scholarly journals “Know your epidemic, know your response”: Epidemiological assessment of the substance use disorder crisis in the United States

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251502
Author(s):  
Andrés Hernández ◽  
Minxuan Lan ◽  
Neil J. MacKinnon ◽  
Adam J. Branscum ◽  
Diego F. Cuadros
Keyword(s):  
United States ◽  
Substance Use ◽  
The United States ◽  
Mortality Data ◽  
Male Population ◽  
Demographic Groups ◽  
Policy Interventions ◽  
Health Related ◽  
The U.S ◽  
Related Mortality

The United States (U.S.) is currently experiencing a substance use disorders (SUD) crisis with an unprecedented magnitude. The objective of this study was to recognize and characterize the most vulnerable populations at high risk of SUD mortality in the U.S., and to identify the locations where these vulnerable population are located. We obtained the most recent available mortality data for the U.S. population aged 15–84 (2005–2017) from the Centers for Diseases and Prevention (CDC). Our analysis focused on the unintentional substance poisoning to estimate SUD mortality. We computed health-related comorbidities and socioeconomic association with the SUD distribution. We identified the most affected populations and conducted a geographical clustering analysis to identify places with increased concentration of SUD related deaths. From 2005–2017, 463,717 SUD-related deaths occurred in the United States. White population was identified with the highest SUD death proportions. However, there was a surge of the SUD epidemic in the Black male population, with a sharp increase in the SUD-related death rate since 2014. We also found that an additional average day of mental distress might increase the relative risk of SUD-related mortality by 39%. The geographical distribution of the epidemic showed clustering in the West and Mid-west regions of the U.S. In conclusion, we found that the SUD epidemic in the U.S. is characterized by the emergence of several micro-epidemics of different intensities across demographic groups and locations within the country. The comprehensive description of the epidemic presented in this study could assist in the design and implementation of targeted policy interventions for addiction mitigation campaigns.

scholarly journals Toward Achieving a Vaccine-Derived Herd Immunity Threshold for COVID-19 in the U.S.

2021 ◽  
Vol 9 ◽  
Author(s):  
Abba B. Gumel ◽  
Enahoro A. Iboi ◽  
Calistus N. Ngonghala ◽  
Gideon A. Ngwa
Keyword(s):  
Public Health ◽  
United States ◽  
Herd Immunity ◽  
Face Mask ◽  
The United States ◽  
Mortality Data ◽  
Deterministic System ◽  
Therapeutic Benefits ◽  
The U.S ◽  
Pharmaceutical Interventions

A novel coronavirus emerged in December of 2019 (COVID-19), causing a pandemic that inflicted unprecedented public health and economic burden in all nooks and corners of the world. Although the control of COVID-19 largely focused on the use of basic public health measures (primarily based on using non-pharmaceutical interventions, such as quarantine, isolation, social-distancing, face mask usage, and community lockdowns) initially, three safe and highly-effective vaccines (by AstraZeneca Inc., Moderna Inc., and Pfizer Inc.), were approved for use in humans in December 2020. We present a new mathematical model for assessing the population-level impact of these vaccines on curtailing the burden of COVID-19. The model stratifies the total population into two subgroups, based on whether or not they habitually wear face mask in public. The resulting multigroup model, which takes the form of a deterministic system of nonlinear differential equations, is fitted and parameterized using COVID-19 cumulative mortality data for the third wave of the COVID-19 pandemic in the United States. Conditions for the asymptotic stability of the associated disease-free equilibrium, as well as an expression for the vaccine-derived herd immunity threshold, are rigorously derived. Numerical simulations of the model show that the size of the initial proportion of individuals in the mask-wearing group, together with positive change in behavior from the non-mask wearing group (as well as those in the mask-wearing group, who do not abandon their mask-wearing habit) play a crucial role in effectively curtailing the COVID-19 pandemic in the United States. This study further shows that the prospect of achieving vaccine-derived herd immunity (required for COVID-19 elimination) in the U.S., using the Pfizer or Moderna vaccine, is quite promising. In particular, our study shows that herd immunity can be achieved in the U.S. if at least 60% of the population are fully vaccinated. Furthermore, the prospect of eliminating the pandemic in the U.S. in the year 2021 is significantly enhanced if the vaccination program is complemented with non-pharmaceutical interventions at moderate increased levels of compliance (in relation to their baseline compliance). The study further suggests that, while the waning of natural and vaccine-derived immunity against COVID-19 induces only a marginal increase in the burden and projected time-to-elimination of the pandemic, adding the impacts of therapeutic benefits of the vaccines into the model resulted in a dramatic reduction in the burden and time-to-elimination of the pandemic.

scholarly journals Recent Trends in Heat-Related Mortality in the United States: An Update through 2018

