ increased adminis- trative capacity to implement programs and larger budgets to
  • 15. pay for them. An unexpected finding was the association between the absence of alcohol and substance use disorders and report of employment in a workplace that performs drug testing. This may relate to one of the limitations of the study, discussed below. Our discussion will focus on potential explanations for these findings, their implications and areas for future study and potential policy interventions. Key to this discussion is an acknowledgement of one of the limitations of the study: the lack of specificity of the outcome variable: “Does your workplace ever test its employees for drug use?” Some respondents may have answered “yes,” referring to their knowledge or perception that that drug testing took place in their workplace, when they themselves had not undergone testing. In light of this, we hypothesize two explanations for racial differences in report of being employed in a workplace that performs drug testing that are not mutually exclusive and may interrelate. First is the structural hypothesis: blacks (and Hispanic technicians and other support workers) dispropor- tionately held jobs where workplace drug testing occurred. Second is the discrimination hypothesis: employers may have consciously or unconsciously discriminated against blacks at the individual or group level by differentially requiring workplace drug testing even within the same job. Interrelation of these two hypotheses could have occurred; for example, an employer could have enforced mandatory workplace drug testing in an entire division of its workforce in part because of the racial composition of that division. Empirical data on workplace testing among communication workers unions supports this hypothesis.20 Due to the lack of specificity of the dependent variable, we were unable to fully test these hypotheses. However, through the use of detailed analyses—logistic regression and stratifica-
  • 16. tion among certain occupations—we observed a persistence of the association between black race and report of being employed in a workplace that performs drug testing, suggesting that the structural hypothesis cannot entirely explain these differences. Further study is needed at the individual workplace level to understand the potential mechanisms of structural versus discriminatory workplace drug testing especially given the potential for significant health‐related consequences of workplace drug testing, including the inability to obtain employment or the loss of employment and health insurance. Our study has other limitations. First, data were obtained via self‐report, which has an inherent degree of recall bias, possibly leading to inaccuracy and misclassification of information.21 It is possible that recall bias operated differently for different racial/ethnic groups; for example, blacks may have disproportionately been more likely to recall (and thus report) workplace drug testing due to heightened awareness of perceived or actual racial profiling and stigma. Additionally, individuals without alcohol and substance use disorders may have disproportionately answered that they were employed in a workplace that performs drug testing, assuming that it was occurring in others with alcohol and substance use disorders. Also, individuals with alcohol or substance use disorders may have been underrepresented in the study since they may have been more likely to be unemployed because of results of prior workplace drug testing. Second, as the data are cross‐sectional, we could not infer causal relationships between variables and thus avoided doing so. Though we adjusted for several potential confounds of the relationship between race/ethnicity and report of being employed in a workplace that performs drug testing, the cross‐sectional nature of the analysis allows for the possibility of unmeasured confounders. Our study, the first to investigate the association between
  • 17. race and report of being employed in a workplace that performs Becker et al. July–August 2014 361 drug testing within and across occupations, revealed significant differences in report of a practice that can have far‐reaching implications for workers, their livelihoods and their health. The hypotheses that we have presented on the precipitants of this disparity deserve further study at a more detailed level in order to guide policy‐level interventions. Dr. Becker was supported by a Veterans Health Adminis- tration Health Services Research & Development Career Development Award (08‐276); Dr. Fiellin was supported by NIDA R01‐DA020576‐01A1 and NIAAA U01‐AA020795‐01. Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. Declaration of Interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article. REFERENCES 1. Holden C. Doctors square off on employee drug testing. Science. 1987;238:744–745. 2. Carpenter CS. Workplace drug testing and worker drug use. Health Serv
  • 18. Res. 2007;42:795–810. 3. Cashman CM, Ruotsalainen JH, Greiner BA, et al. Alcohol and drug screening of occupational drivers for preventing injury. Cochrane Database Syst Rev. 2009; 1–21. 4. Kraus JF. The effects of certain drug‐testing programs on injury reduction in the workplace: An evidence‐based review. Int J Occup Environ Health. 2001;7:103–108. 5. Committee on Drug Use in the Workplace, National Research Council/ Institute of Medicine. Under the Influence?: Drugs and the American Work Force. Washington, DC: The National Academies Press; 1994. 6. Macdonald S, Hall W, Roman P, et al. Testing for cannabis in the work‐ place: A review of the evidence. Addiction. 2010;105:408–416. 7. Marmot M. Social determinants of health inequalities. Lancet. 2005;365:1099–1104. 8. Puig‐Barrachina V, Malmusi D, Martenez JM, et al. Monitoring social determinants of health inequalities: The impact of unemployment among vulnerable groups. Int J Health Serv. 2011;41:459–482. 9. Braveman PA, Kumanyika S, Fielding J, et al. Health disparities and health
  • 19. equity: The issue is justice. Am J Public Health. 2011;101(Suppl 1):S149– S155. 10. Bush DM. The U.S. Mandatory Guidelines for Federal Workplace Drug Testing Programs: Current status and future considerations. Forensic Sci Int. 2008;174:111–119. 11. Burgess DJ, van Ryn M, Crowley‐Matoka M, et al. Understanding the provider contribution to race/ethnicity disparities in pain treatment: Insights from dual process models of stereotyping. Pain Med. 2006;7:119– 134. 12. Crowley‐Matoka M, Saha S, Dobscha SK, et al. Problems of quality and equity in pain management: Exploring the role of biomedical culture. Pain Med. 2009;10:1312–1324. 13. Becker WC, Starrels JL, Heo M, et al. Racial differences in primary care opioid risk reduction strategies. Ann Fam Med. 2011;9:219– 225. 14. Larson SL, Eyerman J, Foster MS, et al. Worker Substance Use and Workplace Policies and Programs. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2007.
