scholarly journals Opioid Overdose in Ohio: Comprehensive Analysis of Associated Socioeconomic Factors

2019 ◽  
Author(s):  
Chihyun Park ◽  
Sara Crawford ◽  
Rocio Lopez ◽  
Anna Seballos ◽  
Jean R. Clemenceau ◽  
...  
Keyword(s):  
Socioeconomic Factors ◽  
Census Tract ◽  
Rural Areas ◽  
Urban Areas ◽  
Death Rate ◽  
Opioid Overdose ◽  
Death Rates ◽  
Census Tracts ◽  
Socioeconomic Characteristics ◽  
Census Tract Level

ABSTRACTObjectiveOur study focused on identifying socioeconomic factors associated with death by opioid overdose in Ohio communities at the census tract level.Materials and MethodsA large-scale vital statistic dataset from Ohio Department of Health (ODH) and U.S. Census datasets were used to obtain opioid-related death rate and socioeconomic characteristics for all census tracts in Ohio. Regression analysis was performed to identify the relationships between socioeconomic factors of census tracts and the opioid-related death rate for both urban and rural tracts.ResultsIn Ohio from 2010-2016, whites, males, and people aged 25-44 had the highest opioid-related death rates. At the census tract level, higher death rates were associated with certain socioeconomic characteristics (e.g. percentage of the census tract population living in urban areas, percentage divorced/separated, percentage of vacant housing units). Predominately rural areas had a different population composition than urban areas, and death rates in rural areas exhibited fewer associations with socioeconomic characteristics.DiscussionPredictive models of opioid-related death rates based on census tract-level characteristics held for urban areas more than rural ones, reflecting the recently observed rural-to-urban geographic shift in opioid-related deaths. Future research is needed to examine the geographic distribution of opioid abuse throughout Ohio and in other states.ConclusionRegression analysis identified associations between population characteristics and opioid-related death rates of Ohio census tracts. These analyses can help government officials and law official workers prevent, predict and combat opioid abuse at the community level.

The Impact of Variation in Trauma Care Times: Urban versus Rural

1995 ◽  
Vol 10 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Thomas J. Esposito ◽  
Ronald V. Maier ◽  
Frederick P. Rivara ◽  
Susan Pilcher ◽  
Janet Griffith ◽  
...  
Keyword(s):  
Trauma Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Death Rate ◽  
Motor Vehicle ◽  
Preventable Death ◽  
Retrospective Case ◽  
Death Rates ◽  
Physician Contact ◽  
The Impact

AbstractStudy Objectives:To document the existence and nature of variation in times to trauma care between urban and rural locations; to assess the impact of identified variations on outcome.Design:Retrospective case reviewSetting:Washington state, 1986Participants:Motor-vehicle-collision fatalitiesMethods:Previously unreported definitions of urban and rural location and possibly preventable death were used to conduct a comparative analysis of urban and rural fatalities. Trauma care times in the prehospital and the emergency department (ED) phases of care were abstracted. Their relationships to corresponding crude death rates and possibly preventable death rates also were examined.Results:Prehospital times averaged two times longer in rural locations than in urban areas. First-physician contact in the ED averaged six times longer in rural locations than in urban settings. Concomitantly, the crude death rate in rural settings was three times that of the urban areas. The overall possibly preventable death rate was double the urban rates in rural incidents. When stratified by phase of care, rate of possibly preventable death showed no urban/rural variation for the prehospital phase, but was three times greater for the ED phase in rural areas than in urban ones.Conclusions:Trauma care times and adverse outcome appear to be associated. Allocation of resources to decrease length of and geographic variation in time to definitive care, particularly in the ED phase, seems appropriate.

