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

scholarly journals Black and Native Overdose Mortality Overtook that of White Individuals During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Joseph Friedman ◽  
Helena Hansen
Keyword(s):  
Alaska Native ◽  
Drug Overdose ◽  
The United States ◽  
Racial Justice ◽  
Death Rates ◽  
Overdose Death ◽  
Time Period ◽  
Race Ethnicity ◽  
Overdose Mortality ◽  
First Time

Drug overdose mortality rates have increased sharply during the COVID-19 pandemic. In recent years, overdose death rates were rising most rapidly among racial/ethnic minority communities. The pandemic has disproportionately affected communities of color in a wide swath of health, social, and economic outcomes. Careful attention is therefore warranted to trends in overdose mortality by race/ethnicity during COVID-19. We calculated total drug overdose death rates per 100,000 population by race/ethnicity for the 1999-2020 time period. We find that Black overdose mortality overtook that of White individuals in 2020 for the first time since 1999. Between 2019 and 2020 Black individuals had the largest percent increase in overdose mortality, of 48.8%, compared to 26.3% among White individuals. In 2020, Black overdose death rates rose to 36.8 per 100,000, representing 16.3% higher than the rate for White individuals for the same period. American Indian and Alaska Native (AI/AN) individuals experienced the highest rate of overdose mortality in 2020, of 41.4 per 100,000, representing 30.8% higher than the rate among White individuals. Our findings suggest that drug overdose mortality is increasingly becoming a racial justice issue in the United States and appears to have been exacerbated by the COVID-19 pandemic. Providing individuals with a safer supply of drugs, closing gaps in access to MOUD and harm reductions services, and ending routine incarceration of individuals with substance use disorders represent urgently needed, evidence-based strategies that can be employed to reduce rising inequalities in overdose.

scholarly journals Urban–Rural Differences in Drug Overdose Death Rates, 1999–2019

2021 ◽  
Author(s):  
Holly Hedegaard
Keyword(s):  
Drug Overdose ◽  
Vital Statistics ◽  
Mortality Data ◽  
Death Rates ◽  
Overdose Death ◽  
Urban Rural ◽  
Drug Overdose Death

This report uses the most recent mortality data from the National Vital Statistics System (NVSS) to examine urban–rural differences in drug overdose death rates, for all drugs and by selected types of opioids and stimulants.

scholarly journals Predicting County-Level Overdose Death Rates Amid the Escalating Overdose Crisis in the United States: A Statistical Modeling Approach Predicting Deaths Through 2022

2022 ◽  
Author(s):  
Charles Marks ◽  
Daniela Abramowitz ◽  
Christl A. Donnelly ◽  
Daniel Ciccarone ◽  
Natasha Martin ◽  
...  
Keyword(s):  
Negative Binomial ◽  
The United States ◽  
Similar Efficacy ◽  
Original Model ◽  
Mortality Data ◽  
County Level ◽  
Online Application ◽  
Death Rates ◽  
Overdose Death ◽  
The Us

Aims. U.S. overdose (OD) deaths continue to escalate but are characterized by geographic and temporal heterogeneity. We previously validated a predictive statistical model to predict county-level OD mortality nationally from 2013 to 2018. Herein, we aimed to: 1) validate our model’s performance at predicting county-level OD mortality in 2019 and 2020; 2) modify and validate our model to predict OD mortality in 2022.Methods. We evaluated our mixed effects negative binomial model’s performance at predicting county-level OD mortality in 2019 and 2020. Further, we modified our model which originally used data from the year X to predict OD deaths in the year X+1 to instead predict deaths in year X+3. We validated this modification for the years 2017 through 2019 and generated future-oriented predictions for 2022. Finally, to leverage available, albeit incomplete, 2020 OD mortality data, we also modified and validated our model to predict OD deaths in year X+2 and generated an alternative set of predictions for 2022.Results. Our original model continued to perform with similar efficacy in 2019 and 2020, remaining superior to a benchmark approach. Our modified X+3 model performed with similar efficacy as our original model, and we present predictions for 2022, including identification of counties most likely to experience highest OD mortality rates. There was a high correlation (Spearman’s ρ = 0.93) between the rank ordering of counties for our 2022 predictions using our X+3 and X+2 models. However, the X+3 model (which did not account for OD escalation during COVID) predicted only 62,000 deaths nationwide for 2022, whereas the X+2 model predicted over 87,000.Conclusion. We have predicted county-level overdose death rates for 2022 across the US. These predictions, made publicly available in our online application, can be used to identify counties at highest risk of high OD mortality and support evidence-based OD prevention planning.