  • 20. 15. United States Department of Health and Human Services. National survey on drug use and health, 2009 [Computer file]. In: Substance Abuse and Mental Health Services Administration, ed. Ann Arbor, MI: Inter‐ University Consortium for Political and Social Research. 16. United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health, 2010 [computer file]. Ann Arbor, MI: Inter‐ University Consortium for Political and Social Research; 2010. 17. United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health, 2008. Ann Arbor, MI: Inter‐University Consortium for Political and Social Research; 2008. 18. Kennet J, Gfroerer J. Introduction. In: Kennet J, Gfroerer J, eds. Evaluating and Improving Methods Used in the National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2005. 19. U.S. Office of Personnel Management. Federal Civilian Workforce Statistics: Occupations of Federal White‐Collar and Blue‐Collar Workers.
  • 21. Washington, DC: U.S. Office of Personnel Management; 2000. 20. Gee GC, Curbow B, Ensminger ME, et al. Are you positive? The relationship of minority composition to workplace drug and alcohol testing. J Drug Issues. 2005;35:755–778. 21. Raphael K. Recall bias: A proposal for assessment and control. Int J Epidemiol. 1987;16:167–170. 362 Differences in U.S. Workplace Drug Testing July–August 2014 Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. [1] PS 1010 – American Government Fall 2016 Essay #2
  • 22. Topic: Unlike other advanced presidential democracies, the United States does not directly elect its chief executive. The election of the president is a seminal debate in American politics; in modern times, the Electoral College has come under increased scrutiny following the 2000 election which saw Democratic nominee Al Gore win the popular vote yet lose to Republican nominee George W. Bush. More recently, the Electoral College has been challenged by the emergence of the National Popular Vote (NPV) compact, which would require signatory states to award their electoral votes to the winner of the national popular vote regardless if that candidate won the popular vote within the state. (For example: Texas would have awarded its electoral votes in 2012 to Obama under NPV despite Obama losing the popular vote in Texas.) While critics argue the Electoral College is inherently anti-democratic, supporters are much more likely to argue that the Electoral College provides a necessary check on the masses (e.g. preventing a demagogue from being elected), while also challenging the notion that the presidential election is meant to be popular (i.e. directly elected by voters). Directions: For this essay, you will compose a “position paper” on ONE (1) of the following topics: 1. Defend the Electoral College; provide an argument justifying why the Electoral College is a necessary inclusion in the U.S. political system.
  • 23. 2. Revise the Electoral College; identify how you would “improve” the Electoral College to make it more democratic, etc. 3. Abolish/Replace the Electoral College; explain why and how you would replace the Electoral College with a “better” method. Format: Your essay should take the form of a one-page (single- spaced) position paper. You will need to start with an introduction which includes your thesis statement. Good thesis statements clearly state to your reader the purpose of your essay. For example: if you believe the Electoral College is inherently anti-democratic, your thesis may be: “The Electoral College denies the people their basic, democratic right to choose who governs them; therefore, it should be abolished.” Generally, your thesis statement will be the final sentence in your introduction. Next, you will offer your rationale/proposal. It is expected that this section will be several paragraphs, where you rely extensively on outside sources and course concepts in justifying your position. This is the body of your position paper. While there is no definitive way to craft this section, you should make sure that your argument proceeds in a logical fashion. For instance: if you wish to keep the Electoral College, you may elect to arrange your body section as three
  • 24. paragraphs, each with a “reason” for keeping it. Finally, you should include a conclusion which provides a summation of your position. This may, unlike a formal essay, be relatively brief (3-4 sentences) rather than a substantive restitution. Your position paper should be: 1. Single-spaced; 2. 1-page MAXIMUM; 3. Time News Roman, 11-point or 12-point font; 4. Normal, 1-inch margins; 5. Cited correctly; and 6. Name placed at the beginning of the paper (preferably in the header). Citations: Throughout your essay, it is expected that you will refer extensively to outside sources and/or course concepts discussed in lectures and readings. Given the space constraints, moreover, you should NOT rely on direct quotes; rather, you should paraphrase and synthesize information from your sources. Remember: citation is an important formatting technique which allows you to correctly attribute information/ideas/concepts which are not your own without plagiarizing. Whenever you use an idea which is not yours, you should cite where that idea came from.
