scholarly journals Variation in US Drug Overdose Mortality Within and Between Hispanic/Latine Subgroups: A Disaggregation of National Data

2022 ◽  
Author(s):  
Manuel Cano ◽  
Camila Gelpi-Acosta
Keyword(s):  
Educational Attainment ◽  
Puerto Rican ◽  
Drug Overdose ◽  
Puerto Ricans ◽  
Mortality Rates ◽  
Mortality Data ◽  
The Us ◽  
Rate Ratios ◽  
Overdose Mortality ◽  
The Relationship

This study examined differences across Latine heritage groups (i.e., Mexican, Puerto Rican, Cuban, Dominican, Central American, South American) in rates of US drug overdose mortality. The study utilized 2015-2019 mortality data from the National Center for Health Statistics for 29,137 Hispanic individuals who died of drug overdose. Using population estimates from the American Community Survey, age-standardized drug overdose mortality rates were calculated by specific Latine heritage and sex, nativity, educational attainment, and geographic region. Standardized rate ratios (SRRs), incidence rate ratios (IRRs) from negative binomial regression models, and 95% Confidence Intervals (CIs) were calculated, and multiple imputation was used for missing Latine heritage group in select models. Drug overdose mortality rates in the Puerto Rican heritage population were more than three times as high as in the Mexican heritage population (IRR 3.61 [95% CI 3.02-4.30] in unadjusted model; IRR 3.70 [95% CI 3.31-4.15] in model adjusting for age, sex, nativity, educational attainment, and region; SRR 3.23 [95% CI, 3.15-3.32] in age-standardized model with missing Hispanic heritage imputed). Higher age-standardized rates of drug overdose mortality were observed in males than females across all Latine groups, yet the magnitude of the sex differential varied by Latine heritage. The relationship between drug overdose mortality and nativity differed by Latine heritage; in all groups except Puerto Rican, overdose mortality rates were significantly higher in the US-born than those not US-born. In contrast, overdose mortality rates were significantly lower in US-born Puerto Ricans than in Puerto Ricans who were not US-born (e.g., born in Puerto Rico; SRR, 0.84 [95% CI 0.80-0.88]). The relationship between drug overdose mortality and educational attainment (for ages 25+) also varied between Latine groups. The diverse subgroups comprising the US Latine population vary not only in rates of drug overdose mortality, but also in demographic risk factors for fatal drug overdose.

Structural and Interpersonal Violence Among Puerto Rican Drug Users

2003 ◽  
Vol 25 (3) ◽  
pp. 28-31 ◽  
Author(s):  
Michael Duke ◽  
Wei Teng ◽  
Janie Simmons ◽  
Merrill Singer
Keyword(s):  
Life History ◽  
Lived Experience ◽  
Puerto Rican ◽  
Interpersonal Violence ◽  
Drug Users ◽  
Ethical Issues ◽  
Puerto Ricans ◽  
The Us ◽  
The Usa ◽  
The Relationship

The lives of Puerto Rican street drug users living on the US mainland are structured by addiction and violence. For some, drugs act as a palliative against the trauma of being exposed to extreme physical or emotional harm. For others, the effects of structural oppression, coupled with the cruel logic of addiction, situates violence just below the surface of lived experience (Singer 1996). This paper will explore the relationship between exposure to violence and drug using behaviors, as well as the degree to which violence becomes a byproduct of those behaviors. Drawing from life history interviews and survey data of drug users in Hartford, Connecticut, we will discuss the ways in which addiction, violent upbringings, and the ruthlessness of narco-capitalism-each operating within the context of Puerto Ricans' status as a colonized people vis a vis the USA-create an atmosphere in which violence becomes a near inevitable part of everyday life. We will also briefly address the complex ethical issues involved in studying violence.

scholarly journals Drug Overdose Trends among Black Indiana Residents: 2013-2017

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Raven Helmick
Keyword(s):  
Mortality Rate ◽  
Drug Overdose ◽  
Rate Increase ◽  
Mortality Rates ◽  
Time Frame ◽  
Minority Population ◽  
Racial Inequalities ◽  
Specific Mortality ◽  
Overdose Mortality ◽  
Overdose Deaths

