Socioeconomic risk factors for fatal opioid overdoses in the United States

Findings from the Mortality Disparities in American Communities Study (MDAC)

Datos Bibliográficos

ID23378750
AutoresSean F Altekruse (0000-0002-2783-6057, National Institutes of Health, autor de correspondencia), Candace M Cosgrove (0000-0002-3883-388X, United States Census Bureau), William C Altekruse, William Altekruse (National Institutes of Health), Richard A Jenkins (National Institutes of Health), Carlos Blanco (0000-0001-6187-3057, National Institutes of Health)
EditoresBecky L Genberg
Año2020
Volumen15
Número1
Páginase0227966
Fecha de publicación2020-01-17
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaPLoS ONE (JOURNAL)
Identificadores de la revistaISSN: 1932-6203 • E-ISSN: 1932-6203
EditorialPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pone.0227966
PMID31951640
OpenAlexW2999287971
IdiomaEN
Citas recibidas68
Referencias citadas52

BACKGROUND: Understanding relationships between individual-level demographic, socioeconomic status (SES) and U.S. opioid fatalities can inform interventions in response to this crisis. METHODS: The Mortality Disparities in American Community Study (MDAC) links nearly 4 million 2008 American Community Survey responses to the 2008-2015 National Death Index. Univariate and multivariable models were used to estimate opioid overdose fatality hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: Opioid overdose was an overrepresented cause of death among people 10 to 59 years of age. In multivariable analysis, compared to Hispanics, Whites and American Indians/Alaska Natives had elevated risk (HR = 2.52, CI:2.21-2.88) and (HR = 1.88, CI:1.35-2.62), respectively. Compared to women, men were at-risk (HR = 1.61, CI:1.50-1.72). People who were disabled were at higher risk than those who were not (HR = 2.80, CI:2.59-3.03). Risk was higher among widowed than married (HR = 2.44, CI:2.03-2.95) and unemployed than employed individuals (HR = 2.46, CI:2.17-2.79). Compared to adults with graduate degrees, those with high school only were at-risk (HR = 2.48, CI:2.00-3.06). Citizens were more likely than noncitizens to die from this cause (HR = 4.62, CI:3.48-6.14). Compared to people who owned homes with mortgages, those who rented had higher HRs (HR = 1.36, CI:1.25-1.48). Non-rural residents had higher risk than rural residents (HR = 1.46, CI:1.34, 1.59). Compared to respective referent groups, people without health insurance (HR = 1.30, CI:1.20-1.41) and people who were incarcerated were more likely to die from opioid overdoses (HR = 2.70, CI:1.91-3.81). Compared to people living in households at least five-times above the poverty line, people who lived in poverty were more likely to die from this cause (HR = 1.36, CI:1.20-1.54). Compared to people living in West North Central states, HRs were highest among those in South Atlantic (HR = 1.29, CI:1.11, 1.50) and Mountain states (HR = 1.58, CI:1.33, 1.88). DISCUSSION: Opioid fatality was associated with indicators of low SES. The findings may help to target prevention, treatment and rehabilitation efforts to vulnerable groups.

(+)-Naloxone · Environmental health · Opioid · Opioid overdose · Population · Socioeconomic status · Demography · Emergency Medicine · HIV, Drug Use, Sexual Risk · Internal Medicine · Medicine · Opioid Use Disorder Treatment · Suicide and Self-Harm Studies · Gerontology