Spatial Epidemiological Analysis and Geographical Information System of Opioid Overdoses in New York State (Preprint)

2020 ◽  
Author(s):  
Anuwat Pengput ◽  
Peter Elkin
Keyword(s):  
Public Health ◽  
New York ◽  
New York State ◽  
Geographical Information ◽  
Opioid Overdose ◽  
Hospital Inpatient ◽  
Opioid Use ◽  
Public Health Services ◽  
Public Health Response ◽  
Overdose Deaths

BACKGROUND Opioid analgesics are pain relievers. There are no better drugs than opioids for treating severe pain, however, opioids are the main drugs associated with overdose deaths. OBJECTIVE The study aimed to identify the distribution and clusters of opioid overdoses across New York. METHODS We used the deidentified hospital inpatient discharges datasets (SPARCS) from 2010 – 2015. ICD 9 and ICD 10 codes were used to identify and retrieve opioid overdose patients. We merged and aggregated SPARCS datasets to a geographic shapefile by all counties in New York. RESULTS More than half of the opioid overdose population (n = 235,178) were male (70%). Most patients were 30 - 49 years old (48.3%). Among patients, white non-Hispanics had the highest opioid overdose. Nearly all counties showed increasing rates of overdoses over six years. The high overdose clusters were identified in Niagara, Orleans, Genesee, Madison, Chenango, Delaware, and Sullivan counties (P < 0.05). The highest overdose rates were identified in the Central and Eastern New York regions. CONCLUSIONS The areas of highest overdose deaths among opioid use disorders were not necessarily the areas with the highest usage rates. This tells us that public health services may be lacking in these communities and this represents an opportunity for the New York Department of Public Health to improve our education and public health response in these communities. Opioid use and overdose rates do not always correlate well. This shows that special attention to counties with high overdose/user rates is warranted. The findings could inform health policy decisions at the county and state levels based on the geographic and demographic patterns to prevent and control opioid crises.

CommunityStat: A Public Health Intervention to Reduce Opioid Overdose Deaths in Burlington, Vermont, 2017–2020

2021 ◽  
pp. 009145092110521
Author(s):  
Brandon del Pozo
Keyword(s):  
Public Health ◽  
New York ◽  
Performance Metrics ◽  
Public Health Intervention ◽  
Police Department ◽  
Opioid Use Disorder ◽  
Health Staff ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Overdose Deaths

From 2017 to early 2020, the US city of Burlington, Vermont led a county-wide effort to reduce opioid overdose deaths by concentrating on the widespread, low-barrier distribution of medications for opioid use disorder. As a small city without a public health staff, the initiative was led out of the police department—with an understanding that it would not be enforcement-oriented—and centered on a local adaptation of CompStat, a management and accountability program developed by the New York City Police Department that has been cited as both yielding improvements in public safety and overemphasizing counterproductive police performance metrics if not carefully directed. The initiative was instrumental to the implementation of several novel interventions: low-threshold buprenorphine prescribing at the city’s syringe service program, induction into buprenorphine-based treatment at the local hospital emergency department, elimination of the regional waiting list for medications for opioid use disorder (MOUD), and the de-facto decriminalization of diverted buprenorphine by the chief of police and county prosecutor. An effort by local legislators resulted in a state law requiring all inmates with opioid use disorder be provided with MOUD as well. By the end of 2018, these interventions were collectively associated with a 50% (17 vs. 34) reduction in the county’s fatal overdose deaths, while deaths increased 20% in the remainder of Vermont. The reduction was sustained through the end of 2019. This article describes the effort undertaken by officials in Burlington to implement these interventions. It provides an example that other municipalities can use to take an evidence-based approach to reducing opioid deaths, provided stakeholders assent to sustained collaboration in the furtherance of a commitment to save lives. In doing so, it highlights that police-led public health interventions are the exception, and addressing the overdose crisis will require reform that shifts away from criminalization as a community’s default framework for substance use.

scholarly journals New York State Public Health System Response to Hurricane Sandy: Lessons From the Field

2016 ◽  
Vol 10 (3) ◽  
pp. 443-453 ◽  
Author(s):  
Asante Shipp Hilts ◽  
Stephanie Mack ◽  
Millicent Eidson ◽  
Trang Nguyen ◽  
Guthrie S. Birkhead
Keyword(s):  
Public Health ◽  
New York ◽  
New York State ◽  
Hurricane Sandy ◽  
System Response ◽  
Health Staff ◽  
Health Departments ◽  
Public Health Response ◽  
Public Health Preparedness ◽  
York State