ObjectiveTo understand trends in race-specific mortality rates between blacks and whites to discover any racial inequalities that might exist for drug overdose deaths. To delve into the types of drugs that are prominently involved in black drug overdose deaths from 2013-2017 in the state of Indiana.IntroductionBlack Hoosiers, the largest minority population in Indiana, make up almost 10% of the state’s population, and accounted for 8% of the total resident drug overdose deaths from 2013-2017 compared to whites at 91%. However, a closer look at race-specific mortality rates might reveal racial inequalities. Therefore, the purpose of this project was to analyze drug overdose morality rates among white and black Hoosiers to discover possible racial inequalities and to discover trends in drug involvement in overdose deaths among blacks.MethodsDrug overdose deaths that occurred in Indiana between 2013 and 2017 were identified using the underlying and contributing cause of death ICD-10 codes and abstracted from the Indiana State Department of Health’s annual finalized mortality dataset. Race-specific drug overdose death rates were calculated and compared among racial groups. Drug overdose deaths in blacks were examined for trends over time and by the types of drugs involved.ResultsBetween 2013 and 2017, drug overdose mortality rates for whites increased from 17.05 to 27.28 per 100,000. Blacks saw a higher rate increase during this same time frame: from 10.74 to 30.62 per 100,000, surpassing the mortality rate of whites by the end of 2017. Drug overdose deaths in blacks increased 197% from 2013-2017 and drug specific mortality rate increases were seen across all drug category’s. Opioids, which were involved in 61% of the 2017 drug overdose deaths among blacks, had a rate increase from 3.05 to 18.62 per 100,000 between 2013 and 2017. Drug specific overdose mortality rate increases were also seen for overdoses involving cocaine (1.76 to 10.62 per 100,000), benzodiazepines (0.32 to 3.08 per 100,000), and psychostimulants other than cocaine (0.16 to 1.69 per 100,000) such as amphetamines.ConclusionsWhile white Hoosiers had higher drug overdose mortality rates between 2013 and 2016, black Hoosiers had a greater mortality rate increase and surpassed the mortality rate in whites in 2017. Opioids, the most frequently involved substance in overdose deaths among blacks from 2013-2017, showed increasing rates during this time period. However, increases in drug specific overdose mortality rates for cocaine, benzodiazepines, and psychostimulants other than cocaine also call for public health attention. These results promote the inclusion of minority health experts in drug overdose prevention efforts and issue a call for future prevention efforts to be targeted toward the state’s largest minority population. 

scholarly journals Opioid Epidemic in the United States: Empirical Trends, and A Literature Review of Social Determinants and Epidemiological, Pain Management, and Treatment Patterns

2019 ◽  
Vol 8 (2) ◽  
pp. 89-100 ◽  
Author(s):  
Gopal K Singh ◽  
Isaac E. Kim, Jr. ◽  
Mehrete Girmay ◽  
Chrisp Perry ◽  
Gem P. Daus ◽  
...  
Keyword(s):  
Pain Management ◽  
Social Determinants ◽  
Drug Overdose ◽  
The United States ◽  
Opioid Epidemic ◽  
The Us ◽  
Drug Overdoses ◽  
Race Ethnicity ◽  
Overdose Mortality ◽  
Racial Ethnic

Objectives: Dramatic increases in opioid and drug overdose mortality have occurred in the United States (US) over the past two decades. To address this national public health crisis and identify gaps in the literature, we analyzed recent empirical trends in US drug overdose mortality by key social determinants and conducted a selective review of the recent literature on the magnitude of the opioid crisis facing different racial/ethnic, socioeconomic, and rural-urban segments of the US population. Methods: We used the 1999-2017 mortality data from the US National Vital Statistics System to analyze trends in drug overdose mortality by race/ethnicity, age, and geographic area. Log-linear regression was used to model mortality trends. Using various key words and their combinations, we searched PubMed and Google Scholar for select peerreviewed journal articles and government reports published on the opioid epidemic between 2010 and 2018. Results: Our original analysis and review indicate marked increases in drug overdose mortality overall and by race/ethnicity and geographic regions, with adolescents and young adults experiencing steep increases in mortality between 1999 and 2017. Our selective search yielded 405 articles, of which 39 publications were selected for detailed review. Suicide mortality from drug overdose among teens aged 12-19 increased consistently between 2009 and 2017, particularly among teen girls. The rise of efficient global supply chains has increased opioid prescription use and undoubtedly contributed to the opioid epidemic. Many other important contributing factors to the epidemic include lack of education and economic opportunities, poor working conditions, and low social capital in disadvantaged communities. Conclusions and Global Health Implications: Our analysis and review indicate substantial disparities in drug overdoses and related mortality, pain management, and treatment outcomes according to social determinants. Increases in drug overdoses and resultant mortality are not only unique to the US, but have also been observed in other industrialized countries. Healthcare systems, community leaders, and policymakers addressing the opioidepidemic should focus on upstream structural factors including education, economic opportunity, social cohesion, racial/ethnic disadvantage, geographic isolation, and life satisfaction. Key words: • Opioids • Drug overdose • Mortality • Pain management • Treatment • Race/Ethnicity • Social determinants • Health disparities Copyright © 2019 Singh et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Politics of Status

