Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017
The objective of this initiative was to conduct a comprehensive opioid overdose vulnerability assessment in Indiana and evaluate spatial accessibility to opioid use disorder treatment, harm reduction services, and opioid response programs. We compiled 2017 county-level (n = 92) data on opioid-relate...
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doaj-2e998790e2bd4237858b956e892aecab2021-09-01T04:20:53ZengElsevierPreventive Medicine Reports2211-33552021-12-0124101538Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017Jared L. Sawyer0Shikhar Shrestha1Jennifer C. Pustz2Robert Gottlieb3Deborah Nichols4Michelle Van Handel5Cailyn Lingwall6Thomas J. Stopka7Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, United StatesDepartment of Public Health and Community Medicine, Tufts University School of Medicine, Boston, United StatesDepartment of Public Health and Community Medicine, Tufts University School of Medicine, Boston, United StatesIndiana Department of Health, United StatesIndiana Department of Health, United StatesCenters for Disease Control and Prevention, United StatesCouncil of State and Territorial Epidemiologists, United StatesDepartment of Public Health and Community Medicine, Tufts University School of Medicine, Boston, United States; Corresponding author at: Department of Public Health and Community Medicine, Clinical and Translational Science, Institute Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, United States.The objective of this initiative was to conduct a comprehensive opioid overdose vulnerability assessment in Indiana and evaluate spatial accessibility to opioid use disorder treatment, harm reduction services, and opioid response programs. We compiled 2017 county-level (n = 92) data on opioid-related and socioeconomic indicators from publicly available state and federal sources. First, we assessed the spatial distribution of opioid-related indicators in a geographic information system (GIS). Next, we used a novel regression-weighted ranking approach with mean standardized covariates and an opioid-involved overdose mortality outcome to calculate county-level vulnerability scores. Finally, we examined accessibility to opioid use disorder treatment services and opioid response programs at the census tract-level (n = 1511) using two-step floating catchment area analysis. Opioid-related emergency department visit rate, opioid-related arrest rate, chronic hepatitis C virus infection rate, opioid prescription rate, unemployment rate, and percent of female-led households were independently and positively associated with opioid-involved overdose mortality (p < 0.05). We identified high-risk counties across the rural–urban continuum and primarily in east central Indiana. We found that only one of the 19 most vulnerable counties was in the top quintile for treatment services and had naloxone provider accessibility in all of its census tracts. Findings from our vulnerability assessment provide local-level context and evidence to support and inform future public health policies and targeted interventions in Indiana in areas with high opioid overdose vulnerability and low service accessibility. Our approach can be replicated in other state and local public health jurisdictions to assess opioid-involved public health vulnerabilities.http://www.sciencedirect.com/science/article/pii/S221133552100228XOpioid vulnerability assessmentOpioid-involved overdoseGeographical information systemIndianaTwo-step floating catchment area analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jared L. Sawyer Shikhar Shrestha Jennifer C. Pustz Robert Gottlieb Deborah Nichols Michelle Van Handel Cailyn Lingwall Thomas J. Stopka |
spellingShingle |
Jared L. Sawyer Shikhar Shrestha Jennifer C. Pustz Robert Gottlieb Deborah Nichols Michelle Van Handel Cailyn Lingwall Thomas J. Stopka Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017 Preventive Medicine Reports Opioid vulnerability assessment Opioid-involved overdose Geographical information system Indiana Two-step floating catchment area analysis |
author_facet |
Jared L. Sawyer Shikhar Shrestha Jennifer C. Pustz Robert Gottlieb Deborah Nichols Michelle Van Handel Cailyn Lingwall Thomas J. Stopka |
author_sort |
Jared L. Sawyer |
title |
Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017 |
title_short |
Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017 |
title_full |
Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017 |
title_fullStr |
Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017 |
title_full_unstemmed |
Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017 |
title_sort |
characterizing opioid-involved overdose risk in local communities: an opioid overdose vulnerability assessment across indiana, 2017 |
publisher |
Elsevier |
series |
Preventive Medicine Reports |
issn |
2211-3355 |
publishDate |
2021-12-01 |
description |
The objective of this initiative was to conduct a comprehensive opioid overdose vulnerability assessment in Indiana and evaluate spatial accessibility to opioid use disorder treatment, harm reduction services, and opioid response programs. We compiled 2017 county-level (n = 92) data on opioid-related and socioeconomic indicators from publicly available state and federal sources. First, we assessed the spatial distribution of opioid-related indicators in a geographic information system (GIS). Next, we used a novel regression-weighted ranking approach with mean standardized covariates and an opioid-involved overdose mortality outcome to calculate county-level vulnerability scores. Finally, we examined accessibility to opioid use disorder treatment services and opioid response programs at the census tract-level (n = 1511) using two-step floating catchment area analysis. Opioid-related emergency department visit rate, opioid-related arrest rate, chronic hepatitis C virus infection rate, opioid prescription rate, unemployment rate, and percent of female-led households were independently and positively associated with opioid-involved overdose mortality (p < 0.05). We identified high-risk counties across the rural–urban continuum and primarily in east central Indiana. We found that only one of the 19 most vulnerable counties was in the top quintile for treatment services and had naloxone provider accessibility in all of its census tracts. Findings from our vulnerability assessment provide local-level context and evidence to support and inform future public health policies and targeted interventions in Indiana in areas with high opioid overdose vulnerability and low service accessibility. Our approach can be replicated in other state and local public health jurisdictions to assess opioid-involved public health vulnerabilities. |
topic |
Opioid vulnerability assessment Opioid-involved overdose Geographical information system Indiana Two-step floating catchment area analysis |
url |
http://www.sciencedirect.com/science/article/pii/S221133552100228X |
work_keys_str_mv |
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