AbstractObjectiveThe aim of this study was to conduct interviews with public health staff who responded to Hurricane Sandy and to analyze their feedback to assess response strengths and challenges and recommend improvements for future disaster preparedness and response.MethodsQualitative analysis was conducted of information from individual confidential interviews with 35 staff from 3 local health departments in New York State (NYS) impacted by Hurricane Sandy and the NYS Department of Health. Staff were asked about their experiences during Hurricane Sandy and their recommendations for improvements. Open coding was used to analyze interview transcripts for reoccurring themes, which were labeled as strengths, challenges, or recommendations and then categorized into public health preparedness capabilities.ResultsThe most commonly cited strengths, challenges, and recommendations related to the Hurricane Sandy public health response in NYS were within the emergency operations coordination preparedness capability, which includes the abilities of health department staff to partner among government agencies, coordinate with emergency operation centers, conduct routine conference calls with partners, and manage resources.ConclusionsHealth departments should ensure that emergency planning includes protocols to coordinate backup staffing, delineation of services that can be halted during disasters, clear guidelines to coordinate resources across agencies, and training for transitioning into unfamiliar disaster response roles. (Disaster Med Public Health Preparedness. 2016;10:443–453)

scholarly journals A large-scale retrospective study of opioid poisoning in New York State with implications for targeted interventions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xin Chen ◽  
Wei Hou ◽  
Sina Rashidian ◽  
Yu Wang ◽  
Xia Zhao ◽  
...  
Keyword(s):  
New York ◽  
Race And Ethnicity ◽  
Large Scale ◽  
New York State ◽  
Temporal Trends ◽  
Opioid Overdose ◽  
York State ◽  
Targeted Interventions ◽  
Level Data ◽  
Zip Code

AbstractOpioid overdose related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP). To discover trends and patterns of opioid poisoning and the demographic and regional disparities, we analyzed large scale patient visits data in New York State (NYS). Demographic, spatial, temporal and correlation analyses were performed for all OP patients extracted from the claims data in the New York Statewide Planning and Research Cooperative System (SPARCS) from 2010 to 2016, along with Decennial US Census and American Community Survey zip code level data. 58,481 patients with at least one OP diagnosis and a valid NYS zip code address were included. Main outcome and measures include OP patient counts and rates per 100,000 population, patient level factors (gender, age, race and ethnicity, residential zip code), and zip code level social demographic factors. The results showed that the OP rate increased by 364.6%, and by 741.5% for the age group > 65 years. There were wide disparities among groups by race and ethnicity on rates and age distributions of OP. Heroin and non-heroin based OP rates demonstrated distinct temporal trends as well as major geospatial variation. The findings highlighted strong demographic disparity of OP patients, evolving patterns and substantial geospatial variation.

Preparing pharmacists to increase naloxone dispensing within community pharmacies under the Pennsylvania standing order

2020 ◽  
Author(s):  
Heather M Santa ◽  
Samira G Amirova ◽  
Daniel J Ventricelli ◽  
George E Downs ◽  
Alexandra A Nowalk ◽  
...  
Keyword(s):  
Community Pharmacists ◽  
The United States ◽  
Health Concern ◽  
Community Pharmacies ◽  
Opioid Overdose ◽  
Patient Counseling ◽  
Opioid Use ◽  
Overdose Prevention ◽  
Standing Order ◽  
Overdose Deaths

Abstract Purpose Opioid misuse and overdose deaths remain a public health concern in the United States. Pennsylvania has one of the highest rates of opioid overdose deaths in the country, with Philadelphia County’s being 3 times higher than the national average. Despite several multimodal interventions, including use of SBIRT (screening, brief intervention, and referral to treatment) methods and naloxone distribution, the rate of overdose deaths remains high. Methods To gain insights on strategies for improving access to naloxone and naloxone distribution by pharmacists in Philadelphia County, a study was conducted in 11 community pharmacies (chain and independent) in Philadelphia. Twenty-four pharmacists were recruited and completed SBIRT and naloxone trainings. Each pharmacy elected to have at least 1 pharmacy champion who received additional training on and helped develop pharmacy site–specific naloxone dispensing protocols. Results Pre-post survey results showed a reduction in stigmatizing attitudes regarding naloxone dispensing and an increase in pharmacists’ understanding of the standing order and appropriate naloxone use. There was an increase in pharmacists’ self-reported confidence in their ability to appropriately identify, discuss, and dispense naloxone to patients. All pharmacies increased their average monthly dispensing rate following protocol implementation. Conclusion Pharmacists who received both trainings were more likely to change naloxone dispensing practices, leading to an overall increase in naloxone dispensing by community pharmacists. The study addressed overall gaps in pharmacists’ knowledge, reduced stigma, and prepared pharmacists to address opioid use and overdose prevention with their patients. The described pharmacist-led patient counseling and intervention service for overdose prevention may be explored as a model for other community pharmacies to adopt to improve naloxone dispensing and similar interventions to reduce overdose deaths.