2020 ◽  
pp. 34-53
Author(s):  
Amílcar Antonio Barreto
Keyword(s):  
Puerto Rico ◽  
Puerto Rican ◽  
Political Party ◽  
Party System ◽  
Puerto Ricans ◽  
The United States ◽  
State Of The Union ◽  
The Us ◽  
The Status ◽  
Political Party System

Puerto Ricans, US subjects since 1898, were naturalized en masse in 1917. Congress did so to eliminate the possibility of independence from the US. That citizenship is the cornerstone of island-mainland relations for those advocating a continued relationship with the United States—either in the form of the 1952 Commonwealth constitution or statehood. The epicenter of Puerto Rican partisan life remains the status question. This remarkably stable political party system featured two strong parties of near-equal strength—the pro-Commonwealth PPD and its statehood challenger, the PNP— and a small independence party, the PIP. A core feature of the PNP’s platform has been estadidad jíbara—"creole statehood.” In theory, a future State of Puerto Rico would be allowed to retain its cultural and linguistic autonomy while attaining full membership as the 51st state of the Union.

scholarly journals Exploring Drug Overdose Mortality Data in Harris County, Texas

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Eric V. Bakota ◽  
Deborah Bujnowski ◽  
Larissa Singletary ◽  
Sherry Onyiego ◽  
NAdia Hakim ◽  
...  
Keyword(s):  
Public Health ◽  
Substance Abuse ◽  
Drug Overdose ◽  
The United States ◽  
Mortality Data ◽  
Harris County ◽  
Death Rates ◽  
Overdose Death ◽  
The Past ◽  
Overdose Mortality

ObjectiveIn this session, we will explore the results of a descriptive analysis of all drug overdose mortality data collected by the Harris County Medical Examiner's Office and how that data can be used to inform public health action.IntroductionDrug overdose mortality is a growing problem in the United States. In 2017 alone over 72,000 deaths were attributed to drug overdose, most of which were caused by fentanyl and fentanyl analogs (synthetic opioids)1. While nearly every community has seen an increase in drug overdose, there is considerable variation in the degree of increase in specific communities. The Harris County community, which includes the City of Houston, has not seen the massive spikes observed in some communities, such as West Virginia, Kentucky, and Ohio. However, the situation in Harris County is complicated in mortality and drug use. From 2010 - 2016 Harris County has seen a fairly stable overdose-related mortality count, ranging from 450 - 618 deaths per year. Of concern, the last two years, 2015-2016, suggest a sharp increase has occurred. Another complexity is that Harris County drug related deaths seem to be largely from polysubstance abuse. Deaths attributed to cocaine, methamphetamine, and benzodiazipine all have risen in the past few years. Deaths associated with methamphetamine have risen from approximately 20 per year in 2010 - 2012 to 119 in 2016. This 6-fold increase is alarming and suggests a large-scale public health response is needed.MethodsData were collected by the Harris County Institute of Forensic Sciences (IFS), which is part of the Harris County Medical Examiner's Office. IFS is the agency responsible for collecting and analyzing human tissue of the deceased for toxicological information about the manner and cause of death. IFS is able to test for the presence of multiple substances, including opioids, benzodiazepines, methamphetamines, cocaine, ethanol, and many others.These data were cleaned and labeled for the presence of opioids, cocaine, benzodiazepine, Z-drug (novel drug), amphetamines, ethanol, and carisoprodol. Explorative descriptive analyses were then completed in R (version 3.4) to identify trends. An RShiny app was created to further explore the data by allowing for rapid filtering and/or subsetting based on various demographic characteristics (e.g., age, sex, race).ResultsWe found that Harris County is experiencing a modest upward trend of drug related overdoses, with 529 observed in 2010 and 618 in 2016. We also found that the increase was not uniform across all classified drugs: amphetamines, cocaine, and ethanol all saw increases. Deaths involving amphetamine increased substantially from 21 in 2010 to 119 in 2016 (Figure 1). Deaths involving cocaine saw the next sharpest increase with 144 in 2010 and 237 in 2016. Deaths associated with opioids remained fairly constant, with 291 deaths in 2010 and 271 deaths in 2016.Differences in mortality across race and sex groups were also observed. The proportion of amphetamine deaths among whites jumped sharply, while the proportion of opioid and benzodiazepine deaths among whites decreased in recent years. The proportion of amphetamine and cocaine deaths among men rose more sharply than with women in the past three years, whereas for opioids, the proportion of women dying has dropped.ConclusionsIt is undeniable that the opioid epidemic is a true public health emergency for the nation. New surveillance tools are needed to better understand the impact and nature of this threat. Additionally, as we have found in Harris County, the threat may be polysubstance in nature.Our report offers two important insights: 1) that mortality data is a useful and actionable surveillance resource in understanding the problem of substance abuse; and 2) public health needs to look at substance abuse from a holistic and comprehensive perspective. Keeping the purview limited to opioids alone may create significant blind spots to the public health threat facing us.References1. National Institute of Health. (2018) Overdose Death Rates. Retreived from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