Abstract P873: Structural Racism in Columbus, Ohio Associated With Stroke Prevalence

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Jeffrey J Wing ◽  
Emily E Lynch ◽  
Sarah E Laurent ◽  
Bruce C Mitchell ◽  
Jason Richardson ◽  
...  
Keyword(s):  
Census Tract ◽  
Sociodemographic Factors ◽  
Structural Racism ◽  
Stroke Outcomes ◽  
Census Tracts ◽  
Census Tract Level ◽  
Stroke Prevalence ◽  
Level Information ◽  
Fundamental Cause ◽  
Loan Corporation

Introduction: Racial disparities exist in stroke and stroke outcomes. However, the fundamental cause for these disparities are not biological differences, but structural racism. Using the Home Owners’ Loan Corporation (HOLC) ‘redlining’ scores, as indicator of structural lending practices from middle of the last century, we hypothesize that census tracts with high historic redlining are associated with higher stroke prevalence. Methods: Weighted historic redlining scores (HRS) were calculated using the proportion of 1930s HOLC residential security grades contained within 2010 census tract boundaries of Columbus, Ohio. Stroke prevalence (adults >=18) was obtained at the census tract-level from the CDC’s 500 Cities Project. Sociodemographic factors, as measured by census tract level information (American Community Survey 2014-2018), were considered mediators in the causal association between historic redlining (measured in 1936) and stroke prevalence (measured in 2017) and were not controlled for in regression analysis. The functional form of the association was non-linear, so stroke prevalence within quartiles of the HRS were compared using linear regression instead of a continuous score. Results: Higher HRS, representing greater redlining, were associated with greater prevalence of stroke when comparing the highest to the lowest quartile of HRS (Figure). Census tracts in the highest quartile of HRS had 1.48% higher stroke prevalence compared to those in the lowest quartile (95% CI: 0.23-2.74). No other interquartile differences were observed. Conclusions: Historic redlining practices are a form of structural racism that established geographic systems of disadvantage and consequently, poor health outcomes. Our findings demonstrate disparate stroke prevalence by degree of historic redlining in census tracts across Columbus, Ohio. While ecologic, this study demonstrates the need to acknowledge that racism, not race, drive stroke disparities.

scholarly journals Description of a pharmacist-led clinical video telehealth group clinic for opioid overdose prevention and naloxone education

2019 ◽  
Vol 9 (4) ◽  
pp. 294-297
Author(s):  
Aimee N. Jensen ◽  
Candace M. Beam ◽  
Amber R. Douglass ◽  
Jennifer E. Brabson ◽  
Michelle Colvard ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Rural Areas ◽  
Urban Areas ◽  
Patient Specific ◽  
Opioid Overdose ◽  
Overdose Prevention ◽  
Innovative Practice ◽  
Risk Patients ◽  
Urban And Rural Areas

Abstract To achieve the nationwide goal of reducing opioid-related deaths, a clinical pharmacy specialist–led clinical video telehealth (CVT) clinic was created at a Veterans Affairs medical center (VAMC) to deliver opioid overdose prevention and naloxone education to at-risk patients. The purpose of this innovative practice was to improve access to this potentially life-saving intervention to patients across urban and rural areas. This study is a single-center, descriptive analysis of adult patients across 2 VAMC campuses and 4 community-based outpatient clinics from July 11, 2016, through December 31, 2016. The purpose of this innovative practice was to increase access to overdose education and naloxone distribution (OEND) to at-risk patients across urban and rural areas. Patient-specific factors were also examined among those receiving naloxone through the CVT clinic compared to other prescribers. During the first 6 months from the initiation of the clinic, 1 pharmacist prescribed 21% of the health care system's naloxone. These patients identified by the pharmacist-led CVT clinic were more likely to be considered high-risk due to concomitant use of opioids and benzodiazepines. In conclusion, the pharmacist-led CVT group clinic has been an efficient strategy to extend OEND services to high-risk patients beyond central, urban areas.

scholarly journals Poverty: socioeconomic characterization at tuberculosis

2007 ◽  
Vol 15 (spe) ◽  
pp. 762-767 ◽  
Author(s):  
Maria de Lourdes Sperli Geraldes Santos ◽  
Silvia Helena Figueiredo Vendramini ◽  
Claudia Eli Gazetta ◽  
Sonia Aparecida Cruz Oliveira ◽  
Tereza Cristina Scatena Villa
Keyword(s):  
Socioeconomic Factors ◽  
Incidence Rate ◽  
Total Variation ◽  
Social Factors ◽  
Incidence Rates ◽  
Disease Prevalence ◽  
Socioeconomic Factor ◽  
Census Tracts ◽  
Socioeconomic Characteristics ◽  
The City

