Objectives. We examined whether neighborhood
social characteristics (income distribution and family fragmentation) and
physical characteristics (clean sidewalks and dilapidated housing) were
associated with the risk of fatalities caused by analgesic overdose.
Methods. In a case-control study, we compared
447 unintentional analgesic opioid overdose fatalities (cases) with 3436
unintentional nonoverdose fatalities and 2530 heroin overdose fatalities
(controls) occurring in 59 New York City neighborhoods between 2000 and 2006.
Results. Analgesic overdose fatalities were less
likely than nonoverdose unintentional fatalities to have occurred in
higher-income neighborhoods (odds ratio [OR] = 0.82; 95% confidence interval
[CI] = 0.70, 0.96) and more likely to have occurred in fragmented neighborhoods
(OR = 1.35; 95% CI = 1.05, 1.72). They were more likely than heroin overdose
fatalities to have occurred in higher-income (OR = 1.31; 95% CI = 1.12, 1.54)
and less fragmented (OR = 0.71; 95% CI = 0.55, 0.92) neighborhoods.
Conclusions. Analgesic overdose fatalities
exhibit spatial patterns that are distinct from those of heroin and nonoverdose
unintentional fatalities. Whereas analgesic fatalities typically occur in
lower-income, more fragmented neighborhoods than nonoverdose fatalities, they
tend to occur in higher-income, less unequal, and less fragmented neighborhoods
than heroin fatalities.
Full article at:
By: 
Yusuf Ransome, MS, Katherine M. Keyes, PhD, Karestan C. Koenen, PhD, Kenneth Tardiff, MD, David Vlahov, RN, PhD, and Sandro Galea, MD, DrPH
Yusuf Ransome, MS, Katherine M. Keyes, PhD, Karestan C. Koenen, PhD, Kenneth Tardiff, MD, David Vlahov, RN, PhD, and Sandro Galea, MD, DrPH
Magdalena Cerdá,
Katherine M. Keyes, Karestan C. Koenen and Sandro Galea are with the Department
of Epidemiology, Columbia University Mailman School of Public Health, New York,
NY. Yusuf Ransome is with the Department of Sociomedical Sciences, Columbia
University Mailman School of Public Health. Kenneth Tardiff is with the
Department of Psychiatry, Weill Cornell Medical College, New York, NY. David
Vlahov is with the School of Nursing, University of California, San Francisco.
Corresponding
author.
Correspondence should be sent to Magdalena Cerdá, DrPH, MPH,
Department of Epidemiology, Columbia University Mailman School of Public
Health, 722 W168th St, Room 527, New York, NY 10032 (e-mail: ude.aibmuloc@6223cm). Reprints can be ordered at http://www.ajph.org by clicking on the “Reprints” link.
Peer Reviewed
Contributors
M. Cerdá designed the analysis, conducted the literature
review, and wrote the article. Y. Ransome collaborated on the design of the
analysis, implemented the analysis, and provided input on the article. K. M.
Keyes and K. C. Koenen collaborated on the analysis plan and literature review
and substantially edited all sections of the article. K. Tardiff and D. Vlahov
collaborated on the design and implementation of the study and edited all
sections of the article. S. Galea collaborated on the design and implementation
of the study, as well as on the design of the analysis, and substantially
edited all sections of the article.
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