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Journal Article

Citation

Gruenewald PJ, Ponicki WR, Remer LG, Waller LA, Zhu L, Gorman DM. Am. J. Public Health 2013; 103(7): 1262-1270.

Affiliation

Paul J. Gruenewald, William R. Ponicki, and Lillian G. Remer are with the Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. Lance A. Waller is with the Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA. Li Zhu is with the Surveillance Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD. Dennis M. Gorman is with the Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX.

Copyright

(Copyright © 2013, American Public Health Association)

DOI

10.2105/AJPH.2012.300779

PMID

23078474

Abstract

Objectives. From 1983 to 2008, the incidence of methamphetamine abuse and dependence (MA) presenting at hospitals in California increased 13-fold. We assessed whether this growth could be characterized as a drug epidemic. Methods. We geocoded MA discharges to residential zip codes from 1995 through 2008. We related discharges to population and environmental characteristics using Bayesian Poisson conditional autoregressive models, correcting for small area effects and spatial misalignment and enabling an assessment of contagion between areas. Results. MA incidence increased exponentially in 3 phases interrupted by implementation of laws limiting access to methamphetamine precursors. MA growth from 1999 through 2008 was 17% per year. MA was greatest in areas with larger White or Hispanic low-income populations, small household sizes, and good connections to highway systems. Spatial misalignment was a source of bias in estimated effects. Spatial autocorrelation was substantial, accounting for approximately 80% of error variance in the model. Conclusions. From 1995 through 2008, MA exhibited signs of growth and spatial spread characteristic of drug epidemics, spreading most rapidly through low-income White and Hispanic populations living outside dense urban areas. (Am J Public Health. Published online ahead of print October 18, 2012: e1-e9. doi:10.2105/AJPH.2012.300779.


Language: en

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