This study aimed to evaluate the epidemiological status of Tuberculosis regarding to the socioeconomic characteristics of São José do Rio Preto between 1998 and 2004. Indexes estimated for 432 urban census tracts from the demographic census of 2000, sorted systematically according to the values of socioeconomic factors and grouped into quartiles were taken into account. The socioeconomic characterization was outlined based on Schooling, Income, and Number of Residents. The incidence rates were considered for 1998, 1999, 2003, and 2004. The socioeconomic factor accounted for 87% of the total variation. The disease prevalence is higher in the poorest areas. The incidence rate and the risk of being infected by TB in the poorest areas declined in 2003 and 2004. The results confirm that TB is determined by the population's living conditions in the city studied. It strengthens the relevance of understanding the TB conditional social factors to transform the worrisome scenario in which this population is inserted.

scholarly journals Thematic Maps of the Impact of Urbanization and Socioeconomic Factors on the Distribution of the Incidence of Cutaneous Leishmaniasis Cases in Sefrou Province, Central North of Morocco (2007–2011)

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Fatima Zahra Talbi ◽  
Nordine Nouayti ◽  
Hajar El Omari ◽  
Mohamed Najy ◽  
Khadija Lahouiti ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Socioeconomic Factors ◽  
Cutaneous Leishmaniasis ◽  
Rural Areas ◽  
Urban Areas ◽  
Pearson Correlation ◽  
Correlation Study ◽  
Poverty Rate ◽  
Impact Of Urbanization ◽  
The Impact

Background. Leishmaniases are vector-borne diseases with health risks. They cause a big health problem. These parasitic diseases are transmitted by the parasite of the genus Leishmania through sandflies. Objective. The aim of this work is to study the distribution of the incidence of cutaneous leishmaniasis (CL) cases and the impact of urbanization and socioeconomic factors and their effects as leishmaniasis risk factors. Methods. We conducted a retrospective study of CL cases collected at the level of Sefrou Province during the period from 2007 to 2011. The data was collected from registers of the Medical Delegation of Sefrou Province. The socioeconomic data, namely, the poverty rate, the popular density, and the type of environment (urban/rural) of Sefrou Province, were obtained from the High Commission for Planning. Statistical analysis was performed by SPSS software (version 20). The data were registered in a Microsoft Excel 2010 file. Statistical analysis was based on one-way analysis of variance (ANOVA), and then a correlation study was carried out (Pearson correlation). The results were considered significant when p was less than 0.05. The database was analyzed by QGIS 2.18, which is open source software. Results. A total of 349 cases of CL were collected at Sefrou Province from 2007 to 2011. A percentage of 49% of the cases come from urban areas, while 51% of the cases come from rural areas. In the statistical analysis, the division of the incidence of CL cases was found to be significantly associated only with urbanization. For the other factors, the number of people or the poverty rate is not taken into account in the incidence dynamics. Conclusion. This study may be useful for the implementation of future adequate measures and controls. Getting rid of leishmaniasis requires a comprehensive approach by acting on the sources of contamination through good continuous surveillance, appropriate management, effective vector control, and awareness-raising strategies.

Demographic and socioeconomic factors affecting infant mortality in Egypt

1990 ◽  
Vol 22 (4) ◽  
pp. 447-451 ◽  
Author(s):  
Hassan Y. Aly
Keyword(s):  
Infant Mortality ◽  
Socioeconomic Factors ◽  
Rural Areas ◽  
Urban Areas ◽  
Factors Affecting ◽  
Rural And Urban Areas ◽  
Positive Effects ◽  
Rural And Urban ◽  
Reduce Infant Mortality ◽  
Nationally Representative

SummaryThis paper analyses the relative importance of demographic and socioeconomic factors with respect to their role in reducing infant mortality in Egypt.Logit analyses of data from a nationally representative sample of Egyptian households, and for urban and rural households separately, indicate that demographic factors have more effect on infant mortality than socioeconomic factors. The results also show the need to improve housing in urban areas and sewerage systems in rural areas in order to reduce infant mortality. One of the most important policy conclusions, however, concerns the importance of providing a vigorous educational campaign to enlighten mothers and prospective mothers in both rural and urban areas on the positive effects of breast-feeding, longer birth intervals, and fewer children on the survival of infants.