  • 25. While there are several ways to cite an author, for this assignment you can use either APA or APSA citation styles. Besides in-text citation, you should also include a list of references of every source you use in your essay at the end (this [2] page does NOT count against your page limit). Again, each style can provide guidance as to how you construct a works cited/references page. If you are unfamiliar with any of these styles, you can consult the following sources: **Purdue Online Writing Lab (OWL): The Purdue Online Writing Lab (OWL for short) is a fantastic resource for paper writing. It contains graphical links and explanations for APA, Chicago, and MLA citation styles, while also including general guidance on how to write good papers (including grammar help). (Links are also posted on Blackboard under “Essays.”) **American Political Science Association (APSA) Manual of Style: If you wish to use the standard style used by political scientists, you can find an electronic copy of APSA’s citation guide here. (A link is also posted on Blackboard.) **WSU Writing Center: The Writing Center also offers
  • 26. assistance in composing and formatting essays, much like OWL above but with the added benefit of having a “live” person assisting you. The Writing Center is located in the Undergraduate Library, Room 2310. Visit their website to schedule an appointment, or call 313-577-2544 (a link is also posted on Blackboard). Regardless of your writing proficiency, the Writing Center is an invaluable resource which can take your writing to the next level! **See Me: I am available to help with any component of this essay, especially proper citation style. Either visit during my office hours, email me, or otherwise schedule an appointment. Note: I cannot help with questions or drafts submitted within twenty-four hours of the deadline. Grading: Your essay will be submitted on Blackboard via the SafeAssign feature, which will check against plagiarism. As I know that learning to cite requires practice, I will construe failure to cite liberally and use it as a learning opportunity. However, this does not mean I will overlook clear instances of cheating (e.g. copying another’s work or “forgetting” to include an outside source in your works cited page). In grading your essay, I will use the following guidelines (50 points possible): A: Provides a clear thesis statement, identifying the author’s
  • 27. position regarding the Electoral College. Body section is detailed, logical, and creative. Evidence marshalled is cited correctly and used appropriately; the author does not use direct quotes but instead relies on synthesis and paraphrasing. Finally, the paper itself is written as grammatically pleasing, and in clear, concise language. B: Has similar features as an “A” paper above, but may be somewhat less clear, substantively, in spots. Rationale is logical, but there may be areas that further evidence is needed. Author may fail to adequately synthesize materials and relies on one or two direct quotes. Grammatically, there may be some errors present, but they are minor, while the paper itself is written clearly. C: Compared to “A” and “B” papers, “C” papers contain numerous substantive errors; do not have a clear thesis; nor provide sufficient, factual evidence. The writing may be unclear and contain errors which detract from the narrative, making the paper difficult to read. D: In addition to some of the weaknesses of a “C” paper, the essay is marred by significant inaccuracies and/or is missing required elements. F: Plagiarized in part or whole. Too short. Off-topic.
  • 28. Unreadable. Not turned in. SafeAssign: Submit your completed essay on Blackboard. Navigate to the “Essays” tab, click on “Essay #2,” and then click on the SafeAssign link within the folder (i.e. the link which has the directions attached). You can upload your document thereafter. NOTE: Make sure your document is saved as a Word Document (.doc or .docx); failure to upload a Word document will result in delayed grading. If you encounter difficulties with uploading your file, please email me as soon as possible so that I can rectify the situation. ***THIS ESSAY IS DUE AT 12:50 P.M. ON OCTOBER 19, 2016 ON BLACKBOARD*** https://owl.english.purdue.edu/owl/resource/560/01/ https://owl.english.purdue.edu/owl/resource/717/01/ https://owl.english.purdue.edu/owl/resource/747/01/ http://www.apsanet.org/Portals/54/APSA%20Files/publications/ APSAStyleManual2006.pdf clas.wayne.edu/WRITING/