A place-based spatial analysis of racial inequities in overdose in St. Louis County Missouri, United States

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2024-11-02 DOI:10.1016/j.drugpo.2024.104611

Phillip L. Marotta , Benjamin CB Leach , William D. Hutson , Joel M. Caplan , Brenna Lohmann , Charlin Hughes , Devin Banks , Stephen Roll , Yung Chun , Jason Jabbari , Rachel Ancona , Kristen Mueller , Ben Cooper , Theresa Anasti , Nathaniel Dell , Rachel Winograd , Robert Heimer

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引用次数: 0

Abstract

Objective

The objective of this study was to identify place features associated with increased risk of drug-involved fatalities and generate a composite score measuring risk based on the combined effects of features of the built environment.

Methods

We conducted a geospatial analysis of overdose data from 2022 to 2023 provided by the St. Louis County Medical Examiner's Office to test whether drug-involved deaths were more likely to occur near 54 different place features using Risk Terrain Modeling (RTM). RTM was used to identify features of the built environment that create settings of heightened overdose risk. Risk was estimated using Relative Risk Values (RRVs) and a composite score measuring Relative Risk Scores (RRS) across the county was produced for drugs, opioids, and stimulants, as well as by Black and White decedents.

Results

In the model including all drugs, deaths were more likely to occur in close proximity to hotels/motels (RRV=39.65, SE=0.34, t-value=10.81 p<.001), foreclosures (RRV=4.42, SE=0.12, t-value = 12.80, p<.001), police departments (RRV=3.13, SE=0.24, t-score=4.86, p<.001), and restaurants (RRV=2.33, SE=0.12, t-value=7.16, p<.001). For Black decedents, deaths were more likely to occur near foreclosures (RRV=9.01, SE=0.18, t-value =11.92, p<.001), and places of worship (RRV= 2.51, SE=0.18, t-value = 11.92, p<.001). For White decedents, deaths were more likely to occur in close proximity to hotels/motels (RRV=38.97, SE=0.39, t-value=9.30, p<.001) foreclosures (RRV=2.57, SE=0.16, t-value =5.84, p<.001), restaurants (RRV=2.52, SE=0.17, t-value=5.33, p<.001) and, auto painting/repair shops (RRV=0.04, SE=0.18, t-value =3.39, p<.001).

Conclusion

These findings suggest that places of worship, the hospitality industry, and housing authorities may be physical features of the environment that reflect social conditions that are conducive to overdose. The scaling up of harm reduction strategies could be enhanced by targeting places where features are co-located.

查看原文本刊更多论文

对美国密苏里州圣路易斯县用药过量的种族不平等现象进行基于地点的空间分析。

研究目的本研究的目的是确定与涉毒死亡风险增加相关的地点特征，并根据建筑环境特征的综合影响生成衡量风险的综合评分：我们对圣路易斯郡法医办公室提供的2022年至2023年吸毒过量数据进行了地理空间分析，利用风险地形模型（RTM）检验了54个不同地点的特征是否更有可能导致涉毒死亡。风险地形模型用于确定建筑环境中哪些地方会增加吸毒过量的风险。使用相对风险值（RRV）对风险进行估算，并针对毒品、阿片类药物和兴奋剂以及黑人和白人死者得出衡量全县相对风险分数（RRS）的综合分数：在包括所有毒品的模型中，死亡更有可能发生在酒店/旅馆附近（RRV=39.65，SE=0.34，t 值=10.81）：这些研究结果表明，宗教场所、酒店业和住房当局可能是环境的物理特征，反映了有利于吸毒过量的社会条件。针对这些特征共存的场所，可以加强减少伤害战略的推广。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.