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Investigating the Social Ecological Contexts of Opioid Use Disorder and Poisoning Hospitalizations in Pennsylvania.
J Stud Alcohol Drugs. 2018 11; 79(6):899-908.JS

Abstract

OBJECTIVE

Opioid use disorder (OUD) and overdose rates have been sharply on the rise in the United States. Although systematic patterns of geographic variation in OUD and opioid overdose have been identified, the factors that explain why opioid-related hospitalizations increase in certain areas are not well understood.

METHOD

We examined Pennsylvania Health Care Cost Containment Council (PHC4) hospital inpatient discharge data at the ZIP code level to measure the geographic growth and spread of OUD as measured by 44 quarters of inpatient hospitalization data (from 2004 through 2014) for the entire state of Pennsylvania (n = 16,275 ZIP codes). We assessed the relative contribution of specific attributes of areas (e.g., population density) to patterns of OUD, heroin poisonings, and non-heroin opioid poisonings. Unit misalignment and spatial autocorrelation were corrected for using Bayesian space-time conditional autoregressive models.

RESULTS

The associations between a greater density of manual labor establishments and all opioid-related hospitalizations were well supported and positive. A dose-response relationship between population density and opioid-related hospitalizations existed, with a stronger association for heroin poisonings (relative rate, densest quintile vs. least dense: 3.40 [95% credible interval 2.68, 4.39]).

CONCLUSIONS

Posterior distributions from these models enabled the identification of locations most vulnerable to problems related to the opioid epidemic in Pennsylvania. Understanding spatial patterns of OUD and poisonings can enhance the development and implementation of effective prevention programs.

Authors+Show Affiliations

Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

30573021

Citation

Mair, Christina, et al. "Investigating the Social Ecological Contexts of Opioid Use Disorder and Poisoning Hospitalizations in Pennsylvania." Journal of Studies On Alcohol and Drugs, vol. 79, no. 6, 2018, pp. 899-908.
Mair C, Sumetsky N, Burke JG, et al. Investigating the Social Ecological Contexts of Opioid Use Disorder and Poisoning Hospitalizations in Pennsylvania. J Stud Alcohol Drugs. 2018;79(6):899-908.
Mair, C., Sumetsky, N., Burke, J. G., & Gaidus, A. (2018). Investigating the Social Ecological Contexts of Opioid Use Disorder and Poisoning Hospitalizations in Pennsylvania. Journal of Studies On Alcohol and Drugs, 79(6), 899-908.
Mair C, et al. Investigating the Social Ecological Contexts of Opioid Use Disorder and Poisoning Hospitalizations in Pennsylvania. J Stud Alcohol Drugs. 2018;79(6):899-908. PubMed PMID: 30573021.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Investigating the Social Ecological Contexts of Opioid Use Disorder and Poisoning Hospitalizations in Pennsylvania. AU - Mair,Christina, AU - Sumetsky,Natalie, AU - Burke,Jessica G, AU - Gaidus,Andrew, PY - 2018/12/22/entrez PY - 2018/12/24/pubmed PY - 2019/10/19/medline SP - 899 EP - 908 JF - Journal of studies on alcohol and drugs JO - J Stud Alcohol Drugs VL - 79 IS - 6 N2 - OBJECTIVE: Opioid use disorder (OUD) and overdose rates have been sharply on the rise in the United States. Although systematic patterns of geographic variation in OUD and opioid overdose have been identified, the factors that explain why opioid-related hospitalizations increase in certain areas are not well understood. METHOD: We examined Pennsylvania Health Care Cost Containment Council (PHC4) hospital inpatient discharge data at the ZIP code level to measure the geographic growth and spread of OUD as measured by 44 quarters of inpatient hospitalization data (from 2004 through 2014) for the entire state of Pennsylvania (n = 16,275 ZIP codes). We assessed the relative contribution of specific attributes of areas (e.g., population density) to patterns of OUD, heroin poisonings, and non-heroin opioid poisonings. Unit misalignment and spatial autocorrelation were corrected for using Bayesian space-time conditional autoregressive models. RESULTS: The associations between a greater density of manual labor establishments and all opioid-related hospitalizations were well supported and positive. A dose-response relationship between population density and opioid-related hospitalizations existed, with a stronger association for heroin poisonings (relative rate, densest quintile vs. least dense: 3.40 [95% credible interval 2.68, 4.39]). CONCLUSIONS: Posterior distributions from these models enabled the identification of locations most vulnerable to problems related to the opioid epidemic in Pennsylvania. Understanding spatial patterns of OUD and poisonings can enhance the development and implementation of effective prevention programs. SN - 1938-4114 UR - https://www.unboundmedicine.com/medline/citation/30573021/Investigating_the_Social_Ecological_Contexts_of_Opioid_Use_Disorder_and_Poisoning_Hospitalizations_in_Pennsylvania_ L2 - https://www.jsad.com/doi/abs/10.15288/jsad.2018.79.899 DB - PRIME DP - Unbound Medicine ER -