Association between residence at birth and addiction service utilization: a spatial analysis of the Massachusetts birth record cohort.

Frontiers in epidemiology Pub Date : 2025-02-28 eCollection Date: 2025-01-01 DOI:10.3389/fepid.2025.1567257
Yingjing Xia, Carolina Villanueva, Verónica M Vieira
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Abstract

Introduction: Substance use disorders impact a significant portion of the US population. Exposure to neighborhood environment early in life may contribute to disparities in policing, health outcomes and access to treatment for substance use disorders. Although many studies have examined the relationship between neighborhood context and substance use, few studies have accounted for the spatial distribution of substance use and social environment. The current study examined the association between birth address and substance addiction service utilization of individuals born in communities around the New Bedford Harbor Superfund site in southeast Massachusetts that face potential racial, socioeconomic, and environmental stressors.

Methods: The analysis utilized birth record data between January 1992 and December 1998 (N = 12,151) from the Registry of Vital Records and Statistics with follow-up for substance addiction service utilization through June 2022 by the Bureau of Substances Addiction Services within the Massachusetts Department of Public Health (MADPH). We used generalized additive models (GAM) with a smooth for location to estimate local odds ratios (ORs) and 95% confidence intervals (CI) of substance addiction service utilization while adjusting for sociodemographic risk factors to identify important contributors to geographic disparities.

Results: We found that birth addresses were significantly associated with substance addiction service utilization as a young adult (p = 0.037), with the highest statistically significant risk located closest to the harbor (OR = 1.42, 95% CI: 1.00, 2.02). Family education and prenatal care payer were significant predictors (p < 0.001) of substance addiction services use and strong spatial confounders.

Discussion: The current study showed that significant associations between birth addresses and substance addiction service utilization later in life are primarily driven by socioeconomic predictors including family education and prenatal care payer.

出生时居住地与成瘾服务利用之间的关系:马萨诸塞州出生记录队列的空间分析。
物质使用障碍影响了美国人口的很大一部分。生命早期接触邻里环境可能导致警务、健康结果和获得药物使用障碍治疗方面的差异。虽然有许多研究考察了社区环境与物质使用之间的关系,但很少有研究考虑到物质使用的空间分布与社会环境的关系。目前的研究调查了出生在马萨诸塞州东南部新贝德福德港超级基金附近社区的个人的出生地址与物质成瘾服务利用之间的关系,这些社区面临潜在的种族、社会经济和环境压力因素。方法:分析利用生命记录和统计登记处1992年1月至1998年12月的出生记录数据(N = 12,151),并随访马萨诸塞州公共卫生部物质成瘾服务局到2022年6月的物质成瘾服务利用情况。我们使用具有平滑位置的广义加性模型(GAM)来估计物质成瘾服务利用的当地优势比(ORs)和95%置信区间(CI),同时调整社会人口风险因素以确定地理差异的重要因素。结果:我们发现出生地址与年轻人的物质成瘾服务使用率显著相关(p = 0.037),离港口最近的地方的风险最高(OR = 1.42, 95% CI: 1.00, 2.02)。家庭教育和产前护理提供者是显著的预测因素(p讨论:目前的研究表明,出生地址和生命后期物质成瘾服务利用之间的显著关联主要是由社会经济预测因素驱动的,包括家庭教育和产前护理提供者。
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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