Journal article
Using Census Data to Understand County-Level Differences in Overall Drug Mortality and Opioid-Related Mortality by Opioid Type
American journal of public health (1971), Vol.109(8), pp.1084-1091
08/2019
DOI: 10.2105/ajph.2019.305136
PMCID: PMC6611117
PMID: 31219718
Abstract
To examine associations of county-level demographic, socioeconomic, and labor market characteristics on overall drug mortality rates and specific classes of opioid mortality.
We used National Vital Statistics System mortality data (2002-2004 and 2014-2016) and county-level US Census data. We examined associations between several census variables and drug deaths for 2014 to 2016. We then identified specific classes of counties characterized by different levels and rates of growth in mortality from specific opioid types between 2002 to 2004 and 2014 to 2016. We ran multivariate and multivariable regression models to predict probabilities of membership in each "opioid mortality class" on the basis of county-level census measures.
Drug mortality rates overall are higher in counties characterized by more economic disadvantage, more blue-collar and service employment, and higher opioid-prescribing rates. High rates of prescription opioid overdoses and overdoses involving both prescription and synthetic opioids cluster in more economically disadvantaged counties with larger concentrations of service industry workers. High heroin and "syndemic" opioid mortality counties (high rates across all major opioid types) are more urban, have larger concentrations of professional workers, and are less economically disadvantaged. Syndemic opioid counties also have greater concentrations of blue-collar workers.
Census data are essential tools for understanding the importance of place-level characteristics on opioid mortality.
National opioid policy strategies cannot be assumed universally applicable. In addition to national policies to combat the opioid and larger drug crises, emphasis should be on developing locally and regionally tailored interventions, with attention to place-based structural economic and social characteristics.
Details
- Title: Subtitle
- Using Census Data to Understand County-Level Differences in Overall Drug Mortality and Opioid-Related Mortality by Opioid Type
- Creators
- Shannon M Monnat - Shannon M. Monnat is with the Maxwell School of Citizenship and Public Affairs, Lerner Center for Public Health Promotion, Center for Policy Research, and the Department of Sociology, Syracuse University, Syracuse, NY. David J. Peters and Andrew Hochstetler are with the Department of Sociology, Iowa State University, Ames. Mark T. Berg is with the Department of Sociology and Public Policy Center, University of Iowa, Iowa CityDavid J Peters - Shannon M. Monnat is with the Maxwell School of Citizenship and Public Affairs, Lerner Center for Public Health Promotion, Center for Policy Research, and the Department of Sociology, Syracuse University, Syracuse, NY. David J. Peters and Andrew Hochstetler are with the Department of Sociology, Iowa State University, Ames. Mark T. Berg is with the Department of Sociology and Public Policy Center, University of Iowa, Iowa CityMark T Berg - Shannon M. Monnat is with the Maxwell School of Citizenship and Public Affairs, Lerner Center for Public Health Promotion, Center for Policy Research, and the Department of Sociology, Syracuse University, Syracuse, NY. David J. Peters and Andrew Hochstetler are with the Department of Sociology, Iowa State University, Ames. Mark T. Berg is with the Department of Sociology and Public Policy Center, University of Iowa, Iowa CityAndrew Hochstetler - Shannon M. Monnat is with the Maxwell School of Citizenship and Public Affairs, Lerner Center for Public Health Promotion, Center for Policy Research, and the Department of Sociology, Syracuse University, Syracuse, NY. David J. Peters and Andrew Hochstetler are with the Department of Sociology, Iowa State University, Ames. Mark T. Berg is with the Department of Sociology and Public Policy Center, University of Iowa, Iowa City
- Resource Type
- Journal article
- Publication Details
- American journal of public health (1971), Vol.109(8), pp.1084-1091
- DOI
- 10.2105/ajph.2019.305136
- PMID
- 31219718
- PMCID
- PMC6611117
- NLM abbreviation
- Am J Public Health
- ISSN
- 0090-0036
- eISSN
- 1541-0048
- Publisher
- United States
- Grant note
- P2C HD041025 / NICHD NIH HHS
- Language
- English
- Date published
- 08/2019
- Academic Unit
- Sociology and Criminology; Center for Social Science Innovation; Injury Prevention Research Center; Public Policy Center (Archive)
- Record Identifier
- 9983991931402771
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