ArticleJournal of substance use and addiction treatment2024
Development and validation of a community-level social determinants of health index for drug overdose deaths in the HEALing Communities Study.
Article in Journal of substance use and addiction treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.
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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
8 citing papers in PubMed.
- Local level of social inequity moderates implementation of evidence-based practices tailored to minoritized populations to reduce opioid overdose deaths.Journal of substance use and addiction treatment · 2026Trial
- A Multi-Institutional and Nationwide Analysis of the Social Determinants of Persistent Pain After Surgery.Anesthesia and analgesia · 2026Observational
- Evaluating the Combined Effects of an Adverse Childhood Experiences-Focused Family Advocate Model and the Strengthening Families Program: Study Protocol for a Hybrid Type 1 Effectiveness-Implementation Trial in 36 New Jersey Communities.JMIR research protocols · 2026Article
- Opioid Overdose Death Prediction with Graph Neural Networks.medRxiv : the preprint server for health sciences · 2026Article
- Opioid Overdose Death Prediction with Graph Neural Networks.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2026Article
- The Digital Divide and Tele-MOUD: A Qualitative Study of Opioid Community Coalition Perspectives During COVID-19.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2025Article
- Nefopam Misuse: A Cross-Sectional Study in France.European journal of pain (London, England) · 2025Observational
- Community-level determinants of stakeholder perceptions of community stigma toward people with opioid use disorders, harm reduction services and treatment in the HEALing Communities Study.The International journal on drug policy · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
12 authors.
Funding
Abstract
introductionSocial determinants of health (SDoH), such as socioeconomic status, education level, and food insecurity, are believed to influence the opioid crisis. While global SDoH indices such as the CDC's Social Vulnerability Index (SVI) and Area Deprivation Index (ADI) combine the explanatory power of multiple social factors for understanding health outcomes, they may be less applicable to the specific challenges of opioid misuse and associated outcomes. This study develops a novel index tailored to opioid misuse outcomes, tests the efficacy of this index in predicting drug overdose deaths across contexts, and compares the explanatory power of this index to other SDoH indices.
methodsFocusing on four HEALing Communities Study (HCS) states (Kentucky, Massachusetts, New York and Ohio; encompassing 4269 ZIP codes), we identified multilevel SDoH potentially associated with opioid misuse and aggregated publicly available data for each measure. We then leveraged a random forest model to develop a composite measure that predicts age-adjusted drug overdose mortality rates based on SDoH. We used this composite measure to understand HCS and non-HCS communities in terms of overdose risk across areas of varying racial composition. Finally, we compared variance in drug overdose deaths explained by this index to variance explained by the SVI and ADI.
resultsOur composite measure included 28 SDoH measures and explained approximately 89 % percent of variance in age-adjusted drug overdose mortality across HCS states. Health care measures, including emergency department visits and primary care provider availability, were top predictors within the index. Index accuracy was robust within and outside of HCS communities and states. This measure identified high levels of overdose mortality risk in segregated communities.
conclusionsExisting SDoH indices fail to explain much variation in area-level overdose mortality rates. Having tailored composite indices can help us to identify places in which residents are at highest risk based on their composite contexts. A comprehensive index can also help to develop effective community interventions for programs such as HCS by considering the context in which people live.
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