COVID-19 and the Drug Overdose Crisis: Uncovering the Deadliest Months in the United States, January‒July 2020

2021 ◽  
pp. e1-e8
Author(s):  
Joseph Friedman ◽  
Samir Akre
Keyword(s):  
Public Health ◽  
United States ◽  
Drug Overdose ◽  
The United States ◽  
Monthly Data ◽  
The Us ◽  
Control And Prevention ◽  
Pandemic Response ◽  
Overdose Mortality ◽  
Monthly Drug

Objectives. To determine the magnitude of increases in monthly drug-related overdose mortality during the COVID-19 pandemic in the United States. Methods. We leveraged provisional records from the Centers for Disease Control and Prevention provided as rolling 12-month sums, which are helpful for smoothing, yet may mask pandemic-related spikes in overdose mortality. We cross-referenced these rolling aggregates with previous monthly data to estimate monthly drug-related overdose mortality for January through July 2020. We quantified historical errors stemming from reporting delays and estimated empirically derived 95% prediction intervals (PIs). Results. We found that 9192 (95% PI = 8988, 9397) people died from drug overdose in May 2020—making it the deadliest month on record—representing a 57.7% (95% PI = 54.2%, 61.2%) increase over May 2019. Most states saw large-magnitude increases, with the highest in West Virginia, Kentucky, and Tennessee. We observed low concordance between rolling 12-month aggregates and monthly pandemic-related shocks. Conclusions. Unprecedented increases in overdose mortality occurred during the pandemic, highlighting the value of presenting monthly values alongside smoothed aggregates for detecting shocks. Public Health Implications. Drastic exacerbations of the US overdose crisis warrant renewed investments in overdose surveillance and prevention during the pandemic response and postpandemic recovery efforts. (Am J Public Health. Published online ahead of print April 15, 2021: e1–e8. https://doi.org/10.2105/AJPH.2021.306256 )

Availability of Buprenorphine Treatment in the 10 States With the Highest Drug Overdose Death Rates in the United States

2020 ◽  
Vol 26 (1) ◽  
pp. 17-22
Author(s):  
LILA FLAVIN ◽  
MONICA MALOWNEY ◽  
NIKHIL A. PATEL ◽  
MICHAEL D. ALPERT ◽  
ELISA CHENG ◽  
...  
Keyword(s):  
United States ◽  
Drug Overdose ◽  
The United States ◽  
Death Rates ◽  
Overdose Death ◽  
Buprenorphine Treatment ◽  
Drug Overdose Death

scholarly journals The effect of average temperature on suicide rates in five urban California counties, 1999–⁠2019: an ecological time series analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sierra Cheng ◽  
Rebecca Plouffe ◽  
Stephanie M. Nanos ◽  
Mavra Qamar ◽  
David N. Fisman ◽  
...  
Keyword(s):  
Public Health ◽  
Suicide Rate ◽  
Minimum Temperature ◽  
The United States ◽  
Additive Models ◽  
Maximum Temperature ◽  
Mortality Data ◽  
Average Temperature ◽  
Suicide Rates ◽  
Average Maximum

