ArticleDrug and alcohol dependence2023
County-level social vulnerability and nonfatal drug overdose emergency department visits and hospitalizations, January 2018-December 2020.
Article in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Geographic and Policy Factors Influence Telehealth Availability for Substance Use Disorder Treatment.The journal of behavioral health services & research · 2026Article
- Cradle to grave: how social vulnerability correlates with leading causes of injury-related mortality among children and youth.Injury epidemiology · 2025Article
- Geography And Fentanyl: Explaining The Disproportionate Rise In Opioid Overdose Deaths Among Black Americans.Health affairs (Project Hope) · 2025Article
- Spatial associations between alcohol detection in opioid overdose deaths and alcohol outlets.Drug and alcohol dependence · 2025Article
- Overdose as a complex contagion: modelling the community spread of overdose events following law enforcement efforts to disrupt the drug market.Journal of epidemiology and community health · 2025Article
- Neighborhood level factors and use of cigarettes, cannabis and e-cigarettes: A population-based study among Canadian adults.PloS one · 2025Article
- Characteristics associated with adult non-fatal opioid and stimulant overdose and substance use disorder emergency department visits in Michigan.Drug and alcohol dependence reports · 2024Article
- Considerations for Achieving Health Equity Through Substance Misuse Prevention.Focus (American Psychiatric Publishing) · 2024Article
- Preventing Substance Use and Overdose Among Young Adults: The Role of Social Determinants of Health.Focus (American Psychiatric Publishing) · 2024Article
- Social vulnerability adversely affects emergency-department utilization but not patient-reported outcomes after total joint arthroplasty.Archives of orthopaedic and trauma surgery · 2024Article
- Structural Stigma, Racism, and Sexism Studies on Substance Use and Mental Health: A Review of Measures and Designs.Alcohol research : current reviews · 2024Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundNonfatal drug overdoses (NFODs) are often attributed to individual behaviors and risk factors; however, identifying community-level social determinants of health (SDOH) associated with increased NFOD rates may allow public health and clinical providers to develop more targeted interventions to address substance use and overdose health disparities. CDC's Social Vulnerability Index (SVI), which aggregates social vulnerability data from the American Community Survey to produce ranked county-level vulnerability scores, can help identify community factors associated with NFOD rates. This study aims to describe associations between county-level social vulnerability, urbanicity, and NFOD rates.
methodsWe analyzed county-level 2018-2020 emergency department (ED) and hospitalization discharge data submitted to CDC's Drug Overdose Surveillance and Epidemiology system. Counties were ranked in vulnerability quartiles based on SVI data. We used crude and adjusted negative binomial regression models, by drug category, to calculate rate ratios and 95% confidence intervals comparing NFOD rates by vulnerability.
resultsGenerally, as social vulnerability scores increased, ED and hospitalization NFOD rates increased; however, the magnitude of the association varied across drugs, visit type, and urbanicity. SVI-related theme and individual variable analyses highlighted specific community characteristics associated with NFOD rates.
conclusionsThe SVI can help identify associations between social vulnerabilities and NFOD rates. Development of an overdose-specific validated index could improve translation of findings to public health action. The development and implementation of overdose prevention strategies should consider a socioecological perspective and address health inequities and structural barriers associated with increased risk of NFODs at all levels of the social ecology.
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