Does Medicaid expansion influence county health spending? A case of New York counties

2021 ◽  
pp. 1-16
Author(s):  
Shihyun Noh ◽  
Ji-Hyung Park
Keyword(s):  
Public Health ◽  
New York ◽  
Health Services ◽  
Local Governments ◽  
Health Spending ◽  
Medicaid Expansion ◽  
Health Administration ◽  
Public Health Services ◽  
York County ◽  
Uninsured Population

Abstract We investigated the impacts of Medicaid expansion on New York county total health spending and specifics of health spending, including health services, public health facilities and public health administration. Little research considered the financial effect of Medicaid expansion on local governments while well reported are its influences on uninsured rates and health services utilization. New York counties have contributed to health in their boundaries by providing or funding public health services, and supporting a part of the non-federal share of Medicaid expenditures and uncompensated care. Medicaid expansion can reduce the size of county expenditures for health by enrolling more previously uninsured population in the program and offering more generous federal funding for the expanded Medicaid. We offer empirical evidence that Medicaid expansion was associated with reduced county health spending.

Disparities in Opioid Overdose Death Trends by Race/Ethnicity, 2018–2019, From the HEALing Communities Study

2021 ◽  
pp. e1-e4
Author(s):  
Marc R. Larochelle ◽  
Svetla Slavova ◽  
Elisabeth D. Root ◽  
Daniel J. Feaster ◽  
Patrick J. Ward ◽  
...  
Keyword(s):  
Public Health ◽  
New York ◽  
Public Health Approach ◽  
Opioid Overdose ◽  
Death Rates ◽  
Overdose Death ◽  
Race Ethnicity ◽  
State Death ◽  
Rate Ratios ◽  
Hispanic White

Objectives. To examine trends in opioid overdose deaths by race/ethnicity from 2018 to 2019 across 67 HEALing Communities Study (HCS) communities in Kentucky, New York, Massachusetts, and Ohio. Methods. We used state death certificate records to calculate opioid overdose death rates per 100 000 adult residents of the 67 HCS communities for 2018 and 2019. We used Poisson regression to calculate the ratio of 2019 to 2018 rates. We compared changes by race/ethnicity by calculating a ratio of rate ratios (RRR) for each racial/ethnic group compared with non-Hispanic White individuals. Results. Opioid overdose death rates were 38.3 and 39.5 per 100 000 for 2018 and 2019, respectively, without a significant change from 2018 to 2019 (rate ratio = 1.03; 95% confidence interval [CI] = 0.98, 1.08). We estimated a 40% increase in opioid overdose death rate for non-Hispanic Black individuals (RRR = 1.40; 95% CI = 1.22, 1.62) relative to non-Hispanic White individuals but no change among other race/ethnicities. Conclusions. Overall opioid overdose death rates have leveled off but have increased among non-Hispanic Black individuals. Public Health Implications. An antiracist public health approach is needed to address the crisis of opioid-related harms. (Am J Public Health. Published online ahead of print September 9, 2021:e1–e4. https://doi.org/10.2105/AJPH.2021.306431 )

scholarly journals Early introductions and community transmission of SARS-CoV-2 variant B.1.1.7 in the United States

2021 ◽  
Author(s):  
Tara Alpert ◽  
Erica Lasek-Nesselquist ◽  
Anderson F. Brito ◽  
Andrew L. Valesano ◽  
Jessica Rothman ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
New York ◽  
Diagnostic Testing ◽  
The United States ◽  
International Travel ◽  
Health Concern ◽  
Public Health Response ◽  
Community Transmission ◽  
The Uk

SummaryThe emergence and spread of SARS-CoV-2 lineage B.1.1.7, first detected in the United Kingdom, has become a national public health concern in the United States because of its increased transmissibility. Over 500 COVID-19 cases associated with this variant have been detected since December 2020, but its local establishment and pathways of spread are relatively unknown. Using travel, genomic, and diagnostic testing data, we highlight the primary ports of entry for B.1.1.7 in the US and locations of possible underreporting of B.1.1.7 cases. New York, which receives the most international travel from the UK, is likely one of the key hubs for introductions and domestic spread. Finally, we provide evidence for increased community transmission in several states. Thus, genomic surveillance for B.1.1.7 and other variants urgently needs to be enhanced to better inform the public health response.

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