scholarly journals A Demographic and Regional Comparison of Opioid-Related Hospital Visits within Community Type in the United States

2021 ◽  
Vol 10 (16) ◽  
pp. 3460
Author(s):  
Jordan L. Wilkes ◽  
Jessica N. Montalban ◽  
Brian D. Pringle ◽  
Devin Monroe ◽  
Adela Miller ◽  
...  
Keyword(s):  
United States ◽  
Rural Areas ◽  
Census Data ◽  
The United States ◽  
Emergency Department Visits ◽  
Population Characteristics ◽  
Hospital Inpatient ◽  
Opioid Use ◽  
Community Size ◽  
Population Center

Background: The opioid epidemic is a complex national crisis in the United States with a 400% increase in related deaths over the past two decades with no signs of slowing. The purpose of this study was to assess the incidence of opioid use, based on the geographic and population characteristics. Methods: The opioid-related hospital inpatient stays and emergency department visits obtained from the 2010 to 2018 Healthcare Cost and Utilization Project and demographic confounders, including age, race, education, and income gathered from US Census data were analyzed through generalized linear mixed models and reported by community size and region. Results: Opioid use varies among population center sizes and the region analyzed. In general, opioid visits in the southwest region were greatest across the majority of population center sizes. Rural usage was greatest in the northeast, southeast, and southwest. Unemployment and diverse ethnicities were commonly associated with opioid use in the metro areas studied but these associations were not seen in rural areas. Conclusion: Opioid use remains significant among diverse populations across the United States. Understanding the unique dynamics associated with opioid usage in populations within the regions studied is important in guiding future interventions to fight this crisis.

scholarly journals Firework-related injuries treated at emergency departments in the United States during the COVID-19 pandemic in 2020 compared to 2018–2019

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Nathan Maassel ◽  
Abbie Saccary ◽  
Daniel Solomon ◽  
David Stitelman ◽  
Yunshan Xu ◽  
...  
Keyword(s):  
United States ◽  
Census Data ◽  
The United States ◽  
Population Based ◽  
Emergency Department Visits ◽  
Consumer Product Safety Commission ◽  
Injury Surveillance System ◽  
Time Period ◽  
National Estimates ◽  
Us Census

Abstract Background Despite a national decrease in emergency department visits in the United States during the first 10 months of the pandemic, preliminary Consumer Product Safety Commission data indicate increased firework-related injuries. We hypothesized an increase in firework-related injuries during 2020 compared to years prior related to a corresponding increase in consumer firework sales. Methods The National Electronic Injury Surveillance System (NEISS) was queried from 2018 to 2020 for cases with product codes 1313 (firework injury) and narratives containing “fireworks”. Population-based national estimates were calculated using US Census data, then compared across the three years of study inclusion. Patient demographic and available injury information was also tracked and compared across the three years. Firework sales data obtained from the American Pyrotechnics Association were determined for the same time period to examine trends in consumption. Results There were 935 firework-related injuries reported to the NEISS from 2018 to 2020, 47% of which occurred during 2020. National estimates for monthly injuries per million were 1.6 times greater in 2020 compared to 2019 (p < 0.0001) with no difference between 2018 and 2019 (p = 0.38). The same results were found when the month of July was excluded. Firework consumption in 2020 was 1.5 times greater than 2019 or 2018, with a 55% increase in consumer fireworks and 22% decrease in professional fireworks sales. Conclusions Firework-related injures saw a substantial increase in 2020 compared to the two years prior, corroborated by a proportional increase in consumer firework sales. Increased incidence of firework-related injuries was detected even with the exclusion of the month of July, suggesting that the COVID-19 pandemic may have impacted firework epidemiology more broadly than US Independence Day celebrations.

scholarly journals Deployment of Mobile Broadband Service in the United States

2012 ◽  
pp. 1-24 ◽  
Author(s):  
James E. Prieger ◽  
Thomas V. Church
Keyword(s):  
United States ◽  
Native Americans ◽  
Population Density ◽  
Rural Areas ◽  
Census Data ◽  
The United States ◽  
Mobile Broadband ◽  
Broadband Service ◽  
Wireless Broadband ◽  
Fixed Line

Broadband deployment in the United States is expanding rapidly but unevenly. Using new FCC census data on wireline and wireless broadband providers, the authors of this chapter study mobile broadband provision within the United States. Although rural areas lag behind non-rural areas in the availability of residential access to both mobile and fixed broadband, mobile broadband is at least partially filling in geographical gaps in fixed-line broadband coverage. Multiple regression results indicate that population density and growth, and the fraction of blacks, Hispanics, and youth in an area are positive predictors of the number of mobile broadband providers. The fraction of Native Americans, Asians, and senior citizens in an area are negative predictors. Income is positively associated with the number of providers, with largest effects in rural areas. Finally, even after controlling for population density and income, rural areas continue to be associated with a lower number of providers.

