ArticleHealth promotion and chronic disease prevention in Canada : research, policy and practice2022
Stepping up to the Canadian opioid crisis: a longitudinal analysis of the correlation between socioeconomic status and population rates of opioid-related mortality, hospitalization and emergency department visits (2000-2017).
Article in Health promotion and chronic disease prevention in Canada : research, policy and practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Socioeconomic inequities in drug poisoning deaths in Canada.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Drug decriminalization: a co-designed study outlining the implications for providers of youth services.Harm reduction journal · 2025Article
- Income-Based Disparities in Opioid Prescription Dispensing Among Public Drug Plan Beneficiaries in Canada from 2010 to 2018: A Population-Based and Sex-Stratified Retrospective Study.Drugs - real world outcomes · 2025Article
- Implementation of harm reduction services for people who use drugs provided by pharmacy staff: a scoping review protocol.BMJ open · 2025Article
- Creating an 11-year longitudinal substance use harm cohort from linked health and census data to analyse social drivers of health.International journal of population data science · 2024Article
- Changes in opioid distribution and chronic opioid users following outpatient orthopedic surgery: a pre-post intervention study.Canadian journal of surgery. Journal canadien de chirurgieArticle
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Authors and funding
6 authors.
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Abstract
introductionHigh levels of income inequality and increased opioid-related harm across Canada bring into question the role of socioeconomic status (SES) in the opioid epidemic. Only a few studies have examined this association, and most of those have analyzed this issue on a provincial level. This study examined the association between opioid-related health outcomes and SES, and investigated rate ratios over time.
methodsAdministrative databases were used to identify opioid-related mortality, hospitalization and emergency department visits between 2000 and 2017. Patient's postal code was linked to the quintile of median household income at the forward sortation area level. Crude rates and age- and sex-adjusted rates in each quintile were calculated, as well as the adjusted rate ratio of average annual rates between the lowest and highest quintiles. The significance of the time trend of rate ratios for all outcomes was examined using linear regression.
resultsA stepped gradient of opioid-related outcomes across all income quintiles emerged from these data. For mortality, hospitalization and emergency department visits, the average annual rate ratio between lowest quintile and highest quintile was 3.8, 4.3 and 4.9, respectively. These ratios were generally stable and consistent over the study period, albeit the opioid-related mortality SES gap decreased gradually (p < 0.01).
conclusionArea income quintile was found to be highly associated with opioid outcomes. Psychosocial factors (stress, unemployment, housing insecurity) that are typically concentrated in low SES areas may play a significant role in the opioid epidemic. Health policies should address these factors in order to provide effective solutions.
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