ArticlePloS one2020
Socioeconomic risk factors for fatal opioid overdoses in the United States: Findings from the Mortality Disparities in American Communities Study (MDAC).
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 147 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
147 citing papers in PubMed, 3 syntheses or guidelines pooled it, 280 citations in OpenAlex.
- Oxygen Saturation Thresholds for Opioid-induced Respiratory Depression: A Systematic Review.The western journal of emergency medicine · 2026Pooled it
- Vending machines for reducing harm associated with substance use and use disorders, and co-occurring conditions: a systematic review.Harm reduction journal · 2025Pooled it
- Combatting opioid misuse, overuse and abuse: a systematic review of pharmacists' services and outcomes.Pain management · 2024Pooled it
- Factors Associated With Opioid-Involved Overdose: Descriptive Data From a Randomized Controlled Trial Evaluating Extended-Release Buprenorphine for Perinatal Opioid Use Disorder.Substance use & addiction journal · 2026Trial
- The Association of Perceived Risk for Opioid Overdose and Subsequent Overdose Among a Cohort of Opioid Overdose Survivors Who Use Nonprescribed Opioids.Substance use & addiction journal · 2026Trial
- Public perceptions and willingness-to-pay regarding over-the-counter (OTC) naloxone: A national cross-sectional survey informed by the Theory of Planned Behavior.Exploratory research in clinical and social pharmacy · 2026Article
- County by county estimation of possible deaths averted, infections averted, and cost savings of overdose prevention centers in the United States from July 2019-June 2025.The International journal on drug policy · 2026Article
- Opioid use after breast cancer in Denmark: a nationwide study of social and clinical factors.Journal of the National Cancer Institute · 2026Article
- Childhood social characteristics and drug-related mortality by age 41: a register-based study of Finnish birth cohorts 1982-2004.European journal of public health · 2026Article
- County by county estimation of possible deaths averted, infections averted, and cost savings of overdose prevention centers in the United States from July 2019-June 2025.medRxiv : the preprint server for health sciences · 2026Article
- External Validation of Epic's Risk of Opioid Abuse and Overdose Model Among Primary Care Patients in Three Health Systems.Journal of general internal medicine · 2026Article
- Heat exposure and drug overdose mortality in the USA.Addiction (Abingdon, England) · 2026Observational
- OPOSim: An Agent-Based Model for Evaluating Long-Term Effects of Opioid Policy Outcomes in North Carolina.Journal of artificial societies and social simulation : JASSS · 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
- Augmenting Missing Individual Social Determinants of Health with Area-Level Social Deprivation Index for Gene-Environment Interaction: Application to Opioid Use Disorder Prediction.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2026Article
- The evolving epidemiology of opioid use disorder: polysubstance use, drug supply transformation, and policy implications.Frontiers in public health · 2026Review
- Constructing datasets to measure geographic variation in bereavement: integrating mortality, population structure, and survey-based probability.Frontiers in public health · 2026Article
- A Comparative Analysis of Opioid Overdose Hospitalizations Pre- and Post-Pandemic: Insights from the National Inpatient Sample Database.Journal of community hospital internal medicine perspectives · 2026Article
- Family Dynamics and Opioid Misuse Among Black Americans: The Mediating Role of Emotional Support.Couple & family psychology · 2025Article
- Risk of opioid overdose associated with concurrent use of hydrocodone and CYP3A4-inhibiting calcium channel blockers: a population-based cohort study.American journal of epidemiology · 2025Article
87 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnderstanding relationships between individual-level demographic, socioeconomic status (SES) and U.S. opioid fatalities can inform interventions in response to this crisis.
methodsThe 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).
resultsOpioid 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.
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