Compositional and contextual factors associated with drug overdose deaths in the United States

Background: In 2017, the US Department of Health and Human Services declared the Opioid epidemic a public health emergency. In the US, emergency rooms treat more than 1,000 people each day for drug overdose, and 115 of them die. This study examines compositional and contextual factors associated wit...

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Bibliographic Details
Published in:Journal of addictive diseases 2020-02, Vol.38 (2), p.143-152
Main Authors: Kedia, Satish, Ahuja, Nikhil, Wyant, David K., Dillon, Patrick J., Akkus, Cem, Relyea, George
Format: Article
Language:English
Subjects:
Census
Censuses
compositional and contextual factors
Death
Death & dying
Drug overdose
Drug overdose deaths
Emergency medical care
Epidemics
Health insurance
High risk
Mental health
opioid
Opioids
Overdose
Population density
Poverty
Public health
Secondary schools
spatial regression
Statistical analysis
substance abuse
Variables
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Summary:Background: In 2017, the US Department of Health and Human Services declared the Opioid epidemic a public health emergency. In the US, emergency rooms treat more than 1,000 people each day for drug overdose, and 115 of them die. This study examines compositional and contextual factors associated with drug overdose deaths rates in the US. Methods: Local spatial autocorrelation statistics were used to estimate hot spot areas to identify census tracts with high risk of drug overdose death. Logistic regressions investigated the relationship between drug overdose death rates and various compositional and contextual variables across census tracks. Results: The adjusted logistic model shows that compositional variables: depression (OR = 2.47 [2.37-2.58]), poor mental health (OR = 1.71 [1.63-1.79]), median age 1.41 (1.36-1.47) and the percentage of people with a high school diploma (OR = 1.30 [1.24-1.35]) were positively associated with the rate of drug overdose deaths. On the other hand, contextual variables: the percentage having health insurance (OR = 0.66 [0.64-0.69]), the Theil's H index (OR = 0.69 [0.66-0.71]), population density (OR = 0.80 [0.77-0.84]), poverty (OR = 0.90 [0.86-0.95]), and median household income (OR = 0.91[0.86-0.96]) were negatively associated with drug overdose deaths. Discussion: The analysis reveals a consistently strong association between compositional mental health factors and census tract-level death rates from drug overdose.
ISSN:1055-0887
1545-0848
DOI:10.1080/10550887.2020.1729079