The Industrial Distribution of the Urban and Rural Workforces: Estimates for the United States, 1870–1910

1972 ◽  
Vol 32 (4) ◽  
pp. 919-937 ◽  
Author(s):  
Thomas Weiss
Keyword(s):  
United States ◽  
Rural Areas ◽  
Urban Areas ◽  
Service Sector ◽  
Census Data ◽  
Participation Rate ◽  
The United States ◽  
Urban Sector ◽  
Industrial Distribution ◽  
Rural Workforce

The purpose of this article was to present the estimates of the urban and rural workforces derived from census data. These censusbased estimates present a fairly consistent pattern of change over time, and appear useful even in their present state. These estimates should be tested further against other time series so that we will eventually have a sound urban and rural workforce series with which to better analyze the process of structural change. The limited use to which these estimates were put in the present article yielded some interesting results, as well as some suggestions for further research.In terms of the United States workforce, changes in the industrial distribution reflect predominantly the relative shift in population from rural to urban areas, and little change in the workforce structure of either area. Indeed, at the sectoral level, there appears to have been more change occurring in rural than in urban areas. On the other hand, within the service sector there was more erratic change occurring in the rural areas than in the cities, but the differences may be easily reconciled. The urban sector experienced a more rapid increase and greater variability in the participation rate than did the rural sector. The pattern of variability was compared with the known evidence on unemployment, and variation in the former appears explicable in terms of variation in the latter.

Pronounced Regional Disparities in United States Methadone Distribution

2021 ◽  
pp. 106002802110282
Author(s):  
John A. Furst ◽  
Nicholas J. Mynarski ◽  
Kenneth L. McCall ◽  
Brian J. Piper
Keyword(s):  
United States ◽  
Rhode Island ◽  
Rural Areas ◽  
The United States ◽  
Regional Disparities ◽  
Evidence Based ◽  
Opioid Use ◽  
Opioid Treatment ◽  
Treatment Practice ◽  
State Population

Background: Methadone is an evidence-based treatment for opioid use disorder (OUD) and pain management. Methadone for OUD may be difficult for some patients to access, particularly those in rural areas. Objective: The purpose of this study was to characterize methadone distribution patterns between 2017 and 2019 across the United States. Methods: The US Drug Enforcement Administration’s Automated Reports and Consolidated Ordering System was used to acquire the number of opioid treatment programs (OTPs) per state and methadone distribution weight in grams. Methadone distributions by weight, corrected for state population and number of OTPs, were compared from 2017 to 2019 between states, within regions, and nationally. Results: The national distribution of methadone increased +12.3% for OTPs but decreased −34.6% for pain. Whereas all states saw a decrease in pain distribution, the Northeast showed a significantly smaller decrease than all other regions. Additionally, the majority of states experienced an increase in distribution for OTPs, and most states demonstrated a relatively stable or increasing number of OTPs, with an +11.5% increase nationally. The number of OTPs per 100K state population ranged from 2.1 in Rhode Island to 0.0 in Wyoming. Conclusion and Relevance: Although methadone distribution for OUD was increasing in the United States, the pronounced regional disparities identified warrant further consideration to improve patient access to this evidence-based pharmacotherapy, particularly in the Midwest and West regions. Greater implementation of telehealth and involvement of primary care into opioid treatment practice offer possible solutions to eliminating geographical treatment barriers.

Accounting for vulnerable populations in rural hazard mitigation plans: Results of a survey of emergency managers

2017 ◽  
Vol 11 (3) ◽  
pp. 201
Author(s):  
Jennifer A. Horney, PhD, MPH ◽  
Mai Nguyen, PhD ◽  
John Cooper, PhD ◽  
Matt Simon, MA ◽  
Kristen Ricchetti-Masterson, MSPH ◽  
...  
Keyword(s):  
United States ◽  
Emergency Management ◽  
Vulnerable Populations ◽  
Rural Areas ◽  
Census Data ◽  
Hazard Mitigation ◽  
The United States ◽  
Vulnerable Groups ◽  
Rural Counties ◽  
Mitigation Planning