Puerto Rican Colonialism, Caribbean Radicalism, and Pueblos Hispanos’s Inter-Nationalist Alliance

2019 ◽  
Vol 23 (3) ◽  
pp. 50-68
Author(s):  
Cristina Pérez Jiménez
Keyword(s):  
New York ◽  
Puerto Rican ◽  
Communist Party ◽  
Puerto Ricans ◽  
World Order ◽  
Spanish Language ◽  
Nationalist Party ◽  
Political Interests ◽  
The Us ◽  
The Caribbean

Drawing from Earl Browder’s papers, this essay examines the Communist-sponsored, New York Spanish-language newspaper Pueblos Hispanos (1943–44), arguing that the publication staged an uneasy alliance between the Puerto Rican Nationalist Party and the US Communist Party by positioning Puerto Rican independence as central to a wider decolonial Caribbean and postwar world order. By analyzing Pueblos Hispanos’s practice of “inter-nationalism”—a term the author proposes to denote the flexible strategy used to mediate between competing political interests and which can serve as a model for understanding the compromised collaborations between Communist and nationalist leaders in the Caribbean—this essay expands our understanding of Communist influence in Caribbean liberation movements and begins to reinsert the contributions of early-and mid-twentieth-century Puerto Ricans, and more widely, Spanish caribeños, within a Marxist-inflected Caribbean radical tradition.

scholarly journals Educational attainment and adult mortality differentials in Argentina

2014 ◽  
Vol 8 (14) ◽  
pp. 129-163
Author(s):  
Hernán Manzelli
Keyword(s):  
Educational Attainment ◽  
Inverse Relationship ◽  
Age Groups ◽  
Mortality Rates ◽  
Adult Mortality ◽  
Educational Differences ◽  
Specific Mortality ◽  
Educational Groups ◽  
Relationship Of ◽  
The Relationship

In Latin America, there is an important set of studies that show a significant inverse relationship between socioeconomic status and mortality rates, but we know very little about the specific relation between educational attainment and adult mortality. The objective of this paper is to describe the relationship of adult mortality to educational attainment in Argentina for 2010. The data used in this study come from the Argentinean Mortality File of 2010 and from the last Argentinean Census. Results show a clear gradient in the specific mortality rates according to educational groups, for both sexes and for all age groups. The existence and direction of this relationship were as expected; however, the magnitude of educational differences was much higher than what has been found in other countries. The data also exhibited a clear declining trend in mortality inequalities by education as age increased

The Politics of Nationalism and Status in Puerto Rico

2017 ◽  
Vol 50 (4) ◽  
pp. 1083-1101 ◽  
Author(s):  
André Lecours ◽  
Valérie Vézina
Keyword(s):  
Puerto Rico ◽  
Puerto Rican ◽  
Puerto Ricans ◽  
Free Association ◽  
Status Quo ◽  
Peculiar Feature ◽  
Liberal Democracies ◽  
The Status ◽  
Puerto Rican Nationalism ◽  
The Relationship

AbstractOver the last several decades, nationalist movements in liberal democracies have challenged their community's relationship with the state. One such case that has drawn relatively little attention is Puerto Rico. A peculiar feature of Puerto Rican politics is that powerful nationalism coexists with several distinct status options: a reform of the current Commonwealth, statehood (becoming an American state), free association and independence. This article examines the various sources for Puerto Rican nationalism and discusses the relationship between nationalism and each of the status options. It also explains why none of the options has succeeded in gathering majority support amongst Puerto Ricans and why, therefore, the constitutional status quo has so far remained on the island.

scholarly journals Climate Change, Mortality, and Adaptation: Evidence from Annual Fluctuations in Weather in the US

2011 ◽  
Vol 3 (4) ◽  
pp. 152-185 ◽  
Author(s):  
Olivier Deschênes ◽  
Michael Greenstone
Keyword(s):  
Climate Change ◽  
Energy Consumption ◽  
Mortality Rates ◽  
Residential Energy ◽  
Residential Energy Consumption ◽  
Long Run ◽  
The Us ◽  
Business As Usual ◽  
The Relationship ◽  
Annual Mortality

Using random year-to-year variation in temperature, we document the relationship between daily temperatures and annual mortality rates and daily temperatures and annual residential energy consumption. Both relationships exhibit nonlinearities, with significant increases at the extremes of the temperature distribution. The application of these results to “business as usual” climate predictions indicates that by the end of the century climate change will lead to increases of 3 percent in the age-adjusted mortality rate and 11 percent in annual residential energy consumption. These estimates likely overstate the long-run costs, because climate change will unfold gradually allowing individuals to engage in a wider set of adaptations. (JEL I12, Q41, Q54)

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