Urban environmental degradation and the standard of living: the case of the Spanish mining industry (1870–1930)

2015 ◽  
Vol 30 (3) ◽  
pp. 395-421
Author(s):  
ANTONIO ESCUDERO ◽  
MIGUEL Á. PÉREZ DE PERCEVAL ◽  
ANDRÉS SÁNCHEZ-PICÓN
Keyword(s):  
Environmental Degradation ◽  
Rural Areas ◽  
Urban Areas ◽  
Death Rate ◽  
Mining Industry ◽  
Well Being ◽  
Standard Of Living ◽  
Mountain Range ◽  
Market Failures ◽  
Mining Areas

ABSTRACTThis paper analyses the consequences of urban environmental degradation on the well-being of Spanish miners. It is based on analyses of differences in mortality and height. The first part of the paper examines new hypotheses regarding the urban penalty. We take into consideration existing works in economic theory that address market failures when analysing the higher urban death rate. We explain the reduction in height using the model recently created by Floud, Fogel, Harris and Hong for British cities. The second part of the paper presents information demonstrating that the urban areas in the two largest mining areas in Spain (Bilbao and the Cartagena-La Unión mountain range) experienced a higher death rate relative to rural areas as a consequence of market failures derived from what we term an ‘anarchic urbanisation’.

scholarly journals Socioeconomic Determinants of Malaria in Selected Urban and Rural Areas in Anambra State, Nigeria

2020 ◽  
pp. 53-64
Author(s):  
C. C. Nduka ◽  
H. N. Chineke ◽  
P. O. Adogu ◽  
A. F. Chizoba
Keyword(s):  
Socioeconomic Factors ◽  
Rural Areas ◽  
Urban Areas ◽  
Control Measures ◽  
Health Concern ◽  
Skilled Workers ◽  
Quality Health Care ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban

Malaria, a disease of poverty, is of significant public health concern. It is endemic in Nigeria with the risk of transmission appearing to be high because of favorable climatic and environmental factors. Increased susceptibility to malaria has also been linked to dirty surroundings that favor the breeding and propagation of the vector, poor access to quality health care and ignorance especially of malaria prevention strategies. However, this study investigated the role of socioeconomic factors responsible for the observed difference in malaria prevalence between selected rural and urban areas of Anambra, Nigeria. A descriptive comparative cross-sectional study, data on demographic and socioeconomic variables were collected from 202 urban and rural respondents, then analyzed using SPSS platform to generate chi-square test of significance. The results were presented in figures, table and charts for clarity. All the subjects were aware of the term malaria but only 63.4% had adequate specific knowledge of malaria. Generally, 25.7% of rural participants had no formal education while the urban group had only 4% of that particular category. About 52.5% of rural participants earned below 50,000 naira monthly, with 14.9% earning above 100,000 naira while the reverse was the case in the urban area. Also, the number of malaria episodes was inversely proportional to the household monthly income (X2=24.30, p<0.001). More episodes of malaria were also reported among the unskilled workers and skilled workers (71.3%) compared to Professionals (28.7%), yet all the participants reported the presence of a healthcare facility <3km from their houses with 95% and 80.2% of them in the rural and urban areas respectively having to pay out-of-pocket for healthcare services. It is clear that socioeconomic factors play a role in the persistence of malaria as an endemic disease in Nigeria. Therefore, existing control measures should incorporate strategies to end poverty and ignorance especially among the rural populace.

scholarly journals Demographic Disparities in Proximity to Certified Stroke Care in the United States

Stroke ◽  
2021 ◽  
Author(s):  
Cathy Y. Yu ◽  
Timothy Blaine ◽  
Peter D. Panagos ◽  
Akash P. Kansagra
Keyword(s):  
United States ◽  
American Indian ◽  
Census Tract ◽  
Urban Areas ◽  
Stroke Care ◽  
The United States ◽  
Median Income ◽  
Census Tracts ◽  
Median Distance ◽  
Stroke Center

