ArticleAmerican journal of preventive medicine2018
Factors Associated With County-Level Differences in U.S. Drug-Related Mortality Rates.
Article in American journal of preventive medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
98 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A systematic review of the association between alcohol-related deaths and area-level socioeconomic deprivation and other geographic characteristics in high-income countries.BMC public health · 2026Pooled it
- Social and economic determinants of drug overdose deaths: a systematic review of spatial relationships.Social psychiatry and psychiatric epidemiology · 2024Pooled it
- Understanding the Impacts of Novel Coronavirus Outbreaks on People Who Use Drugs: A Systematic Review to Inform Practice and Drug Policy Responses to COVID-19.International journal of environmental research and public health · 2021Pooled it
- A growing socioeconomic divide: Effects of the Great Recession on perceived economic distress in the United States.PloS one · 2019Trial
- Three-year cardiovascular risk prediction among people who use cocaine or methamphetamine.Drug and alcohol dependence reports · 2026Article
- Article
- Economic Cynicism, COVID-19 and Deaths of Despair in Rural Ohio Counties.Sociology of health & illness · 2026Article
- Examining the association between county racialised economic segregation and fatal overdose in US counties, 2018-2022.Journal of epidemiology and community health · 2026Article
- Starting with Story, Not Symptom: Narrative Collapse and Cultural Repair in Appalachia.Journal of Appalachian health · 2026Article
- County health rankings, provider shortages, and the health of incarcerated women with opioid use disorder.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- From addiction to aggression: The spillover effects of opioid policies on intimate partner violence.Journal of health economics · 2025Article
- Associations of community socioeconomic factors and opioid use disorder across an urban-to-rural spectrum in Pennsylvania: an electronic health record-based case-control study.Social psychiatry and psychiatric epidemiology · 2025Article
- Influences and Implications of Medical Mistrust on Healthcare Behaviors in a Low Health Outcomes County in the State of New Jersey.Journal of community health · 2025Article
- The Gender Gap in Life Expectancy in the United States and Deaths of Despair: Trends from 1979 to 2022.Population and development review · 2025Article
- IMPACT OF BOOM-AND-BUST ECONOMIES FROM OIL AND GAS DEVELOPMENT ON PSYCHIATRIC HOSPITALIZATIONS AMONG MEDICAID BENEFICIARIES.Environmental research, health : ERH · 2025Article
- Changes in the association between county industrial composition and working-age mortality from 2000 to 2022.SSM - population health · 2025Article
- Stability and Volatility in the Contextual Predictors of Working-Age Mortality in the United States.Journal of health and social behavior · 2025Article
- Life Expectancy and Health Expectancy in the Twenty-first Century: The Unthinkable, the Inconceivable, and the Unknowable.Demography · 2025Article
- Motor vehicle crash death rates among passenger vehicle occupants and pedestrians by county-level social vulnerability and urbanicity: the USA, 2019.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2025Article
- Individual- and Area-Level Incarceration and Mortality.JAMA network open · 2025Article
38 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
1 author.
Funding
Abstract
introductionOver the past 2 decades, drug-related deaths have grown to be a major U.S. public health problem. County-level differences in drug-related mortality rates are large. The relative contributions of social determinants of health to this variation, including the economic, social, and healthcare environments, are unknown.
methodsUsing data from the U.S. Centers for Disease Control and Prevention Multiple-Cause of Death Files (2006-2015, analyzed in 2017); U.S. Census Bureau; U.S. Department of Agriculture Economic Research Service; Agency for Healthcare Research and Quality; and Northeast Regional Center for Rural Development, this paper modeled associations between county-level drug-related mortality rates and economic, social, and healthcare environments. Spatial autoregressive models controlled for state fixed effects and county demographic characteristics.
resultsThe average county-level age-adjusted drug-related mortality rate was 16.6 deaths per 100,000 population (2006-2015), but there were substantial geographic disparities in rates. Controlling for county demographic characteristics, average mortality rates were significantly higher in counties with greater economic and family distress and in counties economically dependent on mining. Average mortality rates were significantly lower in counties with a larger presence of religious establishments, a greater percentage of recent in-migrants, and counties with economies reliant on public (government) sector employment. Healthcare supply factors did not contribute to between-county disparities in mortality rates.
conclusionsDrug-related mortality rates are not randomly distributed across the U.S. Future research should consider the specific pathways through which economic, social, and healthcare environments are associated with drug-related mortality.
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