Rural areas of the United States are uniquely vulnerable to the impacts of natural disasters. One possible way to mitigate vulnerability to disasters in rural communities is to have a high-quality hazard mitigation plan in place. To understand the resources available for hazard mitigation planning and determine how well hazard mitigation plans in rural counties meet the needs of vulnerable populations, we surveyed the lead planning or emergency management official responsible for hazard mitigation plans in 96 rural counties in eight states in the Southeastern United States. In most counties, emergency management was responsible for implementing the county’s hazard mitigation plan and the majority of counties had experienced a presidentially declared disaster in the last 5 years. Our research findings demonstrated that there were differences in subjective measures of vulnerability (as reported by survey respondents) and objective measures of vulnerability (as determined by US Census data). In addition, although few counties surveyed included outreach to vulnerable groups as a part of their hazard mitigation planning process, a majority felt that their hazard mitigation plan addressed the needs of vulnerable populations “well” or “very well.” These differences could result in increased vulnerabilities in rural areas, particularlyfor certain vulnerable groups.

scholarly journals Su1597 – Increasing Inpatient Burden of Constipation and Its Relation to Opioid Use: National Trends in the United States

2019 ◽  
Vol 156 (6) ◽  
pp. S-577
Author(s):  
Eula P. Tetangco ◽  
Supannee Rassameehiran ◽  
George Tan ◽  
Humberto Sifuentes
Keyword(s):  
United States ◽  
The United States ◽  
Opioid Use ◽  
National Trends

scholarly journals Factors Influencing Land Values in the Presence of Suburban Sprawl

1974 ◽  
Vol 3 (1) ◽  
pp. 112-124 ◽  
Author(s):  
Bruce E. Lindsay ◽  
Cleve E. Willis
Keyword(s):  
United States ◽  
Rural Areas ◽  
The United States ◽  
Land Values ◽  
Suburban Sprawl ◽  
Factors Influencing ◽  
Definition Of

The spread of suburbs into previously rural areas has become commonplace in the United States. A rather striking aspect of this phenomenon has been the discontinuity which results. This aspect is often manifest in a haphazard mixture of unused and densely settled areas which has been described as “sprawl”. A more useful definition of suburban sprawl, its causes, and its consequences, is provided below in order to introduce the econometric objectives of this paper.

scholarly journals Gender disparities in opioid treatment progress in methadone versus counseling

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Erick Guerrero ◽  
Hortensia Amaro ◽  
Yinfei Kong ◽  
Tenie Khachikian ◽  
Jeanne C. Marsh
Keyword(s):  
United States ◽  
Treatment Outcomes ◽  
Treatment Plan ◽  
Dropout Rate ◽  
The United States ◽  
Gender Disparities ◽  
Opioid Use ◽  
Lower Odds ◽  
Male Clients ◽  
Multi Level

Abstract Background In the United States, the high dropout rate (75%) in opioid use disorder (OUD) treatment among women and racial/ethnic minorities calls for understanding factors that contribute to making progress in treatment. Whereas counseling and medication for OUD (MOUD, e.g. methadone, buprenorphine, naltrexone) is considered the gold standard of care in substance use disorder (SUD) treatment, many individuals with OUD receive either counseling or methadone-only services. This study evaluates gender disparities in treatment plan progress in methadone- compared to counseling-based programs in one of the largest SUD treatment systems in the United States. Methods Multi-year and multi-level (treatment program and client-level) data were analyzed using the Integrated Substance Abuse Treatment to Eliminate Disparities (iSATed) dataset collected in Los Angeles County, California. The sample consisted of 4 waves: 2011 (66 SUD programs, 1035 clients), 2013 (77 SUD programs, 3686 clients), 2015 (75 SUD programs, 4626 clients), and 2017 (69 SUD programs, 4106 clients). We conducted two multi-level negative binomial regressions, one per each outcome (1) making progress towards completing treatment plan, and (2) completing treatment plan. We included outpatient clients discharged on each of the years of the study (over 95% of all clients) and accounted for demographics, wave, homelessness and prior treatment episodes, as well as clients clustered within programs. Results We detected gender differences in two treatment outcomes (progress and completion) considering two outpatient program service types (MOUD-methadone vs. counseling). Clients who received methadone vs. counseling had lower odds of completing their treatment plan (OR = 0.366; 95% CI = 0.163, 0.821). Female clients receiving methadone had lower odds of both making progress (OR = 0.668; 95% CI = 0.481, 0.929) and completing their treatment plan (OR = 0.666; 95% CI = 0.485, 0.916) compared to male clients and receiving counseling. Latina clients had lower odds of completing their treatment plan (OR = 0.617; 95% CI = 0.408, 0.934) compared with non-Latina clients. Conclusions Clients receiving methadone, the most common and highly effective MOUD in reducing opioid use, were less likely to make progress towards or complete their treatment plan than those receiving counseling. Women, and in particular those identified as Latinas, were least likely to benefit from methadone-based programs. These findings have implications for health policy and program design that consider the need for comprehensive and culturally responsive services in methadone-based programs to improve outpatient treatment outcomes among women.

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