Background and Purpose: Demographic disparities in proximity to stroke care influence time to treatment and clinical outcome but remain understudied at the national level. This study quantifies the relationship between distance to the nearest certified stroke hospital and census-derived demographics. Methods: This cross-sectional study included population data by census tract from the United States Census Bureau’s 2014–2018 American Community Survey, stroke hospitals certified by a state or national body and providing intravenous thrombolysis, and geographic data from a public mapping service. Data were retrieved from March to November 2020. Quantile regression analysis was used to compare relationships between road distance to the nearest stroke center for each census tract and tract-level demographics of age, race, ethnicity, medical insurance status, median annual income, and population density. Results: Two thousand three hundred eighty-eight stroke centers and 71 929 census tracts including 316 995 649 individuals were included. Forty-nine thousand nine hundred eighteen (69%) tracts were urban. Demographic disparities in proximity to certified stroke care were greater in nonurban areas than urban areas. Higher representation of individuals with age ≥65 years was associated with increased median distance to a certified stroke center in nonurban areas (0.51 km per 1% increase [99.9% CI, 0.42–0.59]) but not in urban areas (0.00 km [−0.01 to 0.01]). In urban and nonurban tracts, median distance was greater with higher representation of American Indian (urban: 0.10 km per 1% increase [0.06–0.14]; nonurban: 1.06 km [0.98–1.13]) or uninsured populations (0.02 km [0.00–0.03]; 0.27 km [0.15–0.38]). Each $10 000 increase in median income was associated with a decrease in median distance of 5.04 km [4.31–5.78] in nonurban tracts, and an increase of 0.17 km [0.10–0.23] in urban tracts. Conclusions: Disparities were greater in nonurban areas than in urban areas. Nonurban census tracts with greater representation of elderly, American Indian, or uninsured people, or low median income were substantially more distant from certified stroke care.

scholarly journals 2325. Relationship Between Neighborhood Census-Tract-Level Poverty and Respiratory Syncytial Virus Infection in hospitalized Adults in the San Francisco Bay area, CA 2015–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S798-S798
Author(s):  
Jenna Holmen ◽  
Bryanna Cikesh ◽  
Lindsay Kim ◽  
Art Reingold
Keyword(s):  
Respiratory Syncytial Virus ◽  
San Francisco ◽  
Census Tract ◽  
San Francisco Bay ◽  
San Francisco Bay Area ◽  
Poverty Level ◽  
Census Tracts ◽  
Bay Area ◽  
Census Tract Level ◽  
Syncytial Virus

Abstract Background In the United States, respiratory syncytial virus (RSV) is a leading cause of admission for adults with respiratory illness. In adults > 50 years of age, it accounts for up to 12% of medically-attended acute respiratory illnesses and has a case fatality proportion of ~6–8%. Poverty can have an important influence on health. Few studies have evaluated the relationship of RSV incidence and poverty level, and no identified studies have evaluated this relationship among adults. We evaluated the incidence of RSV-associated hospitalizations in adults in the San Francisco Bay Area, CA by census-tract-level poverty. Methods Medical record data abstraction was conducted for all adults with a laboratory-confirmed RSV infection who were admitted to a hospital within the 3 counties comprising the catchment area (Alameda, Contra Costa, and San Francisco counties) during the 2015–2016 and 2016–2017 RSV seasons. Patient addresses were geocoded to their corresponding census-tract (CT). Census tracts were divided into four levels of poverty based on American Community Survey data of percentage of people living below the poverty level: 0–4.9%, 5–9.9%, 10-–9.9%, and ³20%. Incidence rates were calculated by dividing the number of RSV cases in each CT poverty-level (numerator) by the number of adults living in each CT poverty level (denominator), as determined from the 2010 US census, and standardized for age. Results There were 526 RSV case-patients with demographic characteristics as outlined in Table 1. The highest incidence of RSV-associated hospitalization was in CTs associated with the highest levels of poverty (>20%). However, the second highest incidence of RSV-associated hospitalization occurred among adults living in CTs with <5% poverty (Figure 1 and Table 2). Conclusion The incidence rate of RSV-associated hospitalization in adults appears to be positively correlated with highest census-tract level of poverty; however, there is a high incidence among adults living in the lowest poverty census-tracts. Disclosures All authors: No reported disclosures.

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