Citation

Lee JH, Wheeler DC, Zimmerman EB, Hines AL, Chapman DA. Am. J. Prev. Med. 2023; 64(2): 149-156.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.amepre.2022.08.022

PMID

38584644

PMCID

PMC10997338

Abstract

INTRODUCTION: The purpose of this study is to examine nationwide disparities in drug, alcohol, and suicide mortality; evaluate the association between county-level characteristics and these mortality rates; and illustrate spatial patterns of mortality risk to identify areas with elevated risk.

METHODS: The authors applied a Bayesian spatial regression technique to investigate the association between U.S. county-level characteristics and drug, alcohol, and suicide mortality rates for 2004-2016, accounting for spatial correlation that occurs among counties.

RESULTS: Mortality risks from drug, alcohol, and suicide were positively associated with the degree of rurality, the proportion of vacant housing units, the population with a disability, the unemployed population, the population with low access to grocery stores, and the population with no health insurance. Conversely, risks were negatively associated with Hispanic population, non-Hispanic Black population, and population with a bachelor's degree or higher.

CONCLUSIONS: Spatial disparities in drug, alcohol, and suicide mortality exist at the county level across the U.S. social determinants of health; educational attainment, degree of rurality, ethnicity, disability, unemployment, and health insurance status are important factors associated with these mortality rates. A comprehensive strategy that includes downstream interventions providing equitable access to healthcare services and upstream efforts in addressing socioeconomic conditions is warranted to effectively reduce these mortality burdens.

Language: en

Keywords

*Rural Population; *Substance-Related Disorders/mortality; *Suicide/statistics & numerical data; *Urban Population; Bayes Theorem; Ethnicity; Health Status Disparities; Humans; United States/epidemiology