2021 ◽  
Vol 13 (1) ◽  
pp. 95-106
Author(s):  
Scott C. Sheridan ◽  
P. Grady Dixon ◽  
Adam J. Kalkstein ◽  
Michael J. Allen
Keyword(s):  
United States ◽  
Total Mortality ◽  
The United States ◽  
Extreme Heat ◽  
Mortality Data ◽  
The Past ◽  
Extreme Heat Event ◽  
Excess Heat Factor ◽  
Heat Events ◽  
Related Mortality

AbstractMuch research has shown a general decrease in the negative health response to extreme heat events in recent decades. With a society that is growing older, and a climate that is warming, whether this trend can continue is an open question. Using eight additional years of mortality data, we extend our previous research to explore trends in heat-related mortality across the United States. For the period 1975–2018, we examined the mortality associated with extreme-heat-event days across the 107 largest metropolitan areas. Mortality response was assessed over a cumulative 10-day lag period following events that were defined using thresholds of the excess heat factor, using a distributed-lag nonlinear model. We analyzed total mortality and subsets of age and sex. Our results show that in the past decade there is heterogeneity in the trends of heat-related human mortality. The decrease in heat vulnerability continues among those 65 and older across most of the country, which may be associated with improved messaging and increased awareness. These decreases are offset in many locations by an increase in mortality among men 45–64 (+1.3 deaths per year), particularly across parts of the southern and southwestern United States. As heat-warning messaging broadly identifies the elderly as the most vulnerable group, the results here suggest that differences in risk perception may play a role. Further, an increase in the number of heat events over the past decade across the United States may have contributed to the end of a decades-long downward trend in the estimated number of heat-related fatalities.

scholarly journals Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study

BMJ ◽  
2021 ◽  
pp. m4957 ◽  
Author(s):  
Greta Hsu ◽  
Balázs Kovács
Keyword(s):  
United States ◽  
Confidence Interval ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Panel Regression ◽  
County Level ◽  
Regression Methods ◽  
Synthetic Opioids ◽  
Related Mortality

Abstract Objective To examine county level associations between the prevalence of medical and recreational cannabis stores (referred to as dispensaries) and opioid related mortality rates. Design Panel regression methods. Setting 812 counties in the United States in the 23 states that allowed legal forms of cannabis dispensaries to operate by the end of 2017. Participants The study used US mortality data from the Centers for Disease Control and Prevention combined with US census data and data from Weedmaps.com on storefront dispensary operations. Data were analyzed at the county level by using panel regression methods. Main outcome measure The main outcome measures were the log transformed, age adjusted mortality rates associated with all opioid types combined, and with subcategories of prescription opioids, heroin, and synthetic opioids other than methadone. The associations of medical dispensary and recreational dispensary counts with age adjusted mortality rates were also analyzed. Results County level dispensary count (natural logarithm) is negatively related to the log transformed, age adjusted mortality rate associated with all opioid types (β=−0.17, 95% confidence interval −0.23 to −0.11). According to this estimate, an increase from one to two storefront dispensaries in a county is associated with an estimated 17% reduction in all opioid related mortality rates. Dispensary count has a particularly strong negative association with deaths caused by synthetic opioids other than methadone (β=−0.21, 95% confidence interval −0.27 to −0.14), with an estimated 21% reduction in mortality rates associated with an increase from one to two dispensaries. Similar associations were found for medical versus recreational storefront dispensary counts on synthetic (non-methadone) opioid related mortality rates. Conclusions Higher medical and recreational storefront dispensary counts are associated with reduced opioid related death rates, particularly deaths associated with synthetic opioids such as fentanyl. While the associations documented cannot be assumed to be causal, they suggest a potential association between increased prevalence of medical and recreational cannabis dispensaries and reduced opioid related mortality rates. This study highlights the importance of considering the complex supply side of related drug markets and how this shapes opioid use and misuse.

scholarly journals The Effect of Eviction on Maternal Criminal Justice Involvement

2018 ◽  
Vol 4 ◽  
pp. 237802311880896 ◽  
Author(s):  
Aaron Gottlieb ◽  
Jessica W. Moose
Keyword(s):  
United States ◽  
Substance Use ◽  
Criminal Justice ◽  
Low Income ◽  
The United States ◽  
Fragile Families ◽  
Criminal Justice Involvement ◽  
States Experience ◽  
The Impact ◽  
The U.S

Millions of individuals in the United States experience eviction each year, with low-income women being particularly at risk. As a result, scholarship has increasingly sought to understand what the implications of eviction are for families. In this article, we build on this work by presenting the first estimates of the impact of eviction on criminal justice involvement for mothers in the U.S. context and examining three pathways that may help to explain these associations. Using longitudinal data from the Fragile Families and Child Wellbeing Study, adjusted estimates suggest that mothers who have been evicted have more than two times higher odds of experiencing criminal justice involvement. When we differentiate by eviction timing, we find that both recent and less recent evictions are associated with criminal justice involvement. Last, we find that eviction indirectly affects criminal justice involvement through future financial hardship and substance use.

scholarly journals Severity of the COVID-19 pandemic assessed with all-cause mortality in the United States during 2020.

