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

Abstract

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.

Is green space associated with opioid-related mortality? An ecological study at the U.S. county level

“…Other variables that could be relevant or were found to be important in other studies on opioid morbidity and mortality exist. For example, type of health insurance (Schoenfeld et al 2019), transportation and commercial infrastructure (Chichester et al, 2020), hospital visit information (Wilkes et al, 2021), and employment in specific industries (Monnat et al, 2019) could have also confounded our results. However, we were unable to control for such factors due to our study design and timeframe.…”

“…We performed stratified analyses to determine associations between tree canopy cover and opioid mortality in six levels of urbanicity. Previous research on greenness and health outcomes that has conducted sub-analyses based on urbanicity has reported results that vary, often substantially, by level of urbanization (Becker, Browning, 2021;Maas et al, 2006;Mitchell & Popham, 2007; for review, see Browning et al, 2022), as do the determinants of opioid mortality (Wilkes et al, 2021). To perform analyses within each strata, the dataset was divided into six samples according to CDC urban-rural scheme designation and GAM models were run on each of the strata.…”

Examining narratives around adverse childhood experiences and social determinants of health in media coverage of substance use in two mid‐western cities

“…Provisional data from the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics estimated 107,622 drug overdose deaths in 2021 in the United States; this was a 15% increase from 2020 (CDC, 2022). Some communities have been deeply affected, with region, urbanicity, economic conditions, prescribing practices, treatment accessibility, and other factors intersecting to facilitate the crisis (Schieber et al, 2019; Wilkes et al, 2021). Concurrently, the country grapples with endemic adverse childhood experiences (ACEs).…”