ArticleDrug and alcohol dependence2019
Urban-rural variation in the socioeconomic determinants of opioid overdose.
Article in Drug and alcohol dependence, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 1 of them a synthesis that pooled it.
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Who cites it
97 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between prodynorphin gene polymorphisms and opioid dependence susceptibility: a meta-analysis.BMC psychiatry · 2019Pooled it
- Geospatial Determinants and Spatial Heterogeneity of Opioid Overdose Mortality in Arizona.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- Racial/Ethnic and Regional Disparities in Opioid-Involved Overdose Deaths among Children and Adolescents in the United States.Journal of racial and ethnic health disparities · 2026Article
- Higher prevalence of non-fatal overdose with opioid and stimulant use compared to use of opioids alone.Drug and alcohol dependence · 2026Article
- Article
- Spatial Patterns of Opioid Overdose Mortality Risk Across Urban, Transitional, and Rural Communities Using Satellite-Derived and Socioeconomic Indicators.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- A lifeline on wheels: perspectives of stakeholders on the implementation and impact of a mobile medications for opioid use disorder unit.Addiction science & clinical practice · 2026Article
- Examining Ethnic and Racial Variations in Opioid-related Hospitalizations Using Western U.S. Electronic Health Records.Journal of racial and ethnic health disparities · 2026Review
- Narrowing differences in the rate of alcohol-related acute care admissions in the United States between women versus men, 2016-2023.Alcohol, clinical & experimental research · 2026Article
- The geography of risk: understanding disparities in nonmedical opioid mortality and the role of socio-built environments in New Jersey.Harm reduction journal · 2026Article
- Substance use to cope with trauma: the interactive effect of insomnia and neighborhood socioeconomic status.Sleep advances : a journal of the Sleep Research Society · 2026Article
- Smoking & autonomy: the generational tobacco endgame.Monash bioethics review · 2025Article
- Maternal substance use disorder and neonatal health: epidemiologic and socioeconomic determinants in a case-control study, Shiraz, Iran.BMC pregnancy and childbirth · 2025Article
- Associations Between Social Determinants of Health and Opioid-Use Disorder Among Chronic Pain Patients From a Multi-Institutional Dataset.Anesthesia and analgesia · 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
- Evaluation of the Implementation of an Outreach Clinic for Opioid Use Disorder: Protocol for a Participatory Cocreation and Implementation Study.JMIR research protocols · 2025Article
- Spatial associations between alcohol detection in opioid overdose deaths and alcohol outlets.Drug and alcohol dependence · 2025Article
- Perceived Social Isolation and Fentanyl Use Among Adults Who Inject Drugs in Rural Kentucky.Social work in public health · 2025Article
- Disparities in Opioid Agonist Treatment Accessibility for Priority Populations in New South Wales, Australia.Drug and alcohol review · 2025Article
- The Police Opioid Seizure Temporal Risk (POSTeR) model of increased exposure to fatal overdose.The International journal on drug policy · 2025Article
37 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundPrescription opioid overdose (POD) and heroin overdose (HOD) rates have quadrupled since 1999. Community-level socioeconomic characteristics are associated with opioid overdoses, but whether this varies by urbanicity is unknown.
methodsIn this serial cross-sectional study of zip codes in 17 states, 2002-2014 (n = 145,241 space-time units), we used hierarchical Bayesian Poisson space-time models to analyze the association between zip code-level socioeconomic features (poverty, unemployment, educational attainment, and income) and counts of POD or HOD hospital discharges. We tested multiplicative interactions between each socioeconomic feature and zip code urbanicity measured with Rural-Urban Commuting Area codes.
resultsPercent in poverty and of adults with ≤ high school education were associated with higher POD rates (Rate Ratio [RR], 5% poverty: 1.07 [95% credible interval: 1.06-1.07]; 5% low education: 1.02 [1.02-1.03]), while median household income was associated with lower rates (RR, $10,000: 0.88 [0.87-0.89]). Urbanicity modified the association between socioeconomic features and HOD. Poverty and unemployment were associated with increased HOD in metropolitan areas (RR, 5% poverty: 1.12 [1.11-1.13]; 5% unemployment: 1.04 [1.02-1.05]), and median household income was associated with decreased HOD (RR, $10,000: 0.88 [0.87-0.90]). In rural areas, low educational attainment alone was associated with HOD (RR, 5%: 1.09 [1.02-1.16]).
conclusionsRegardless of urbanicity, elevated rates of POD were found in more economically disadvantaged zip codes. Economic disadvantage played a larger role in HOD in urban than rural areas, suggesting rural HOD rates may have alternative drivers. Identifying social determinants of opioid overdoses is particularly important for creating effective population-level interventions.
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