Abstract Background Suicide is among the top 10 leading causes of premature morality in the United States and its rates continue to increase. Thus, its prevention has become a salient public health responsibility. Risk factors of suicide transcend the individual and societal level as risk can increase based on climatic variables. The purpose of the present study is to evaluate the association between average temperature and suicide rates in the five most populous counties in California using mortality data from 1999 to 2019. Methods Monthly counts of death by suicide for the five counties of interest were obtained from CDC WONDER. Monthly average, maximum, and minimum temperature were obtained from nCLIMDIV for the same time period. We modelled the association of each temperature variable with suicide rate using negative binomial generalized additive models accounting for the county-specific annual trend and monthly seasonality. Results There were over 38,000 deaths by suicide in California’s five most populous counties between 1999 and 2019. An increase in average temperature of 1 °C corresponded to a 0.82% increase in suicide rate (IRR = 1.0082 per °C; 95% CI = 1.0025–1.0140). Estimated coefficients for maximum temperature (IRR = 1.0069 per °C; 95% CI = 1.0021–1.0117) and minimum temperature (IRR = 1.0088 per °C; 95% CI = 1.0023–1.0153) were similar. Conclusion This study adds to a growing body of evidence supporting a causal effect of elevated temperature on suicide. Further investigation into environmental causes of suicide, as well as the biological and societal contexts mediating these relationships, is critical for the development and implementation of new public health interventions to reduce the incidence of suicide, particularly in the face increasing temperatures due to climate change.

Driving and Public Health

2021 ◽  
Keyword(s):  
Public Health ◽  
United States ◽  
Health Problem ◽  
Cell Phone ◽  
Motor Vehicle ◽  
Electronic Device ◽  
Public Health Problem ◽  
The United States ◽  
Distracted Driving ◽  
The Past

Distracted driving is defined in the Oxford English Dictionary as “the practice of driving a motor vehicle while engaged in another activity, typically one that involves the use of a mobile phone or other electronic device.” However, other distractions not involving the use of a cell phone or texting are important as well, contributing to this burgeoning public health problem in the United States. Examples include talking to other passengers, adjusting the radio or other controls in the car, and daydreaming. Distracted driving has been linked to increased risk of motor vehicle crashes (MVCs) in the United States, representing one of the most preventable leading causes of death for youth ages 16 to 24 years. Undoubtedly, the proliferation of cell phone, global positioning system (GPS), and other in-vehicle and personal electronic device use while driving has led to this rise in distracted driving prevalence. This behavior has impacted society—including individual and commercial drivers, passengers, pedestrians—in countless numbers of ways, ranging from increased MVCs and deaths to the enactment of new driving laws. In 2016, for example, 20 percent of all US pediatric deaths (nearly 4,000 children and adolescents) were due to fatal MVCs. It has been estimated that at any given time, more than 650,000 drivers are using cell phones or manipulating electronic devices while driving. In the United States, efforts are underway to reduce this driving behavior. In the past two decades, state and federal laws have specifically targeted cell phone use and texting while driving as priority areas for legal intervention. Distracted driving laws have become “strategies of choice” for tackling this public health problem, though their enforcement has emerged as a major challenge and varies by jurisdiction and location. Multimodal interventions using models such as the “three Es” framework—Enactment of a law, Education of the public about the law and safety practices, and Enforcement of the law—have become accepted practice or viewed as necessary steps to successfully change this behavior caused by distractions while driving. This Oxford Bibliographies review introduces these and other aspects (including psychological influences and road conditions) of distracted driving through a presentation of annotated resources from peer- and non-peer-reviewed literature. This selective review aims to provide policymakers, program implementers, and researchers with a reliable source of information on the past and current state of American laws, policies, and priorities for distracted driving.

Cuba and the Covid-19 pandemic

2021 ◽  
Vol 122 (1) ◽  
pp. 118-131
Author(s):  
Bob Oram
Keyword(s):  
Public Health ◽  
United States ◽  
Health System ◽  
Health Professionals ◽  
The United States ◽  
The Past ◽  
The Uk ◽  
Universal Health

For the UK struggling to deal with the Covid-19 pandemic, the experience of Cuba’s Ministry of Public Health over the past six decades provides the clearest case for a single, universal health system constituting an underlying national grid dedicated to prevention and care; an abundance of health professionals, accessible everywhere; a world-renowned science and biotech capability; and an educated public schooled in public health. All this was achieved despite being under a vicious blockade by the United States for all of that time.

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 )

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