2021 ◽  
Author(s):  
Fredrick Dahlgren ◽  
Lauren Rossen ◽  
Alicia Fry ◽  
Carrie Reed
Keyword(s):  
United States ◽  
New York ◽  
Age Groups ◽  
The United States ◽  
Mortality Data ◽  
Demographic Groups ◽  
High Severity ◽  
All Cause Mortality ◽  
The Impact ◽  
Very High

Background. In the United States, infection with SARS-CoV-2 caused 380,000 reported deaths from March to December 2020. Methods. We adapted the Moving Epidemic Method to all-cause mortality data from the United States to assess the severity of the COVID-19 pandemic across age groups and all 50 states. By comparing all-cause mortality during the pandemic with intensity thresholds derived from recent, historical all-cause mortality, we categorized each week from March to December 2020 as either low severity, moderate severity, high severity, or very high severity. Results. Nationally for all ages combined, all-cause mortality was in the very high severity category for 9 weeks. Among people 18 to 49 years of age, there were 29 weeks of consecutive very high severity mortality. Forty-seven states, the District of Columbia, and New York City each experienced at least one week of very high severity mortality for all ages combined. Conclusions. These periods of very high severity of mortality during March through December 2020 are likely directly or indirectly attributable to the COVID-19 pandemic. This method for standardized comparison of severity over time across different geographies and demographic groups provides valuable information to understand the impact of the COVID-19 pandemic and to identify specific locations or subgroups for deeper investigations into differences in severity.

scholarly journals Holding Death at Bay vs. Prolonging Life: Indexing Fatalism and Optimism in the Ideology of Health, Genetics, and Family History in the U. S. and South Korean Media

2015 ◽  
Author(s):  
Soo Hong ◽  
Susan Strauss
Keyword(s):  
Public Health ◽  
United States ◽  
South Korea ◽  
The United States ◽  
Media Discourse ◽  
Discursive Strategies ◽  
South Korean ◽  
Health And Illness ◽  
Health Related ◽  
The U.S

Media discourse creates and shapes views of personhood, of possibilities, of wellness, and at the same time, these views and beliefs, in their turn, shape media discourse. Broadcasts of health-related edutainment programs and advertisements are rich sources for the discovery of stances concerning health and illness. We examine media discourse in the United States and South Korea, and uncover consistent indexical patterns pointing to overall ideologies of fatalism in the U.S. and optimism in South Korea. Specifically, from an indexicality-based perspective, we identify the patterned ways in which the ideologies of fatalism and optimism are indexed with regard to agency and stance. We provide evidence of the culturally distinct patterns of discourse that construct health and illness in the U.S. and South Korean media. In the U.S., heart disease and cancer are threats, medicines are omnipotent, and physicians, omniscient. “Death” is explicit and medicines and physicians hold it at bay. Korean discourse frames “life” as explicit underscoring efforts by doctors and medicines to prolong and enhance it. Implications associated with public health discourses employing diverse discursive strategies are discussed.

scholarly journals Factors That Influence Climate Change-Related Mortality in the United States: An Integrative Review

2021 ◽  
Vol 18 (15) ◽  
pp. 8220
Author(s):  
Ruth McDermott-Levy ◽  
Madeline Scolio ◽  
Kabindra M. Shakya ◽  
Caroline H. Moore
Keyword(s):  
Climate Change ◽  
United States ◽  
Environmental Changes ◽  
Demographic Factors ◽  
The United States ◽  
Integrative Review ◽  
Health Determinants ◽  
Mortality Data ◽  
Human Mortality ◽  
Related Mortality

Global atmospheric warming leads to climate change that results in a cascade of events affecting human mortality directly and indirectly. The factors that influence climate change-related mortality within the peer-reviewed literature were examined using Whittemore and Knafl’s framework for an integrative review. Ninety-eight articles were included in the review from three databases—PubMed, Web of Science, and Scopus—with literature filtered by date, country, and keywords. Articles included in the review address human mortality related to climate change. The review yielded two broad themes in the literature that addressed the factors that influence climate change-related mortality. The broad themes are environmental changes, and social and demographic factors. The meteorological impacts of climate change yield a complex cascade of environmental and weather events that affect ambient temperatures, air quality, drought, wildfires, precipitation, and vector-, food-, and water-borne pathogens. The identified social and demographic factors were related to the social determinants of health. The environmental changes from climate change amplify the existing health determinants that influence mortality within the United States. Mortality data, national weather and natural disaster data, electronic medical records, and health care provider use of International Classification of Disease (ICD) 10 codes must be linked to identify climate change events to capture the full extent of climate change upon population health.

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